Detected early it is highly treatable, even curable. We’re talking bowel cancer. A new test, the Bowel Scope – aka flexible sigmoidoscopy – is currently being rolled out across England and in parts of Scotland (there are no plans yet for Wales and Northern Ireland) for those aged 55 and it could cut the risk of dying from it by 43 per cent. But experts say women are more likely than men to refuse the test out of fear of discomfort, invasiveness or embarrassment. Which makes worrying reading when you consider that bowel cancer is the most common female cancer after breast and lung. It strikes more than 18,000 women in the UK each year and claims the lives of more than 7,000.
Meanwhile, it seems men are less likely to use the existing NHS home testing kit – the FOB (faecal occult blood) test – sent to everyone from age 60, with around one in two kits dropping through the letterbox for men ending up in the bin.
While age is the biggest risk factor for bowel cancer – 95 per cent of cases affect the over-50s and incidence rises sharply between 50 and 54 – it’s vital that younger men and women understand what to look out for.
The number of under-50s with bowel cancer has risen in the last 15 years with more than 2,000 in this age group diagnosed. The trouble is doctors often have a lower index of suspicion in patients under 50, which can result in delays in diagnosis and treatment. And younger women are especially likely to experience delays. One in two younger women with symptoms paid more than five visits to the GP before being referred to a specialist or ended up being diagnosed in A&E, according to a Bowel Cancer UK survey. This is especially disturbing given that diagnosed early, more than 90 per cent of cases can be successfully treated.
It takes ten to 15 years for a polyp (a growth which can become cancerous, although most are benign) to grow into a tumour. During this time there are no obvious symptoms, which makes screening especially important because it can identify hidden blood in stools.
Around four out of ten kits (50% for men and 46% for women) go in the bin or languish on a bathroom shelf – by contrast seven out of ten of us turn up when invited for a mammogram and more than eight out of ten for a cervical smear. Since 2006 when FOB was launched, just 16,853,055 of the 27,482,738 kits dispatched, have been returned: a shortfall of almost 11 million.
GP endorsement and text reminders are being explored to encourage more of us to do the test. But researchers anticipate only a modest increase in uptake (around 5 per cent). Because at the heart of most reluctance to take the test is a distaste at handling ‘poo’ – the test involves collecting a sample on three separate days and smearing it onto a card.
The good news is that in January the UK National Screening Committee announced that a new simplified stool test called FIT (faecal immunochemical test), will supplant FOB. Involving just one sample, it is hoped it will prove more acceptable. This, along with the Bowel Scope, are two significant steps forward. Together they could reduce bowel cancer deaths by a fifth, according to Cancer Research UK. But we need to pull our weight too, so don’t put screening off…
FOB (faecal occult blood) test
What is it? A two yearly DIY stool test to look for hidden blood – if detected, you will be referred for a colonoscopy.
Who is eligible? People aged 60 to 74 (England, Wales and Northern Ireland), 50 to 74 (Scotland)
Need to know. Conditions that cause bleeding, certain medications such as ibuprofen, supplements such as vitamin C and even some foods such as turnips and radishes, may interfere with the result.
FIT (faecal immunochemical test)
What is it? A DIY antibody test. You collect a single sample with a small stick, place it in a tube and send it off to your local NHS screening centre.
Who is eligible? FIT will replace FOB in the next year or so. At the time of writing it’s awaiting parliamentary approval.
Need to know. Medicines and food do not interfere with FIT meaning it is more accurate, producing fewer false positives.
Bowel scope (flexible sigmoidoscopy)
What is it? A test carried out by a trained clinician. A thin, flexible tube with a mini-camera and light at the end is inserted into the lower bowel where seven out of ten cancers occur to look for cancer or polyps. If found these can be painlessly removed, making the test preventive as well as diagnostic.
Who is eligible? People aged 55.
Need to know. There are no pain receptors in the rectum but you may feel a stretching sensation. Ask if you would prefer the test done by a woman.
Know the symptoms
One bowel cancer survivor, Sherrie Hager, opened up about the commonly misdiagnosed symptom of bowel cancer that almost cost her her life.
At the age of 31, she experienced constant and severe bloating, saying, “I was a size 10 but…I looked pregnant.
“Everything I ate and drank went straight through me within an hour. I
couldn’t even drink plain water without feeling bloated and sick.”
As she was a Chron’s sufferer, her bloating was often dismissed as a side-effect of the condition. But suspecting there was something more going on, Sherrie insisted on a colonscopy, which is when she was diagnosed with bowel cancer.
So if you feel as though your bloating is more severe than normal, head straight to your doctor.
We would never advocate self-diagnosis, so we recommend you see your GP if you experience any of these other symptoms:
- bleeding from your bottom
- persistent blood in your stools
- a persistent change in bowel habit lasting three weeks or more – especially going to the loo more often, and experiencing looser stools
- developing a pain or lump in your abdomen, along with bloating or discomfort after eating
- significant unexplained weight loss
7 ways to cut your risk… whatever your age
More than half of cases of bowel cancer could be prevented by healthy lifestyle choices.
Watch meat intake. Red meat may increase risk and The World Cancer Research Fund recommends less than 500g (cooked) red meat per week.
Shoot for seven… fruit and veg a day, that is. A new study suggests they may protect against polyps.
Wake up and smell the coffee. Studies have shown that coffee (six cups caffeinated) can decrease the risk, especially for women, thanks to protective plant chemicals called polyphenols.
Control weight. Weight gain is linked with a higher risk in women. It’s thought fatty tissue produces inflammatory chemicals and cell-damaging compounds.
Stay active. A review published in March 2016 suggests physical activity may speed food waste through the colon, reducing exposure to food-borne carcinogens.
Go easy on alcohol. More than 30g a day – around two small (100ml) glasses of wine – is linked to a higher risk.
Don’t smoke. Cigarette smoke absorbed into the blood stream carries carcinogens to the colon and increases risk of polyps.