Bowel cancer – the facts -  www.cancerscreening.gov.au - ( 1 page pdf )

Bowel cancer is a major public health problem in Australia. Around 90 Australians die each week from the disease.

It is the most commonly occurring internal cancer and the second most common cause of cancer related death, after lung cancer.

Number of deaths from the most commonly occurring internal cancers in Australia, 1998

About 11,300 new cases and 4,600 deaths from bowel cancer each year.

Currently, fewer than 40% of bowel cancers are detected early. However, international randomised control trials have demonstrated that population screening for bowel cancer, using FOBTs, can reduce deaths from bowel cancer.

What is bowel cancer?

It is a malignant growth that develops on the inside of the large bowel (colon) or in the rectum. The majority of bowel cancers develop from adenomas (polyps) that are tiny growths inside the colon or rectum and look like small spots or cherries on stalks. If these adenomas are removed, the risk of bowel cancer is reduced. Not all adenomas will lead to cancer.

What causes bowel cancer?

It is difficult to give one reason. While no cancer is completely preventable, it is believed that eating a healthy diet and exercising regularly could prevent 66 to 75% of bowel cancer cases. The leaflet “Eat Well for Life: Dietary Guidelines for Older Australians”, which is available to order from this website, provides information on nutrition.

How does bowel cancer develop?

The development of bowel cancer takes many years. It starts on the inside wall of the bowel and can grow there for several years before spreading to other parts of the body. Often very small amounts of blood, not visible to the naked eye, are leaked from these cancers long before any symptoms develop. This blood is then passed into the faeces.

Who is at risk of bowel cancer?

Both men and women are at risk of developing bowel cancer. In Australia, the lifetime risk of developing bowel cancer before the age of 75 years is around 1 in 17 for men and 1 in 26 for women. This is one of the highest rates of bowel cancer in the world.

Bowel cancer is rare in people under the age of 50. The risk is greater for people who:

• are aged 50 years and over – risk increases with age
• have a family history of bowel cancer or polyps
• have had an inflammatory bowel disease
• have previously had special types of polyps, called adenomas, in the bowel.

What are the symptoms of bowel cancer?

Bowel cancer can develop with few, if any, early warning symptoms. Symptoms of bowel cancer can include:

• bleeding from the back passage or any sign of blood after a bowel motion;
• a recent and persistent change in bowel habit, for example looser bowel motions, severe constipation and/or needing to go to the toilet more than usual;
• unexplained tiredness (a symptom of anaemia); and
• abdominal pain, especially of recent onset.

People who have symptoms should see their Doctor, even if no blood is detected in their FOBT.

Why screen for bowel cancer?

Screening involves testing for bowel cancer in people who do not have any obvious symptoms of the disease. The aim is to find the cancer early when it is easier to treat and cure. Regular screening is important because bowel cancer can develop without any early warning symptoms.

A family history of bowel cancer

More than 75% of people who develop bowel cancer do not have a family history of bowel cancer. An increased risk of bowel cancer may exist if one or more family members (such as a child, mother, father, sister or brother, grandparent, aunt, uncle, niece, nephew) has had bowel cancer diagnosed at any age. People who have symptoms should see their Doctor, even if no blood is detected in their FOBT. People who think they may have a family history of bowel cancer should see their Doctor to discuss their risk.