“Get screened!” That’s the message regarding colorectal health from U.S. Army Lt. Col. (Dr.) Mary O’Donnell, chief of the Division of Colon and Rectal Surgery at Walter Reed National Military Medical Center.

“Colorectal cancer doesn’t discriminate, so everyone should begin screening at age 45,” O’Donnell said.

According to the Centers for Disease Control and Prevention (CDC) risk factors for colorectal cancer include a personal and/or family history of polyps or cancer, inflammatory bowel disease (IBD), and inherited genetic syndromes. Lifestyle factors that potentially increase the risk of colorectal cancer include diets high in red and processed meats, low fiber intake, obesity, smoking, heavy alcohol use, and physical inactivity.

O’Donnell explained that colorectal cancer happens when cells in the large intestine begin to grow or divide abnormally, and invade the wall of the colon, sometimes lymph nodes or other organs. She added that the disease is often discovered by a colonoscopy, whether done for symptoms or as a screening exam.

Walter Reed manages a number of conditions affecting the colon and rectum, including cancers, inflammatory bowel disease (Crohn’s, Ulcerative Colitis), diverticulitis, hereditary polyposis syndromes, stoma/ostomy complications, fecal incontinence, pilonidal disease, and complex anorectal issues (fissures, recurrent fistula, hemorrhoids, condyloma), O’Donnell added.

To screen, diagnose and treat these conditions, O’Donnell explained that Walter Reed offers an array of services including laparoscopic, robotic, open surgical techniques, sphincter-sparing rectal cancer surgery, and trans-anal minimally invasive surgery (TAMIS).

Walter Reed also offers the ligation of intersphincteric fistula tract procedure, hemorrhoid treatments (fiber counseling, banding, transanal doppler-guided hemorrhoid artery ligation, hemorrhoidectomy), fissure treatments, lateral internal sphincterotomy, botox injection, sacral nerve stimulator implantation, and diagnostic and therapeutic colonoscopy, proctoscopy, and anoscopy.

“Small, early colon cancers can be treated by a gastroenterologist through advanced colonoscopy techniques,” O’Donnell explained. “The majority of colon cancers are treated through surgical removal of a portion of the colon and its associated lymph nodes. This is performed by surgeons, like me, who specialize in intestinal surgery.”

Annually, nearly 150,000 new cases of colorectal cancer are diagnosed in the United States, according to the CDC. Roughly 1 in 24 people will be diagnosed with colorectal cancer in their lifetime, and it is the third most common cancer in the U.S. and the second leading cause of cancer-related deaths, accounting for more than 50,000 deaths each year.

Retired U.S. Army Col. (Dr.) Craig Shriver, director of the John P. Murtha Cancer Center at Walter Reed, the Department of War’s only Cancer Care Center of Excellence, has stressed the impact of a cancer diagnosis on military readiness, explaining that about 1,500 active-duty service members are diagnosed with a cancer annually. “This is among the healthiest, generally young, and most active of our nation’s population. Every one of them is important to the military and warfighter readiness.

When we lose one to treatment for a while, or [the service member] has to be transitioned out of the military, it impacts readiness.”

In addition to screenings, O’Donnell stressed that people should “eat plenty of fruits and vegetables, avoid smoking and excessive alcohol use, and exercise.”

She explained that although colorectal cancer can be asymptomatic, it can present symptoms in some people, including “but not limited to, blood in the stool, weight loss, changes in stool habits or caliber, diarrhea, constipation or feeling that the bowel does not empty completely, fatigue, anemia, abdominal pain or bloating, nausea and vomiting.”

“Screening exams, like colonoscopies, are the best way to detect these cancers early or before polyps can become cancer,” O’Donnell added. “A colonoscopy also allows your doctor to remove polyps, which if left in place, may grow into cancer.”

“All beneficiaries in our Military Health System have access to this screening if prescribed by your doctor,” said O’Donnell. “It is important to talk to your doctor about any symptoms you may be having, and if you have a family history of colorectal cancer or colon polyps.”

For more information, visit the Walter Reed website at https://walterreed.tricare.mil/Health-Services/Hospital-Care-Surgery/Colorectal-Surgery.