South Heartland District Health Department

You’ve Got Guts – Screen for Colon Cancer

March 10, 2025

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March is colorectal cancer awareness month, so I want to talk about preventing this disease, which is the 2nd leading cancer killer in Nebraska.

This month, the Nebraska Cancer Coalition has a campaign called “You’ve Got Guts – Kick it in the Butt! So, let’s answer some questions about how to know if you are at risk and what you can do to prevent colorectal cancer. I want to encourage readers to prioritize their health and get screened for colorectal cancer!

Before everyone out there stops reading because maybe you are uncomfortable thinking about a topic involving guts and poop, I want to say that I’m old enough that I’ve had personal experience with colorectal cancer screening and, really, screening isn’t that bad! It is definitely worth a little bit of discomfort to catch this deadly disease early, when it is very treatable!

Why should you care? In Nebraska, three in every five people are being diagnosed with advanced stage colorectal cancer. Colorectal cancer incidence (number of new cases) and mortality (death) rates are higher in Nebraska when compared to overall U.S. rates. In 2025, the American Cancer Society estimates 940 new cases and 360 deaths in Nebraska.

Do you know the signs and symptoms of colorectal cancer? That’s kind of a trick question, because it is often a “silent” disease with no symptoms. This is why it is really important to get screened. Screening can help prevent this cancer, or catch it early when it is easiest to treat. With more advanced stage cancer there can be symptoms, including:

     • A change in bowel habits, such as diarrhea, constipation, or narrow stool, that lasts more than a few days

     • Weakness and fatigue

     • Rectal bleeding with bright red blood

     • Blood in your stool, which might make the stool look dark brown or black

     • A feeling that you need to have a bowel movement that doesn’t go away after you have one

     • Losing weight without trying

     • Cramping or abdominal (belly) pain

If you are experiencing any of these symptoms, you should talk to a health care provider as soon as possible. But, again – there may be no symptoms right away, which is why it is important to be screened at the right age.

Age 45 is the recommended age to start regular screening for colorectal cancer. However, if you are at high risk, with a family history of colon cancer or if you are experiencing symptoms – you might need to be screened at a younger age. To determine the best age for you to start screening for colorectal cancer, talk to a health care provider about your risk.

Unfortunately, in Nebraska, only 38% of 45-54-year-olds report being up to date with colorectal cancer screening. I want to point out: if you delay getting screened, then there is more chance that if cancer is found, it will be a more advanced cancer. Colorectal cancer is more treatable, with higher survival rates, when it is diagnosed at early stages.

There are three main types of colorectal cancer screening tests:

     1. One screening test checks for blood in your stool. These are called FIT or FOBT tests. These tests are completed at home through collection of a stool sample, no prep needed. This type of test needs to be done every year. If the test comes back as “not normal”, then a follow up colonoscopy is required.

     2. Another screening test, called Cologuard, checks your stool for blood DNA that is not normal. This test is also completed at home through collection of a stool sample, no prep needed, and is recommended to be completed every 3 years. If this test comes back as “not normal”, then a follow up colonoscopy is required.

     3. The third screening test is called a colonoscopy. This test checks for small growths, called polyps, in your colon that can become cancer. The test is performed in a medical setting, by a specialist. There is preparation needed before the test is done to make sure the specialist can see the surface of the colon. If any small polyps are discovered, they are removed and sent for more testing. Colonoscopy screening is recommended every 10 years.

I want to emphasize again, that regular screening, beginning at age 45 for men and women with average risk, is the key to preventing colorectal cancer or finding it early when it is easiest to treat. Talk to a healthcare provider about your risk, when you should be screened for colorectal cancer, and which screening option is best for you.

Most insurance plans, including Medicare, help pay for colorectal cancer screening, So, check with your health insurance provider to learn more about your colorectal cancer screening benefits. If you don’t have insurance that covers colonoscopy, contact the health department for assistance with resources and options for screening.

Don’t put it off! “You’ve got guts – so kick it in the butt” by getting screened for colorectal cancer!

For more information on colorectal cancer, please visit The Nebraska Cancer Coalition website necancer.org or contact South Heartland District Health Department at 402-462-6211 for information or to request an at-home colon cancer screening kit.

Michele Bever is the executive director for South Heartland District Health Department, serving Adams, Clay, Nuckolls and Webster Counties in Nebraska. She may be reached at 402-462-6211 or toll free at 1- 877-238-7595.

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