Ronald Reagan and Colon Cancer: What Screening and Polyps Can Teach Us

A polyp, then another, then a third

The Washington Post reported the sequence at the time. A routine rectal exam in May 1984 turned up a benign polyp. A second appeared in March 1985. A colonoscopy that July found a third.

On July 13, 1985, surgeons at Bethesda Naval Hospital removed a tumor about five centimeters across, along with roughly a third of President Reagan's colon, in an operation lasting just under three hours. Doctors reported no abnormality in the liver and took lymph nodes for examination. Final pathology was still pending when the first reports ran.

A year later, UPI reported that the tumor had been malignant, that his doctors called it "of the most treatable variety," and that the surgical team was confident it had all been removed. Follow-up exams every six months showed no recurrence through that point.

The presidency paused briefly. NPR later recounted that Vice President George Bush served as acting president for eight hours, from 11:28 a.m. to 7:22 p.m. A White House archive notes that Reagan returned to the White House a week after surgery.

That is the documented record. What follows is the medicine, which is the part that can change a reader's own odds.

Most of these cancers begin as a polyp

A polyp is a growth on the inner lining of the colon or rectum. Most polyps are harmless. Some types, including the villous adenoma reported in Reagan's case, can turn into cancer over years.

That slow timeline is the single most useful fact about this disease. It creates a window in which a growth can be found and snipped out before it ever becomes cancer.

Risk rises with age, and NCI names advancing age as the most important risk factor. Others include a family history in a parent, sibling, or child, a personal history of polyps or colorectal cancer, inherited syndromes such as familial adenomatous polyposis and Lynch syndrome, chronic inflammatory bowel disease, heavy alcohol use, cigarette smoking, and obesity.

Screening that prevents, not only detects

Colorectal cancer is unusual. Most screening finds cancer earlier. This screening can stop cancer from forming at all, because removing a polyp removes the thing that would have become the tumor.

The US Preventive Services Task Force sets the schedule. It gives a grade A recommendation for screening every adult aged 50 to 75, and a grade B recommendation for adults aged 45 to 49. For ages 76 to 85 it advises clinicians to offer screening selectively, weighing overall health.

Several tests qualify, and the right one depends on preference and access:

• A stool test for hidden blood, either FIT or high-sensitivity gFOBT, once a year.
• A stool DNA-FIT test every one to three years.
• CT colonography every five years.
• Flexible sigmoidoscopy every five years, or every ten years with a yearly FIT.
• Colonoscopy every ten years.

The best test is the one a person will actually complete on schedule.

When to get checked

Screening is for people with no symptoms. Symptoms need their own visit, whatever the screening calendar says.

The NHS gives a clear threshold: see a doctor if you have had any bowel cancer symptom for three weeks or more. Those symptoms include:

• A change in your stool, such as looser stool, diarrhea, or constipation.
• Going more often or less often than is normal for you.
• Blood in the stool, or bleeding from the back passage.
• A constant feeling that you need to go, even just after going.
• Abdominal pain, bloating, or a lump in the abdomen.
• Losing weight without trying, or feeling very tired or short of breath.

Some findings need faster action. Seek urgent advice for black or dark red stool, or for bloody diarrhea. Go to an emergency department for heavy bleeding that will not stop, or if the toilet water turns red or you pass large clots.

NCI adds narrower stools than usual, frequent gas pains, cramps, and vomiting to the symptom list. Blood should never be written off as hemorrhoids without an examination.

Staging, and what treatment involves

Doctors stage colon cancer with the AJCC TNM system. Stage 0 is confined to the innermost lining. Stage I has grown into the submucosa or the muscle layer, with no nodes involved. Stage II has pushed beyond the muscle layer but still spares the nodes. Stage III means regional lymph nodes contain cancer. Stage IV means it has reached distant organs.

Treatment follows the stage. Stage 0 may be handled by endoscopic or local removal. Stage I is treated with surgery, and NCI notes that chemotherapy after surgery is generally not recommended. Stage II is surgery, with chemotherapy considered when high-risk features are present. Stage III is surgery plus chemotherapy as standard. Stage IV combines surgery, chemotherapy, targeted therapy, and radiation depending on where the disease has spread.

Prognosis tracks how deep the tumor grew through the bowel wall, whether nodes are involved, whether it has spread, whether the bowel was obstructed or perforated, and the level of a blood marker called CEA before treatment. That same marker is used afterward to watch for recurrence.

What the numbers show

The American Cancer Society projects 158,850 new colorectal cancers and 55,230 deaths in the United States in 2026, which is 7.5 percent of new cancer diagnoses; SEER, the federal statistics program, republishes those projections. Worldwide, NCI reports colorectal cancer as the third most common cancer, with about 1.93 million new cases in 2022.

Stage at diagnosis drives survival. Among people diagnosed between 2016 and 2022, five-year relative survival is 91.3 percent for localized disease, 75.2 percent for regional spread, and 16.9 percent for distant disease. Overall it is 65.4 percent. About 34 percent of cases are localized when found, and 23 percent have already spread far.

NCI states that surgery is the primary treatment and cures roughly half of patients, while recurrence after surgery remains a major problem.

These are group figures from many thousands of people diagnosed in past years. They set context. They do not describe any individual reader, and no one's outcome can be read off a table.

Sources

• https://www.cancer.gov/types/colorectal/hp/colon-treatment-pdq
• https://www.cancer.gov/types/colorectal/patient/colon-treatment-pdq
• https://seer.cancer.gov/statfacts/html/colorect.html
• https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/colorectal-cancer-screening
• https://www.nhs.uk/conditions/bowel-cancer/symptoms/
• https://www.washingtonpost.com/archive/politics/1985/07/14/reagan-tumor-removed/ea845bc2-6373-4a5a-81b3-98bc5a77c67b/
• https://www.upi.com/Archives/1986/07/12/Reagan-has-bounced-back-from-cancer-surgery-a-year-ago/6590521524800/
• https://www.npr.org/2004/06/16/1960579/bush-not-reagan-was-the-acting-president
• https://georgewbush-whitehouse.archives.gov/history/thisday/0713.html
• https://www.cancer.org/research/cancer-facts-statistics.html