Bowel Cancer

Both men and women can get bowel cancer. It is more common in older people with most people diagnosed being over the age of 60.

The risk of developing bowel cancer depends on many factors, including:

• Age – almost 9 in 10 people with bowel cancer are aged 60 or over.
• Diet – a diet high in red or processed meats and low in fibre can increase your risk.
• Weight – bowel cancer is more common in overweight or obese people.
• Exercise – being inactive increases your risk of getting bowel cancer.
• Alcohol – drinking alcohol might increase your risk of getting bowel cancer.
• Smoking– smoking may increase your chances of getting bowel cancer.
• Family history – having a close relative (mother or father, brother or sister) who developed bowel cancer under the age of 50 puts you at a greater lifetime risk of developing the condition; screening is offered to people in this situation, and you should discuss this with a GP.
• Medical conditions – such as familial adenomatous polyposis (FAP), Lynch syndrome, ulcerative colitis and Crohn’s disease
• Radiation

Read more about the causes of bowel cancer

The 3 main symptoms of bowel cancer are:

• Persistent blood in your poo – that happens for no obvious reason or is associated with a change in bowel habit. This can also lead to an unexplained iron deficiency anaemia.
• A persistent change in your bowel habit – which is usually having to poo more, and your poo may also become runnier.
• Persistent lower abdominal (tummy) pain, bloating or discomfort that’s always caused by eating and may be associated with loss of appetite or significant, unintentional weight loss.

Most people with these symptoms do not have bowel cancer. Other health problems can cause similar symptoms. For example:

• Blood in the poo when associated with pain or soreness is more often caused by piles (haemorrhoids).
• A change in bowel habit or abdominal pain is usually caused by a reaction to something you’ve eaten.
• A change in bowel habit to going less often, with harder poo, is not usually caused by any serious condition – therefore it may be worth trying laxatives before seeing a GP

These symptoms should be taken more seriously as you get older and when they persist despite simple treatments.

Read about the symptoms of bowel cancer

Although there are some risks you cannot change, such as your age or family history, there are several ways you can lower your chances of developing bowel cancer:

• Red meat and bowel cancer risk
• Eating a healthy balanced diet
• Losing weight
• Health and fitness
• Stopping smoking
• Tips on cutting down on alcohol

You should consult your GP if you have any of the symptoms of bowel cancer for 3 weeks or more.

The GP may decide to:

• Examine your tummy and bottom to make sure you have no lumps or swellings.
• Arrange for a simple blood test to check for iron deficiency anaemia – this can show whether there’s any bleeding from your bowel that you have not been aware of.
• Arrange for you to do a FIT test to see if there are microscopic traces of blood in your poo
• Arrange for you to have a simple test in hospital to make sure there’s no serious cause of your symptoms.

Make sure you see a GP if your symptoms persist or keep coming back after stopping treatment, regardless of their severity or your age. You’ll probably be referred to hospital.

Read more about diagnosing bowel cancer

Under national cancer guidelines any patient referred to a specialist for suspected cancer should be seen within 14 days of referral (the “Two Week Wait” initiative).

Local referral guidelines for Devon & Cornwall recommend that the following patients should be referred to a specialist colorectal service via a Two Week Wait pathway to exclude bowel cancer:

Colorectal cancer:

• Aged under 50 with rectal bleeding and any of the following unexplained symptoms or findings (consider):
  • abdominal pain.
  • change in bowel habit.
  • weight loss.
  • unexplained iron-deficiency anaemia.
• Aged 40 and over with unexplained weight loss and abdominal pain.
• Aged 50 and over with unexplained rectal bleeding.
• Aged 60 and over with either of:
  • iron-deficiency anaemia or
  • changes in bowel habit
• Rectal or abdominal (but not pelvic) mass (consider).
• Patient with low-risk symptoms testing positive for Faecal Immunochemical Testing (FIT) – see “Bowel Cancer Screening” below

Anal cancer:

• Unexplained anal mass or unexplained anal ulceration (consider)

Bowel cancer can be treated using a combination of different treatments, depending on where the cancer is in your bowel and how far it has spread.

The main treatments are:

• Surgery – the cancerous section of bowel is removed; it’s the most effective way of curing bowel cancer and in many cases is all you need.
• Chemotherapy – where medicine is used to kill cancer cells.
• Radiotherapy – where radiation is used to kill cancer cells.
• Targeted therapies – a newer group of medicines that increases the effectiveness of chemotherapy and prevents the cancer spreading.

As with most types of cancer, the chance of a complete cure depends on how far it’s spread by the time it’s diagnosed. If the cancer is confined to the bowel, surgery is usually able to completely remove it.

Keyhole or robotic surgery is being used more often, which allows surgery to be performed with less pain and a quicker recovery.

Read more about how bowel cancer is treated

To detect cases of bowel cancer sooner, the NHS offers 2 types of bowel cancer screening to adults registered with a GP in England:

• All men and women aged 50 to 74 are invited to carry out a FIT or FOB test (these are tests that look for microscopic traces of blood in the faeces). Every 2 years, they’re sent a home test kit, which is used to collect a poo sample. If you’re 75 or over, you can ask for this test by calling the freephone helpline on 0800 707 60 60.
• An additional one-off test called bowel scope screening is gradually being introduced in England. This is offered to men and women at the age of 55. It involves a doctor or nurse looking inside the lower part of the bowel using a camera on the end of a thin, flexible tube.

Taking part in bowel cancer screening reduces your chances of dying from bowel cancer. Removing any polyps – small growths that can develop on the inner lining of your bottom (rectum) – found in bowel scope screening can prevent cancer.

However, all screening involves a balance of potential harms, as well as benefits. It’s up to you to decide if you want to have it.

Read about bowel cancer screening, including more about what the 2 tests involve, what the different possible results mean, and the potential risks.

• Bowel Cancer UK
• Macmillan cancer support
• Cancer Research UK
• Bowel Cancer – NHS UK

If you have been referred for a specialist opinion your details will be reviewed and it may be recommended that you are seen by a hospital clinician. Information to support you in choosing your preferred hospital, including waiting times can be found using the links below.

How long will I wait?

If a hospital assessment and/or treatment is clinically recommended your information will be sent to a specialist. Click below to find out more about waiting times for routine hospital assessment and/or treatment.

• Waiting times
• Find services near you