Every April, Cathy Uvanni drinks the gallon preparation mix for her colonoscopy and heads to Tampa’s Moffitt Cancer Center for the procedure.
The 70-year-old retired insurance underwriter living in Crystal River has no patience for people who avoid colonoscopies every five to 10 years.
“I have no sympathy for you. When I have to have one every year, I have no sympathy,” Uvanni said.
March is National Colorectal Cancer Awareness Month, and Uvanni said she doesn’t want anyone to go through colon cancer the way she did in 2008, when surgeons removed half her colon.
Studies vary about how effective colonoscopies are, but generally the procedure reduces the risk of developing colorectal cancer 40 percent to 69 percent and reduces the risk of death by as much as 88 percent, according to one study published in the New England Journal of Medicine in 2022.
About a third of US adults, 50 years old or older, are not up to date on their colonoscopies, according to the Centers for Disease Control and Prevention.
It’s one of the most preventable cancers because during the procedure the doctor removes polyps in the colon that can develop into cancer. And if the polyp has already become cancerous, but confined to the polyp, it’s likely the doctor can still remove it and the patient can avoid surgery.
Colon cancer is the second-leading cause of cancer deaths in the United States and is expected to cause more than 52,000 people to die in 2023, according to the American Cancer Society.
About 90 percent of colorectal cancers and deaths are thought to be preventable with regular colorectal cancer screenings, exercise and maintaining a healthy weight, according to UCSF Heath, which is part of University of California San Francisco.
Time lines vary
It usually takes about 10 years for a colon polyp to develop into cancer.
Uvanni didn’t have nearly that much time. Her colon cancer developed in less than a year.
That’s likely because Uvanni has Lynch Syndrome, which drastically increases her risk of colon cancer.
Lynch syndrome is caused by mutations in genes that are meant to repair DNA and protect us from cancer.
About one in 25 men and women will get colorectal cancer in their lifetimes, according to the American Cancer Society.
As many as four out of five men with Lynch Syndrome will get colorectal cancer. As many as three out of five women with the mutation will be diagnosed in their lifetime with colorectal cancer. Both men and women with the syndrome are also far more likely to get other types of cancer than the general population.
That’s why Uvanni downs her preparation mix and stops eating solid food before her screening. If she can manage the screening every year, she doesn’t understand why others can’t every 10 years.
Most doctors recommend people 50 and over with no history of polyps or cancer should get colonoscopies every 10 years.
Uvanni’s daughter was diagnosed with colon cancer at 27. Uvanni’s mother also had colon cancer, as well as four other types of cancer.
![]()
Cathy Uvanni.
fredhiers / Fred Hiers / Chronicle Reporter
In 2007 Uvanni had a hysterectomy to reduce the chance of endometrial, cervical, ovarian and uterine cancers. Meanwhile, she’s had multiple aggressive skin cancers on her face.
People without Lynch Syndrome are lucky, she said, and they shouldn’t squander that good fortune by not getting colonoscopies.
Reducing the risk
Uvanni wants people to use Colorectal Cancer Awareness Month as a springboard to start reducing the risks of the cancer.
Many in Citrus County don’t take that precautionary step.
Six out of the eight years from 2012 to 2019, Citrus County had a higher rate of colorectal cancer than the Florida average, according the Florida HealthCharts, which collects health data from county departments of health. 2019 was the most recent year colorectal cancer data was collected for individual counties. The data was also age adjusted.
The colorectal cancer rate for Citrus County is 41.1 per 100,000 residents.
The death rate because of colorectal cancer in Citrus County tells a similar story.
Between 2014 and 2021 Citrus County’s death rate due to colorectal cancer was higher every year than the Florida average. 2021 was the most recent year data was available from Florida HealthCharts and was also age adjusted.
When the data is not age adjusted, Citrus had a higher rate of deaths due to colorectal cancer than the state average every year since 2002 when the data was first collected. In 2021 the county’s colorectal cancer death rate was 35.1 per 100,000 residents.
Why do not more people age 50 and above get screened?
According to the American Cancer Society, the top five reasons people give for going unchecked are:
They heard the test is difficult or painful, and they may be embarrassed to discuss colorectal cancer screening with their doctor
Because they have no family history, they think they aren’t at risk and don’t have to be screened.
They think screening is only for those who have symptoms.
They are concerned about the cost of the test. (Most insurance covers most costs).
They are concerned about the complexity and costs of screening, including taking time off from work, getting a ride home, and high out-of-pocket expenses.
Don’t put it off
Karen Fisher had colon cancer in 2020, during the worst of the COVID-19 pandemic.
She was a pharmacist at, then, Citrus Memorial Hospital. If she wanted a colonoscopy, her insurance required she get it at the hospital.
![]()
In July 2020, Karen Fisher had surgery to fight colon cancer.
Today, she stays physically active and has recovered from the
disease.
mattbeck / Matthew Beck / Chronicle photo editor
Her treatment was to remove half her colon.
Under 60, she didn’t think she needed a colonoscopy, and admits she was embarrassed to have one performed by her coworkers, so she put it off.
Now she has no such embarrassment.
“After what I went through I don’t care,” she told the Chronicle. “It beats the alternative.”
Fisher is now also offering a cancer support group that will during the first Wednesday of every month, beginning in April.
Bravera Health Seven Rivers Hospital will provide the meeting space for the support group.
The Crystal River hospital will also host Fisher 11 a.m.–2 p.m. on March 31 in the hospital’s lobby so she can provide colorectal screening information and talk about her experience and the support group. Fisher can be reached at 352-503-8777 for more information.
“Because I want people to have a place to come and talk about it,” Fisher said of the new support group. “Because it was helpful to me.”
Fisher said people need to be educated about colorectal cancer and she is afraid that people don’t talk about it because they’re embarrassed.
People also think colorectal cancer happens to other people, not them, she said.
“(They think) it’s an old man’s disease,” Fisher said.
Linda Stockton, CEO of Bravera Health Seven Rivers, said providing some space for Fisher was what health care was about.
“Being able to provide care for our community when they need us is a privilege,” she said. “When patients choose us, we want to make sure that we do everything we can to support them before, during and after their time with us.”
“In this case we saw a gap in the continuum of care for patients with a cancer diagnosis as well as their family and caregivers. We were pleased to be able to help fill that gap by offering space at Seven Rivers for the new Cancer Support Group,” she said.
Dr. Trupti Shindi is a gastroenterologist with offices in Crystal River and Inverness.
Shindi said people shouldn’t worry about being shy when it comes to colonoscopies. People went into the health profession to help people, she said.
Especially younger patients who don’t want to talk about it, she said.
And a lot has changed since people had to drink a gallon of bad-tasting fluid to clean their colons for the screening, she said. New preparations involve only a couple of cups of fluid mix followed by glasses of water, she said.
For any inconvenience associated with the screening, the alternative is much worse, Shindi said.
“People have to come out and talk about it,” she said.
“Older patients understand that … ,” she said. “Younger patients think, ‘I’m young and it doesn’t happen to me.’ It can.”
