As a colorectal surgeon, I am regularly asked to assess patients with gut symptoms – most commonly rectal bleeding but also changes in the bowel habit and abdominal pain. All of these symptoms must be taken seriously, particularly if they have been present for more than a few weeks, or seem to be getting worse.

The single most important symptom in the detection of bowel cancer is bleeding with a bowel action – this should NEVER be ignored.

Of course, many symptoms are due to a benign cause – bleeding from haemorrhoids or an anal fissure, changes in bowel habit from irritable bowel syndrome and abdominal pain from diverticular disease or gynaecological problems.

It remains important to check the symptoms out properly before presuming that it is all OK – that’s where a specialist like a colorectal surgeon comes in.

Bowel cancer is a curable disease – as long as it is detected early enough. Patients with a Stage A cancer (just invading into the bowel wall) have a 95% chance of surviving the disease, whereas those with Stage D (where it has spread to other organs) have about a 15% chance of surviving 5 years. That’s a huge difference in prognosis.

It is a devastating disease, made all the more so by the knowledge that it can be cured if detected early.

Everyone, especially those over 40 years of age, should have a plan to manage their bowel cancer risk. Important parts of the plan would be;

Primary prevention: A healthy lifestyle has been shown to prevent bowel cancer. In particular the following aspects:-

  • Regular moderate to vigorous exercise
  • High fibre, low fat, low red meat diet
  • Modest alcohol intake
  • Weight in the healthy range

Report all bowel symptoms to your GP, especially rectal bleeding.

Understand your personal risk: Most people will be at average risk, but some are at increased risk and need a personalised plan (usually regular colonoscopy). This includes:-

  • People with a family history of bowel cancer, especially if a close family member had bowel cancer at a young age or if multiple family members have had the disease
  • People who have had bowel cancer in the past, or certain types of colonic polyps
  • People who have been diagnosed with inflammatory bowel disease, such as ulcerative colitis of Crohn’s Disease.

Screening: For those at average risk, a regular (at least every 2 years) faecal occult blood test (at home screening test) is an essential part of the bowel cancer risk management plan. Officially this should start at the age of 50 with the National Bowel Cancer Screening Program (NBCSP), but there is increasing evidence that this test should be started earlier in life to gain the most benefit.

At home screening tests have revolutionised bowel cancer management in Australia, although only a frustratingly small 35% of people participate in the NBCSP. Figures show that 45% of NBCSP detected cancers are in the curable Stage A group, compared to only about 10% of cancers that are found after symptoms have started. This translates into thousands of lives saved. Imagine how many more lives could be saved if everyone just did that simple test!

The Jodi Lee Foundation has been ahead of its time. ‘The early detection of bowel cancer saves lives’ is no longer just a motto or a theory. It is a fact.