Bowel cancer screening
Bowel cancer – some facts
Bowel cancer is the 2nd most common cause of cancer death in the UK. Over 80% of bowel cancer cases occur in people aged 60 years or more. The lifetime risk of bowel cancer is 1 in 18 for men and 1 in 20 for women. Over 41,000 people were diagnosed with bowel cancer in 2009 in the UK. This is the equivalent to more than 110 people each day.
In 2009, 22,700 men were diagnosed with bowel cancer in the UK making it the third most common cancer in men after prostate and lung cancer. Bowel cancer is also the third most common cancer in women after lung and breast cancer, with around 18,400 new cases diagnosed in the UK in 2009.
Although 5 year survival rates for bowel cancer have doubled over the last 40 years – they are still low. Risk factors for bowel cancer include eating too much red and processed meat, drinking too much alcohol, smoking and obesity.
Watch the video on bowel cancer epidemiology and risk factors.
Bowel cancer screening
Screening looks for early signs of a particular disease in healthy people who do not have any symptoms and when treatment is likely to be curative.
Bowel cancer screening aims to detect bowel cancer at an early stage when there is a good chance that treatment will cure the cancer.
Colonoscopy is considered the gold standard of bowel cancer screening methods for its ability to view the entire colon and both detect and remove polyps during the same procedure. It is the only test that allows both of these to be done at the same time.
Colonoscopy avoids the radiation exposure that occurs in some of the other tests (equivalent to receiving more than 250 chest x-rays at one time) that may be used for screening.
There are 2 NHS bowel cancer screening programmes: a national BCSP which is based on faecal occult blood testing (FOBT) followed by colonoscopy (if FOBT positive) and “Bowel Scope” which is based on flexible sigmoidoscopy.
Watch the video on bowel cancer screening.
Symptoms of bowel cancer
The symptoms of bowel cancer can include blood in the motions or looser motions than normal. You should see your doctor if you’ve had either of these symptoms for 3 weeks or more. Other bowel cancer symptoms include:
- A pain or lump in the abdomen
- Feeling more tired than usual for some time or dizziness and breathlessness which may be signs of iron deficiency anaemia due to bleeding from the bowel
- Losing weight for no obvious reason
Not all symptoms mean it’s bowel cancer. They can be due to other conditions, such as haemorrhoids (piles), which may still need treatment.
Other risk factors
Having a colonoscopy for bowel cancer screening allows any polyps that are found, to be removed, meaning the risk of developing bowel cancer in the future is greatly reduced. Some people have a higher than normal risk of developing bowel cancer. This is because some diseases cause an increased risk of developing bowel cancer. Also, relatives of people with certain diseases have an increased risk of developing bowel cancer. Therefore, some people are offered regular screening tests, often from a young age. These groups of people offered screening tests include:
- People with certain inherited conditions including familial adenomatous polyposis (FAP), hereditary non-polyposis colorectal cancer (HNPCC) and Peutz-Jeghers or Juvenile polyposis syndrome
- Close relatives of people with with FAP or HNPCC
- People with a strong family history of first-degree relatives (mother, father, brother, sister, child) who have had bowel cancer
- People with long-standing or severe ulcerative colitis or Crohn’s disease affecting the colon or rectum
- People with acromegaly
- People who have had several colonic polyps removed
- People who have had bowel cancer in the past