The recent death of Japanese novelist Keigo Higashino from colorectal cancer prompted a difficult but important question:
Can earlier screening change what happens next?
No one can know whether screening would have changed the course of one individual’s illness. His screening history, stage at diagnosis and treatment details have not been publicly explained. But the wider lesson is clear:
Many serious diseases are easier to manage before they begin to make you feel ill.
That is the purpose of early screening.
It is not designed only for people who already have obvious symptoms. It looks for disease, risk factors or early changes while a person may still feel completely healthy.
No Symptoms Does Not Always Mean No Disease
Most people seek medical care when something hurts, changes or stops working normally. That is understandable. Symptoms are the body’s way of asking for attention.
The problem is that symptoms may appear only after a disease has developed enough to disrupt normal function.
Screening and diagnostic testing are therefore not the same.
Screening is used to look for disease in people who do not have symptoms. Diagnostic testing investigates an existing symptom, an abnormal examination or a positive screening result.
This distinction matters.
Screening creates an opportunity to act during the “quiet period”—after an abnormal process has begun, but before it starts causing obvious problems.
Early and Late Detection Can Lead to Very Different Journeys
Finding a disease earlier does not guarantee a cure. But it may change the range of options available.
An early, localised abnormality may be managed with a smaller procedure, more limited treatment or close surveillance. A disease discovered after it has spread may require more complex treatment, longer recovery and greater disruption to everyday life.
Colorectal cancer illustrates this difference clearly.
Current US SEER data report a five-year relative survival rate of more than 90% for localised colorectal cancer. Outcomes are substantially poorer once the cancer has spread to distant parts of the body.
Survival statistics describe groups of patients, not an individual person’s future. Even so, they demonstrate why the timing of detection can matter.
Colorectal Cancer Is One of the Clearest Examples
Many colorectal cancers begin as abnormal growths called polyps.
Most polyps will not become cancer. However, some adenomas and other precancerous lesions can gradually develop into cancer over time.
This creates a valuable screening window.
A colonoscopy allows a doctor to inspect the lining of the colon directly. When a suitable polyp is found, it can often be removed during the same procedure and sent for pathology testing.
That is what makes colorectal screening unusual.
It may do more than discover cancer at an earlier stage. By finding and removing precancerous growths, colonoscopy can sometimes help prevent colorectal cancer from developing at all.
Long-term research has also associated the removal of adenomas during colonoscopy with a substantial reduction in deaths from colorectal cancer.
“But I Feel Completely Healthy”
Feeling healthy is a good thing.
It is not, however, a screening result.
A colorectal polyp may not cause pain. Early colorectal cancer may not cause visible bleeding, major changes in bowel habits or other obvious warning signs.
Waiting for symptoms can therefore mean waiting until an important opportunity for simpler intervention has passed.
This does not mean that everyone needs every available test. It means that the absence of symptoms should not be the only reason for postponing age-appropriate or risk-based screening.
Screening Is Not the Same as Ordering More Tests
A longer examination list does not automatically make a health screening package better.
Screening tests can produce false-positive results, causing anxiety and unnecessary follow-up procedures. False-negative results are also possible. Some programmes may detect slow-growing abnormalities that would never have caused harm, creating the risk of overdiagnosis and overtreatment.
Responsible screening must therefore consider both benefits and potential harms.
The appropriate plan depends on factors such as:
- Age and sex
- Family and personal medical history
- Smoking and lifestyle history
- Previous screening results
- Existing health conditions
- The accuracy and purpose of the proposed test
A test should be selected because evidence suggests that it is useful for a particular person—not simply because it is new, expensive or included in a premium package.
When Should Colorectal Screening Begin?
There is no single starting age that applies to every country and every person.
The US Preventive Services Task Force recommends colorectal cancer screening for average-risk adults between the ages of 45 and 75. Adults aged 76 to 85 may be screened selectively, depending on their overall health and previous screening history.
Malaysia’s Ministry of Health guidance has recommended screening average-risk adults from age 50 to 75. The national strategy includes an immunochemical faecal occult blood test, or iFOBT, followed by colonoscopy when the result is positive. People with relevant family histories or hereditary risk may need earlier assessment.
This difference is a useful reminder:
Screening should follow local medical guidance and personal risk—not a number copied from social media.
Earlier assessment may be appropriate for people with a first-degree relative who developed colorectal cancer, a personal history of polyps, inflammatory bowel disease or a hereditary colorectal cancer syndrome.
Rectal bleeding, persistent changes in bowel habits, unexplained anaemia, weight loss or abdominal pain also require medical evaluation. Once symptoms are present, the examination is no longer simply routine screening.
Modern Screening Can Also Be More Comfortable
One reason people postpone colonoscopy is fear of pain, embarrassment or the preparation process.
Modern sedation can make the examination considerably more manageable. During a sedated or “painless” colonoscopy, the patient rests while the doctor examines the colon and removes suitable polyps when necessary.
For many patients, the preparation remains the least pleasant part—not the examination itself.
Comfort matters because even an effective screening test has limited value when people are too afraid to complete it.
Previous reading: What to Expect from a Painless Colonoscopy
A Good Screening Plan Is Selected, Not Stacked
The real value of health screening is not measured by the number of machines used or blood tubes collected.
It is determined by the decisions behind the package:
Is this test appropriate for your age and risk?
Can it detect a meaningful problem early?
Will the result change what happens next?
Is there a clear pathway for interpretation, follow-up and specialist care?
A well-designed screening programme prioritises conditions for which earlier action can genuinely improve the next step.
It should also explain which examinations are unnecessary.
Do Not Wait for Your Body to Become Loud
Screening cannot predict every illness or eliminate every health risk.
It is not a guarantee that nothing will happen.
Its value lies in creating more time and more options.
Sometimes screening finds nothing and provides useful reassurance. Sometimes it identifies a risk that can be monitored. And sometimes—as with a precancerous colorectal polyp—it finds a problem early enough to remove it before it becomes something far more serious.
Do not wait for your body to become loud before you start listening.
If you are unsure which screenings are appropriate for your age, family history and health goals, speak with a healthcare coordinator before choosing a package.
A personalised screening plan can help you focus on the examinations that genuinely matter. You can book here.
Related Post: What’s in a Malaysian Endoscopy Package, You Need to Know
Sources
- The Japan Times. Japanese Author Keigo Higashino, Known for Penning Intricate Mystery Novels, Dies at 68.
https://www.japantimes.co.jp/culture/2026/07/27/books/keigo-higashino-obituary/ - Centers for Disease Control and Prevention. Screening for Colorectal Cancer.
https://www.cdc.gov/colorectal-cancer/screening/index.html - Centers for Disease Control and Prevention. Colorectal Cancer Awareness.
https://www.cdc.gov/cancer/features/colorectal-cancer.html - U.S. Preventive Services Task Force. Recommendation: Colorectal Cancer Screening.
https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/colorectal-cancer-screening - National Cancer Institute. Screening Tests to Detect Colorectal Cancer and Polyps.
https://www.cancer.gov/types/colorectal/screening-fact-sheet - National Cancer Institute. Colonoscopy Reduces Colorectal Cancer Deaths.
https://www.cancer.gov/types/colorectal/research/colonoscopy-reduces-deaths - National Cancer Institute SEER Program. Cancer Stat Facts: Colorectal Cancer.
https://seer.cancer.gov/statfacts/html/colorect.html - Ministry of Health Malaysia. Clinical Practice Guidelines: Management of Colorectal Carcinoma.
https://www.moh.gov.my/images/04-penerbitan/penerbitan-klinikal/panduan-amalan-klinikal/QR_Management_of_Colorectal_Carcinoma_1.pdf - Ministry of Health Malaysia. National Strategic Plan for Colorectal Cancer 2021–2025.
https://www.moh.gov.my/images/04-penerbitan/rujukan/penyakit-berjangkit/kanser/National_Strategic_Plan_for_Colorectal_Cancer_NSPCRC_2021-2025.pdf - Ministry of Health Malaysia. Guidebook for Colorectal Cancer Screening and Early Detection, Third Edition.
https://www.moh.gov.my/images/04-penerbitan/rujukan/penyakit-berjangkit/kanser/BUKU_PANDUAN_SARINGAN_DAN_PENGESANAN_AWAL_KANSER_KOLOREKTAL_EDISI_3_2020.pdf - International Agency for Research on Cancer. Questions and Answers on Cancer Screening Metrics.
https://www.iarc.who.int/wp-content/uploads/2024/04/Q_A_Cancer-screening-metrics.pdf