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Take control of your gut health

April is Colorectal/Bowel Cancer Awareness Month. Read our advice on how to detect and prevent bowel cancer.

One in 20 of us will be affected by colorectal/bowel cancer (CRC). CRC is highly preventable, so why is the death rate still so high? It’s the second biggest cancer killer in the UK, claiming a life every 30 minutes. Survival rates here in Britain are lower than in many European countries.

Most bowel cancers develop from precancerous polyps. These are small growths arising in the lining of the bowel, which grow at a very slow rate, which give us a unique oppor- tunity to detect them. Polyps are visible and mostly removable when the bowel is examined with a camera (called a colonoscopy or sigmoidoscopy) by an expert.

People in Britain are lucky to have an NHS Bowel Cancer Screening Programme (BCSP) starting at age 60. Screening means testing people without any symptoms. Sadly, the uptake of this testing is still to reach optimal levels (currently only 50% of people take the test). If you receive this kit through the post, please discuss it with your GP.

The risk of bowel cancer increases around the age of 50, and can be screened for via several tests. Any obviously concerning bowel symptoms need the appropriate diagnostic evaluation.

X-ray image, highlighting the bowel

This is a deadly disease, which is highly preventable and potentially beatable - but only if caught early.

SCREENING TESTS

A regular screening test for colon cancer is the single best way to protect yourself from this disease.

There are many effective screening tests for colon cancer:

  1. Stool tests looking for hidden blood, including fecal occult blood test (FOBT) and fecal immunochemical test (FIT), are used by the BCSP.
  2. Flexible sigmoidoscopy - a limited camera examination of only the lower part of the colon. This is currently being rolled-out as part of the BCSP.
  3. Virtual colonoscopy - a type of CT scan that creates 3D images of the inside of the colon.
  4. Colonoscopy - a flexible camera examination of the full length of the inside of the bowel. Detected polyps can be removed during the test. Most experts would agree that the colonoscopy is the gold standard screening test. If other tests find anything suspicious, a colonoscopy is usually needed.

The test you have depends on your medical history and personal choices, but any is better than none. Take control of your own health. So, don’t be afraid to ask, and get screened. 

Colonoscopy information

A nurse holding bowel examination equipment

Bowel cancer - frequently asked questions

CRC symptoms don’t usually develop until the cancer is advanced, by which time it’s less likely to be curable. Early on there are few, if any, symptoms.

The symptoms for bowel cancer are called ‘red flags’ and include blood in the stools or a change in the stools, such as them being looser or more frequent.

Difficulty emptying the bowels, low energy, unexpected weight loss and a lump in the abdomen are among the other symptoms to heed.

CRC generally affects older people. However, there’s been an alarming increase noted in younger age groups — those aged 20-39 — in the past few years.

Three in 10 rectal cancer (in lower part of the bowel) diagnoses are now in patients aged under 55.

The message to take home is that any gut symptom needs evaluation if it persists; no matter how young or old you are.

If you have concerning symptoms, whatever your age, take control and see your GP for advice.

Only a minority will require referral or investigation, but this may be life-saving.

It’s important to know and share your family history. This includes any cancer diagnoses, such as breast, ovarian and stomach cancer as well as colorectal cancer.

Knowledge of affected family members allows you to be proactive about your health.

Some conditions greatly increase the risk of colorectal cancer.

  1. Hereditary nonpolyposis colon cancer (HNPCC, also called Lynch syndrome) 
    Affects one in 300 people. It’s an inherited condition with increased risk of colorectal cancer, occurring at younger ages. It accounts for one in 30 cases of colorectal cancer. It also increases the risk of other cancers, i.e. uterus, stomach, small bowel, bladder, kidney, brain, ovary and skin. This is under-recognised and under-diagnosed in the UK.
  2. Familial adenomatous polyposis (FAP)
    Rare inherited condition affecting one in 10,000 people. Almost 100% risk of developing colorectal cancer. Most cancers occur up to the age 50.
  3. Inflammatory bowel disease
    People with Crohn’s colitis and ulcerative colitis have an increased risk of colorectal cancer, especially with inflammation of the entire colon and colitis of more than 10 years’ duration.

The answer is yes. To do so:

  • Eat less red and processed meats, and increase your intake of green leafy and dark yellow vegetables.
  • Low-dose aspirin (75mg daily) appears equally effective as some screening tests. However, the benefits have been found to occur only after eight years of use. There’s also a side effect of gut bleeding, so consult your GP.
  • Stop smoking. This is the single best thing you can do for your health. Quitting has real benefits.
  • Maintain a healthy weight — the second biggest risk for getting cancer is being overweight. There are no less than 11 cancers that are linked to obesity, and colon cancer is one of them.
  • Be physically active. Regular exercise lowers the risk of many serious diseases, including colon cancer. Aim for around 20-30 minutes of moderate activity each day. Brisk walking, dancing, gardening, or even cleaning the house counts.
  • Drink in moderation. In moderation, alcohol is heart-healthy. What does this mean? For moderate drinkers there’s no reason to stop. For teetotallers, there’s no reason to start. Heavy drinkers should cut down.

• Get enough calcium, vitamin D and folate (folic acid or vitamin B9). Evidence shows that getting enough of these vitamins and minerals helps protect against colon cancer.

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