Hemmroids and anal bleeding…?

Could my hemmroids be why I'm bleeding?

My DR mentioned surgery, but how are they going to know if I have hemmroids or a fissure is why I'm bleeding?
I'm having a colonoscopy soon, and he said he'll know more after that.
I had a colonoscopy years ago, but I refused surgery then.

I hurt so badly now, and I've heard if you don't have the surgery you can develop colon cancer.