This month is National Bowel Cancer Month. Dr Zak Uddin, North-East GP, discusses exciting new advances in disease which if identified early, may save many lives

YOU may be reticent to talk about your bowel movements, but sitting on your worries is the worst thing you can do.

April is National Bowel Cancer Awareness Month and the introduction of a new risk assessment tool to help general practitioners in identify individuals under 50 who may have bowel cancer is potentially lifesaving.

Developed by researchers at the University of Exeter, the tool combines symptoms, physical examination findings and blood test results to give a percentage chance of bowel cancer. If this is above three per cent, it recommends that the person be referred for urgent colonoscopy.

This is exciting news, as evidence shows that younger persons may be perceived to be at less risk of bowel cancer by the medical profession itself, despite symptoms that would raise alarm in an older age group. At the same time, it appears that some younger individuals wait longer before they attend their doctor, as they too feel that the symptoms are more likely due to benign conditions, for example bleeding haemorrhoids.

The UK already has a successful national bowel screening programme, which is able to identify two per cent of bowel cancers in individuals with no symptoms whatsoever. This is a very simple test, without harm, and involves submitting two faeces samples in a sealed envelope, with the sample kit provided entirely free of charge. If blood is detected in the samples, the person is offered an urgent colonoscopy to identify a potential cancer in the bowel, which may be causing the bleeding. At present, screening is offered every two years to all individuals from 50-74 in Scotland and from 60-74 in the rest of the UK.

Sadly, the figures for bowel cancer make bleak headlines. It is the fourth commonest cancer diagnosis and the second highest recorded cause of death due to cancer. There are over 40,000 new diagnoses in the UK every year, and 16,000 deaths. This means every day roughly 44 persons will die due to bowel cancer. The majority of sufferers are older than 60, but it can occur at any age.

Despite this, there is a vast amount to be optimistic about. Five year survival rates for bowel cancer have doubled in the past 40 years, due to multiple factors including improved surgical techniques and post-operative care, greater public awareness of symptoms of bowel cancer, and the national screening programme. We know that if bowel cancer is diagnosed and treated at an early stage, there is greater than 90 per cent survival at five years. Indeed, earlier presentation means that your treatment may be less aggressive, with fewer side effects.

There are six so-called red flag symptoms for bowel cancer, which are very easy to remember. Any rectal bleeding should prompt immediate consultation with your regular GP. Unexplained persistent abdominal pain, especially if it keeps you awake at night, should not be ignored. A change in bowel habit, typically tending to more loose stools for more than three weeks, may be the first sign of bowel cancer. Any new lump in the abdomen should not be dismissed and needs to be examined by a trained medical professional. Lastly, persistent fatigue or unintentional weight loss merit a discussion with your family doctor.

Some individuals will be at higher risk of bowel cancer, namely those with a family history, or who already have an inflammatory bowel disease. Your risk of bowel cancer, as with any cancer, also increases with age. Yet there are lifestyle factors that can be addressed to potentially reduce this risk.

Diets high in red meat, smoking and excess alcohol consumption, are all associated with bowel cancer. Regular cardiovascular exercise has been demonstrated to lower the risk of bowel cancer, as well as improving physical and mental wellbeing as an extra bonus.

Bearing in mind all of the above, the message is not to be fearful. No matter what age you are, if you have any red flag symptoms for bowel cancer, please attend your routine GP at the earliest possible time. If you are over sixty, please don’t be shy, and make use of the National Bowel Screening programme.

Encourage friends and relatives who are eligible to make full use of it. Despite the North East being the first region to have fully coverage by the bowel screening programme, uptake is still disappointing at only 55 per cent.

Try to make small adjustments to your everyday life that will improve your overall health. Most importantly, don’t be scared of cancer, but don’t be scared to promptly address potentially concerning symptoms; you will be much better for having them dealt with in a timely manner.

If you have any red flag symptoms for bowel cancer, please attend your routine GP at the earliest possible time.