Bowel cancer is among the most common cancers in the developed world. Yet, due to the nature of its location in the body, it is rarely spoken about like many other cancers are. This must change, and we all need to become more “bowel cancer aware”.
In Australia in 2022, according to Bowel Cancer Australia:
- Bowel cancer was the third most common newly diagnosed cancer and the second-deadliest cancer behind lung cancer.
- A person had a 1 in 19 (5.2%) risk of being diagnosed with bowel cancer by age 85, and a 1 in 66 (1.5%) risk of dying from it by age 85.
- The risk is slightly higher for men than women and it increases with age.
- On average, 300 Australians are diagnosed with bowel cancer each week – that’s 15, 610 per year. 1,680 of these are under the age of 50 years.
- 103 Australians die from bowel cancer each week; 6 are under the age of 50.
- The incidence of bowel cancer in younger people is rising, and the overall risk of colon cancer today for people born in 1990 is double what it was for those born in 1950.
- 99% of cases of bowel cancer can be successfully treated if diagnosed early – yet fewer than 50% of cases are currently diagnosed in their early stages.
It’s important to understand that bowel cancer is also one of the easier cancers to diagnose early – and it is highly curable when it is diagnosed early.
As such, it’s incredibly important to be aware of the causes of this type of cancer, your risks, the symptoms, and how to take control of your health to prevent this cancer from developing and advancing.
What is Bowel Cancer?
“Bowel cancer” refers to cancers of the colon (69%) and rectum (31%). It does not include anal cancer (anal cancer involves the very end of the digestive tract, different types of cells, and has different causes. Anal cancer is also much rarer and is treated differently).
It can affect any part of the colon (large intestine) or rectum. The colon makes up the longest part of the large intestine and receives and transports food that has been almost completely digested from the small intestine. The colon absorbs nutrients and water and passes the waste (i.e., faeces, poo, stool) into the rectum for elimination via the anus.
Most bowel cancers begin as small benign polyps which are non-cancerous growths on the bowel lining or wall. These are very common, with up to 40% of adults having bowel polyps. Most will never cause an issue, however, some can become malignant and develop into cancer over time. This usually takes many years. Cancer in the lining of the bowel can metastasize (spread) through the bowel wall, into the lymph nodes, and to the bones and other organs. Once cancer has spread, it is far more difficult (and often impossible) to manage.
Early detection and treatment are essential.
Signs and Symptoms
In its early stages, bowel cancer usually has no symptoms.
If you notice any of the following, it is time to see your doctor promptly:
- Blood – on the toilet paper, on your faeces, or in the toilet bowl. While blood, especially bright red and on the toilet paper, often signifies benign haemorrhoids, you need to be certain that nothing sinister is causing it and that it is not originating in the rectum or colon.
- Changes to normal bowel habits – everyone has their own “normal”. If your “normal” recently and persistently changes with no apparent cause, see your doctor. This includes regularity, constipation, diarrhoea, and changes to the size, shape, and/or colour of faeces. The presence of mucous on the faeces can also be a red flag.
- Extreme tiredness– if there is no apparent cause and especially if it is ongoing.
- Unexplained weight loss or weakness.
- Low blood iron levelswith no other explanation.
- Swelling or lumpin the abdomen.
- Pain – it may be vague and achy, colicky, or severe, may occur when defecating, and may be accompanied by nausea or vomiting.
- Age – The risk rises dramatically from age 50 – though the risk for under-50s is rising.
- Family/Genetics – In approximately 30% of all bowel cancer cases, there is a family history of bowel cancer. This is often due to an inherited gene mutation.
- Alcohol consumption
- High saturated fat consumption
- Being overweight or obese
- Lack of physical activity
- High red meat intake – especially charred/well-done meat
- Other diseases – including Type II diabetes, Crohn’s disease, Inflammatory Bowel Disease, and Ulcerative Colitis.
- High processed/deli meat intake, especially cured, salted, smoked, and preserved meats.
Bowel Cancer Screening is safe and easy. For those with a low to average risk of developing bowel cancer, screening is recommended every 2 years from age 50 via the immunochemical faecal occult blood test (iFOBT) as well as for those aged 40-49 who request it from their GP. This is a simple stool-sample test collected at home and sent for testing.
For those at higher risk or with symptoms, a colonoscopy is recommended for screening and diagnostic purposes. This is a simple, day-only hospital procedure carried out under sedation. Polyps and early cancers can usually be removed on the spot.
- Know your family history. If your parent, grandparent, or sibling has been diagnosed with colon cancer or an inherited gene mutation, especially at a younger age, you must see your doctor for screening and ongoing preventative management. Known genetic mutations can be diagnosed via a blood test.
- Make healthy choices when it comes to diet and lifestyle. Drink plenty of water, moderate alcohol consumption, and fill your diet with whole grains, fruits, vegetables, healthy lean protein, and healthy fats in moderation (e.g., avocado, nuts, and olive oil).
- Quit smoking. Smoking harms the entire body.
- Maintain a healthy weight and get regular physical activity.
- Probiotics and gut healthare inextricably linked. Probiotics are healthy bacteria that help maintain the balance for optimal gut health. Taking a daily probiotic may support a stronger gut and immune system, and may help prevent bowel cancer from developing when paired with other healthy lifestyle choices.
- See your doctor to discuss your individual risk and specific preventative measures.
Knowledge is power and prevention is better than a cure. Know your risks and get screened when appropriate.