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  • Sponsored Q&A

    Bowel cancer awareness

    Related Topic
    Dr Darren Pavey is a Gastroenterologist and Interventional Endoscopist with an interest in the endoscopic diagnosis and treatment of gastrointestinal conditions, including bowel cancer. Dr Pavey is a Senior Lecturer with the University of NSW and Macquarie University.
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    • Dr Darren Pavey
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  • What is bowel cancer?

    Bowel cancer (also known as colorectal cancer) refers to cancer of the colon or rectum.
     
    Bowel cancer is a malignant growth that develops most commonly in the lining of the large bowel (also known as the colon).  Most bowel cancers develop from pre-cancerous growths called polyps. 

    Over time some polyps can become cancerous.  Cancer can narrow and block the bowel or cause bleeding.  In more advanced cases, the cancer can spread beyond the bowel to other organs.
     
    As most bowel cancers start as polyps, all pre-cancerous polyps should be removed to reduce your risk of developing the disease.  Almost all polyps can be removed without an operation during the procedure of colonoscopy.
     
    Once removed from the bowel, the polyp can no longer develop into cancer.  Even if a polyp develops into cancer, in its early stages it can be cured by surgery.

     

    Who gets bowel cancer?

    Bowel cancer affects men and women, young and old. It is one of the top five causes of premature death among Australians aged 45-74 and is the seventh leading cause of death among those aged 25-44.

    Australia has one of the highest rates of bowel cancer in the world; 1 in 13 Australians will develop the disease in their lifetime. 80 Australians die from bowel cancer every week.

    Around 30% people who develop bowel cancer have either a hereditary contribution, family history or a combination of both. The other 70% of people have no family history of the disease and no hereditary contribution.

    The risk of developing bowel cancer rises sharply and progressively from age 50, but the number of Australians under age 50 diagnosed with bowel cancer has been increasingly steadily. That’s why it’s important to know the symptoms of bowel cancer and have them investigated if they persist for more than two weeks.

     

    What are the symptoms of bowel cancer?

    During the early stages of bowel cancer, patients may have no symptoms, which is why screening is so important.

    Any of the below symptoms could be indicative of bowel or rectal cancer and should be investigated by your GP:

    - Bleeding from the bowel

    - Blood in the stool or in the toilet after a bowel movement

    - A change in bowel habits, especially if severe (including diarrhoea, constipation or the feeling of incomplete emptying)

    - A change in the shape or appearance of the stool (e.g., more narrow than usual)

    - Lower abdominal pain

    - Pain or a lump in the anus or rectum

     

    What is bowel cancer screening?

    Bowel screening can help detect bowel cancer in its early stages. Bowel screening involves testing for bowel cancer in people who do not have any obvious symptoms of the disease. The aim is to find cancers early when they are easier to treat and cure. Screening can also find polyps, which may develop into cancer over time.

    Bowel cancer often develops without any early warning signs. The cancer can grow on the inside wall of the bowel for several years before spreading to other parts of the body. Often very small amounts of blood leak from these growths and pass into the bowel motion (faeces) before any symptoms are noticed. 

    A screening test called a Faecal Immunochemical Test (FIT) is used to collect samples of bowel motions, which are then analysed to detect tiny traces of blood, invisible to the naked eye. The screening test cannot diagnose bowel cancer, but the results will indicate whether a further test (usually a colonoscopy) is needed to rule out bowel cancer.

     

    Why is bowel cancer screening important?

    Almost 90% of bowel cancer cases can be treated successfully when detected early. 

    Bowel cancer can be treated successfully if detected in its early stages; however, fewer than 40 percent of bowel cancers are currently detected early. Research has shown screening for bowel cancer, using an FIT can reduce deaths from the disease by 15-25 percent.

     

    How can I get screened for bowel cancer?

    Bowel cancer screening is safe and easy and can be done at home. It is medically recommended that people aged 50 and over who do not have a family or personal history of bowel cancer, or an inherited gene mutation, should screen using a Faecal Immunochemical Test (FIT) every 1 to 2 years.

    Screening involves placing small samples of toilet water or stool on a special card provided as part of a faecal immunochemical test (FIT). The kit includes a postage paid envelope, in which the samples are mailed to a pathology laboratory. Following analysis, the results are sent to the individual and their GP.

     

    What is the National Bowel Cancer Screening Program (NBCSP)?

    The Australian Government introduced the National Bowel Cancer Screening Program (NBCSP) as a national initiative to reduce the number of deaths from bowel cancer in Australia. Eligible people are sent a free bowel screening test kit by mail and asked to take samples from two separate bowel motions before sending the completed test back to the laboratory for analysis. There is no cost involved in completing the test.

    As part of the NBCSP, people aged 50-74 will receive a tax-payer funded screening test in the mail every 2 years. This screening interval is consistent with the recommendations of the National Health and Medical Research Council.

    For people ineligible to participate in the government program, a BowelScreen Australia screening test can be purchased from participating pharmacies or through Bowel Cancer Australia by calling the Helpline on 1800 555 494.

     

    What do the results of the bowel cancer screening test mean?

    A positive result means blood has been detected in the samples. It does not necessarily mean bowel cancer is present but does require further investigation by a GP and a referral for colonoscopy within 30 days.

    A negative result means blood has not been detected in the samples; however, it does not guarantee no cancer is present or that the person will never develop bowel cancer. It is recommended that you repeat a bowel cancer screening test every 1 to 2 years.

    The at-home test is able to detect blood, otherwise invisible to the naked eye. Blood in the stool is one possible symptom of bowel cancer. If the result of the test is positive, the person is contacted to arrange a colonoscopy.

     

    What is a Colonoscopy?

    A colonoscopy is a procedure to visually examine the bowel. People who receive a positive screening result will generally be referred for a colonoscopy. During the procedure, if the specialist sees anything that needs further investigation, photographs and samples (biopsies) can be taken and simple polyps can be removed.

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