Bowel cancer: new plans to reshape the screening programme

Despite there being a dramatic increase in bowel cancer cases above the age of 50, the screening programme in England is currently only offered to those aged 60 and over. However, Public Health England have recently announced that it plans to bring the starting age for screening down to 50, a move which will mean countless more cases are spotted in the earlier, more easily treatable stages. (1)

What is bowel cancer?

Bowel cancer is cancer of the large intestine, and depending on the area affected, may be referred to as colon cancer or rectal cancer. It is the fourth most commonly diagnosed cancer in the UK, responsible for 42,000 cases and over 16,000 deaths each year. (1, 2)

What are the symptoms?

One of the most common symptoms is blood in your poo. This may be noticed as red streaks on the surface of your poo or the poo being discoloured (red, very dark red/brown or black), toilet water being stained red or pink, or blood visible on toilet paper. Often, blood in poo has other, less serious causes, such as haemorrhoids or anal fissures (cuts). But if you’ve had any of the above symptoms for three weeks or longer, visit your GP. (2, 3)

A change in bowel habit can also be a sign of bowel cancer. One off changes in bowel habit can be caused by eating certain foods or stressful situations, but if this occurs persistently don’t ignore it. If you find you are needing to poo more frequently than what’s usual for you, and the poo is softer and thinner than usual for three weeks or more, see your GP. (2,3)

Another common symptom is lower abdominal pain, discomfort or bloating. This tends to worsen after eating and may therefore put you off eating, leading to weight loss. See your GP if you experience any of the above symptoms. (2, 3)

Other symptoms may include tiredness from anaemia caused by persistent blood loss from the bowel, slime in your poo and feeling like you can’t fully empty your bowel when you poo. (2, 3)

Bowel cancer screening

Currently, the bowel cancer screening programme in England involves inviting everyone aged between 60 and 74 to have a faecal occult blood (FOB) test every two years. This is a simple home testing kit which allows a small stool sample to be collected. When sent to the laboratory, this sample is tested for traces of blood, which could indicate bowel cancer. (1, 2)

A new, more accurate bowel screening kit is due to replace the FOB test this autumn, known as the faecal immunochemical test (FIT). It is the FIT that will be in use when bowel screening is introduced to people aged 50 and over in England. (1)

In some parts of England, a different test is also offered to 55 year olds, called bowel scope screening. During this screening, a healthcare professional will inspect the lower bowel for polyps (small growths that can be an early sign of cancer) using a gentle instrument. (2)

What causes bowel cancer?

Bowel cancer, like all cancers, doesn’t have a definite cause, but there are several risk factors:

• Regularly eating red or processed meat
• Not eating enough fibre
• Being overweight or obese
• Sedentary lifestyle
• Excessive alcohol consumption
• Smoking
• Being 60 years of age or older
• Having a parent or sibling who had bowel cancer under 50 years of age
• Having had ulcerative colitis or Crohn’s disease for over 10 years

As you can see, some factors are unavoidable, but others can be changed. A diet high in fibre, fruit and vegetables and low in red and processed meat will help protect against bowel cancer, as will stopping smoking (if applicable), drinking alcohol in moderation or not at all, getting moderate exercise regularly and maintaining or attaining a healthy weight. (2)

For more information and support, visit Bowel Cancer UK here.

References

1. BBC News (2018). Bowel cancer screening to start earlier at age 50 in England [cited 13 August 2018]. Available at: https://www.bbc.co.uk/news/health-45143895

2. NHS Choices. Overview: Bowel cancer [cited 13 August 2018]. Available at: https://www.nhs.uk/conditions/bowel-cancer/

3. NHS Choices. Bleeding from the bottom (rectal bleeding) [cited 13 August 2018]. Available at: https://www.nhs.uk/conditions/bleeding-from-the-bottom-rectal-bleeding/

   Author: Gabby Gallagher MPharm

   Medically reviewed by: Superintendent pharmacist Margaret Hudson BSc(Hons)MRPharmS 15/08/18