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

A tumor removed in July 1985

On July 13, 1985, surgeons at Bethesda removed a tumor from President Reagan's large intestine, along with about one third of his colon, in an operation of 2 hours and 53 minutes. The Washington Post reported at the time that the surgeons said it went well and that tests on the removed tissue were still to come.

A year later, UPI reported that the tumor, about 2 inches across, had been malignant, that his doctors called the cancer "of the most treatable variety," and that the surgical team was confident it had all been removed. UPI also reported that exams every six months had shown 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 polyps 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.

NCI lists older age as a main 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.

NCI says to check with a doctor about any of these:

• Blood in the stool, either bright red or very dark.
• A change in bowel habits, including diarrhea or constipation.
• A feeling that the bowel does not empty completely.
• Stools that are narrower or shaped differently than usual.
• Belly discomfort such as frequent gas pains, bloating, fullness, or cramps.
• Weight loss with no known reason.

Some findings need faster action. Call your care team right away about black or dark red stool or bloody diarrhea. Call 911 or go to an emergency department for heavy bleeding that will not stop, or if you pass large clots or feel faint.

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 is also treated with surgery, which can be a local removal. For stage I, NCI lists surgery. For stage II, NCI lists surgery, and says the value of chemotherapy afterward is still controversial. For stage III, options include surgery and chemotherapy after surgery. Stage IV treatment can include surgery and drug treatments, 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 notes that recurrence after surgery is a major problem and is often the ultimate cause of death.

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.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