April is Bowel Cancer Awareness Month, an annual opportunity to raise awareness of the fourth most common cancer in the UK 

Bowel cancer, also known as colorectal cancer, is the fourth most common cancer in the UK, behind breast, prostate and lung cancers.1 Each year, around 41,700 people are diagnosed with bowel cancer in the UK.2 While a large majority (94%) of bowel cancer diagnoses are in people aged over 50 years, more than 2,500 new cases are diagnosed annually in those under 50 years.1

Bowel cancer mortality rates have been decreasing significantly in the UK over the past 40 years.2 However, around 16,000 deaths are attributed to the disease each year, and it represents the second most common cause of cancer death in the UK, behind lung cancer.1

Patients whose bowel cancer is diagnosed at an early stage have a much higher chance of successful treatment than those whose cancer has become more widespread. Around 95% of men and almost all women diagnosed with Stage I bowel cancer survive beyond 5 years after diagnosis.1 However, this drops significantly as the disease develops, and only around 5% of men and 10% of women with Stage IV bowel cancer survive more than 5 years after diagnosis. 3 The poor survival among late-stage bowel cancer patients highlights the importance of early identification of the symptoms associated with the disease, which include:

·        Bleeding from your rectum and/or blood in your stool

·        Change in bowel habit for 3 weeks or more

·        Losing weight

·        Extreme tiredness and/or breathlessness

·        Pain or a lump in the abdomen and/or rectum

 It is important to be aware of some of the risk factors that contribute more directly to the development of bowel cancer.

·        Aged over 50

·        First degree relative diagnosed with bowel cancer

·        History of polyps (abnormal non-cancerous growths) in the bowel

·        History of chronic bowel disease (such as ulcerative colitis or Crohn's disease)

·        Lifestyle-associated factors: physical inactivity; alcohol consumption; smoking; overweight/obesity; diet containing lots of red and processed meat or low in fibre. 

 The UK has several screening programmes that test people without any signs or symptoms suggestive of bowel cancer. Screening can pick up cancers at an early stage (when there is a good chance of successful treatment), as well as polyps, which may be removed to avoid future development into bowel cancer.1 These programmes target people aged between 60–74 years (except for Scotland, where screening starts from the age of 50 years. Those eligible to take part are invited to a screening test every 2 years until the age of 75.

Each of the programmes available uses home tests that look for hidden blood in stool samples. The current gold-standard method for screening bowel cancer uses the Faecal Immunochemical Test (FIT), which is being gradually introduced in the UK, as a replacement for the Faecal Occult Blood Test (FOBT).5 FIT uses antibodies that specifically recognize human haemoglobin, and is able to detect and quantify the amount of human blood in a single stool sample.5

A positive screening test suggests that there may be bleeding within the gastrointestinal tract. However, this can also be caused by polyps or another health problem, and so a positive result does not always indicate bowel cancer. A positive test result will be explored by further examination, and this is usually a colonoscopy.

 

References:

1. Bowel Cancer UK Website. Available at: https://www.bowelcanceruk.org.uk/. Last accessed: April 2018

2. Cancer Research UK. Bowel Cancer Statistics. http://www.cancerresearchuk.org/health-professional/cancer-statistics-for-the-uk. Last accessed: April 2018

3. Cancer Research UK. Bowel Cancer Survival. http://www.cancerresearchuk.org/about-cancer/bowel-cancer/survival. Last accessed: April 2018.

4. NHS UK.  https://www.nhs.uk/conditions/bowel-cancer/. Last accessed: April 2018

5. Cancer Research UK. Bowel Screening. http://www.cancerresearchuk.org/health-professional/screening/bowel-screening-evidence-and-resources/faecal-immunochemical-test-fit. Last accessed: April 2018