Remembering Charles M. Schulz and Understanding Colorectal Cancer

How the diagnosis arrived

Charles M. Schulz drew Peanuts himself for nearly fifty years, every panel and every hand-lettered word, without assistants. The strip ran in more than 2,600 newspapers.

CBS News reported that he was diagnosed with colon cancer and had a series of small strokes during emergency abdominal surgery in November 1999. He announced his retirement a few weeks later. The last daily strip ran on 3 January 2000.

He died in his sleep at about 9:45 pm on Saturday 12 February 2000, aged 77, according to his son Craig. It was hours before his final original Sunday strip appeared. NPR reported the same the following day. The Guardian's obituary names cancer as the cause.

That is the record. His stage, his treatment and his own account of it are not part of it, and nothing here fills in the gaps.

Found while looking for something else

The detail worth holding onto is that the cancer turned up during an operation for something else.

This is common, and it cuts against the instinct that you would know if something were wrong. Colorectal cancer can be present for a long time without producing anything a person would take to a doctor.

Why this cancer is unusual

NCI states it plainly: colorectal cancer often begins as a growth called a polyp inside the colon or rectum, and finding and removing polyps can prevent colorectal cancer.

Very few cancers work that way. Most screening tests find cancer earlier. Here, screening can find a growth that has not become cancer yet and take it out in the same appointment.

The anatomy behind it: the colon is the first part of the large intestine and runs about five feet. The rectum and anal canal make up the last six to eight inches. Cancer starting in the colon is colon cancer; starting in the rectum, rectal cancer. Together they are colorectal cancer. Our overview of colorectal cancer covers both.

The tests, and what each one does

NCI lists five screening tests with evidence behind them.

A fecal occult blood test looks for blood in stool that is not visible. A DNA stool test checks stool cells for genetic changes linked to colorectal cancer. Both are done at home, and both are followed by a colonoscopy if the result is abnormal.

Sigmoidoscopy uses a thin lighted tube to look at the rectum and the lower colon. Colonoscopy uses a longer one to look at the whole colon, and it can remove polyps or take samples during the same procedure. Virtual colonoscopy uses CT images to build a picture of the colon from outside.

NCI also names a test that does not work. Studies have shown that screening by digital rectal exam does not reduce deaths from colorectal cancer.

Our pages on colorectal cancer screening and colonoscopy explain what each involves in practice.

The harms, stated honestly

NCI does not present screening as free.

A false-negative result can appear normal when cancer is present, which may lead someone to delay care even when symptoms show up later. A false-positive result causes anxiety and leads to more tests, which carry their own risks.

For colonoscopy, NCI reports that serious problems are rare but include tears in the lining of the colon and bleeding, both of which may need hospital treatment. Both happen more often when a biopsy or polyp removal is done. Sedation adds its own small risk of heart and breathing problems.

Sigmoidoscopy has fewer complications and usually no sedation. Virtual colonoscopy has fewer physical harms, though NCI notes the harms of the x-ray radiation it uses are not known.

When to get checked

Two separate questions sit here, and mixing them up causes trouble.

Screening is for people with no symptoms. Anyone with symptoms needs assessment, not screening.

Signs worth an appointment rather than a wait:

• Blood in the stool, whether bright red or very dark
• A change in bowel habit lasting more than a few weeks, including new diarrhea or constipation
• A feeling that the bowel has not emptied fully
• Abdominal pain or cramping that keeps returning
• Weight loss with no explanation
• Fatigue, or the tiredness of iron-deficiency anemia with no obvious cause

The last one matters more than people expect. Unexplained iron deficiency in an adult, particularly a man or a postmenopausal woman, is a reason to look at the bowel. Our page on cancer symptoms covers how to weigh these without panic.

What has changed since 2000

NCI reports that between 2012 and 2021 the number of new colorectal cancer cases in the United States fell, driven largely by declining rates in adults aged 65 and older. It attributes part of that to increased screening, which can find and remove precancerous growths.

The trend is not uniform. Among adults under 50, new cases rose by about 2.4% per year, the largest increase of any age group. Rates in people aged 50 to 64 rose slightly.

About 158,850 new colorectal cancer diagnoses and about 55,230 deaths are projected in the United States for 2026 by the American Cancer Society, whose estimate SEER, the federal cancer surveillance program, carries. SEER's own data put the median age at diagnosis at 66.

Five-year relative survival is 91.3% for the 34% of cases found while confined to the bowel wall, 75.2% for the 37% that have reached nearby lymph nodes, and 16.9% for the 23% found after distant spread. Across all stages it is 65.4% for people diagnosed from 2016 through 2022.

Those are group averages across a whole registry population. They say nothing about any individual, and they lag current treatment.

What this story cannot tell you

Schulz was treated in 1999 and 2000, and the treatments and screening programs of that period are not today's. His experience is not a description of what happens now.

Nothing in his story is a verdict on anything he did or did not do. Cancer is not a judgment on a person.

And because his diagnosis came during surgery for something else, his case says nothing about how well screening works. If anything it makes the opposite point: the disease was there before anyone was looking for it, which is exactly the window screening is designed to catch.

Sources

• CBS News: 'Peanuts' Creator Dead at 77
• NPR All Things Considered: Charles Schulz
• The Guardian: Charles Schulz obituary
• NCI PDQ: Colorectal Cancer Screening (Patient Version)
• NCI: Colorectal Cancer—Patient Version
• NCI SEER Stat Facts: Colorectal Cancer

How this article was prepared

An AI-assisted editorial system helped prepare this page. No named medical reviewer has reviewed it unless one is listed.

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