Bowel Cancer - The Facts

 

  • Australia has one of the highest rates of bowel cancer in the world
  • It accounts for 13% of all invasive cancers diagnosed in Australia, second only to prostate cancer
  • There were approximately 17000 new cases and more than 4000 deaths each year
  • 1 in 12 Australians will develop bowel cancer before the age of 85
  • 90% of bowel cancers can be successfully treated if detected early
What is bowel cancer?
  • Colorectal cancer (CRC), or bowel cancer, develops when cells in the bowel lining grow too quickly, forming a clump known as a polyp or an adenoma
  • Polyps are usually benign. Polyps can grow for several years before undergoing additional changes and becoming cancerous and spreading to other parts of the body
Bowel cancer risk factors
  • Are 50 and over
  • Are overweight
  • Have a poor diet, such as a diet high in red meats, processed meats (e.g. bacon, sausages), fried foods, alcohol, or low in vegetables, fruit and whole grains (e.g. wholemeal bread, brown rice)
  • Have had an inflammatory bowel disease such as Crohn’s disease or ulcerative colitis
  • Have previously had non-cancerous tumours in the bowel
  •  Have a strong family history of bowel cancer or polyps
    • More than 80 per cent of people who develop bowel cancer do not have a family history of bowel cancer
    • The risk of bowel cancer is twice as high if a patient has a first degree relative with bowel cancer
    • The risk is four times as high if a patient has two first degree relatives with the disease
What are the symptoms?
  • Bowel cancer can develop with few, if any, early warning symptoms. Symptoms of bowel cancer include:
    • bleeding from the rectum, 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)
    • abdominal pain
What you can do
  • Lower your risk of developing bowel cancer by
    • having a healthy diet
    • exercising regularly
    • reducing your alcohol consumption
    • onot smoking
  • There has been additional evidence that low-dose aspirin may reduce the risk of adenoma formation and bowel cancer
    • Aspirin consumed for >5 yr period showed a reduction in incidence of CRC by 25% and mortality by 33%
    • It is now recommended that patients >50 yrs of age and particularly those at an above average risk (FHx, Lynch syndrome, history of adenomas) should be offered low-dose aspirin for chemopreventative effects
  • Participate in a screening program
Screening
  • Colorectal cancer is one of the few cancers for which screening has reduced the incidence
  • National Bowel Cancer Screening Program (NBCSP) Facts
    • Only 36% of those receiving the Faecal Occult Blood Test (FOBT) participated
    • 7.5% of the participants had a positive FOBT
    • Only 68% of those went on to have a documented colonoscopy
    • 9% had advanced adenomas
    • 4% had a colorectal cancer
    • Women participated more than men
    • More men had cancers
  • Current eligible ages receiving the NBCSP begin at age 50 and by 2020 second yearly NBCSP invites will be made to 50 to 74 year olds
  • The program has proved unequivocally effective, reducing predicted CRC mortality by up to 15-25%. Earlier diagnostic staging has also reduced morbidity. There is however much room for improvement with participation and appropriate follow-up.
Treating bowel cancer
  • You will usually require surgery if bowel cancer is found. If the cancer is found at an early stage, the chance of a full recovery is high. Most people will be able to return to their current lifestyle and activities.
What can we do as GPs?
  • Discuss these facts with our patients & explain the importance of participating in the NBCSP
  • If your patient hasn’t been invited, then FOBT testing can be offered every 1-2 years
  • Remember, a negative test does not mean your patient doesn’t have CRC or other gastrointestinal pathology. So, if you’re worried, please refer!

 

This fact sheet is courtesy of Dr Griff Walker, Gastroenterologist & Interventional Endoscopist for Coast Gastroenterology at Gold Coast Private Hospital.

 Call 07 55 746 133 or email admin@coastgastro.com.au for more information.

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