Bowel cancer incidence increases with age. About one in 20 people will develop bowel cancer during their lifetime, accounting for the third most common cancer in the UK. It causes 16,000 deaths yearly in the UK. Bowel cancer screening has been shown to reduce this figure by 16%.
80% of patients are above 60 years of age. If someone in your family has had colon cancer. If you have Inflammatory Bowel Disease (Ulcerative Colitis
or Crohn's disease) for the last 8 years or more. If you have benign tumours or polyps
, or familial adenomatous polyposis. Lifestyle factors: smoking; little exercise; obesity; unhealthy diet low in green vegetables
Symptoms will depend on the site of the cancer. Initially, as the cancer is small, you may be asymptomatic.
Ensuing symptoms include:
- Blood mixed in with your faeces. Sometimes this will not be bright red blood but will turn your faeces very dark or black.
- Mucus mixed in with your faeces.
- Abdominal pain.
- A change in your usual "bowel habit", resulting in diarrhoea or constipation.
- A feeling of not completely emptying your rectum after opening your bowels.
- Other symptoms such as weight loss, tiredness, vomiting, or in severe cases, the bowel can become obstructed and blocked.
You should consult your GP if you suspect you have any of the symptoms listed. Your GP will examine your abdomen and rectum (to feel if there is a cancer in the lower part of your rectum). Subsequent investigations include:
- Colonoscopy: a tube is inserted into your bowel via the anus to visualize the inside of your intestines in detail and to perform a biopsy (a sample of cells taken) if necessary.
- Flexible sigmoidoscopy:
- CT scans
- Barium enema: barium liquid is inserted into your rectum and then x-rays are taken. These show clearer pictures than plain x-ray
Treatment depends on the site and spread of your bowel cancer.
Options include surgery, chemotherapy and radiotherapy.
Your specialist can provide you with more information regarding surgery in terms of scars and if you will require a temporary or permanent colostomy. This is where the surgeon brings an end of your bowel to your abdomen and faeces is caught in a disposable bag.
There is a bowel cancer screening programme in England for men and women aged between 60- 69 years. This has recently been extended to the age of 75. The aim is to detect cancer before symptoms present so that treatment is more likely to be effective.
As the screening has only been recently introduced, there has not been much research to prove the programme's effectiveness. One study has shown that around 2,500 lives could be saved every year in the UK by 2025 due to the screening.
Screening involves "Faecal Occult Blood Testing" . Patients send off a sample of their stool so that it can be examined under the microscope to look for any blood that is not obviously visible to the naked eye.
If the result is positive, you will invited to have a colonoscopy - of these people, 50% will be normal, 40% will have a benign polyp
, and 10% will have cancer.
Family History Screening
If you have close family members who have had colorectal or bowel cancer, or if there is a history of multiple polyps (such as Familial Adenomatous Polyposis), please consult your GP as you may be entitled to colonoscopy screening.