screening for bowel

Overview

Bowel screening means testing people who do not have any symptoms of bowel cancer to see if they might have early signs of the disease. It aims to find cancer early, when treatment is more likely to be successful. It can also find abnormal growths (polyps) before they become cancer.

Yes. In many countries, bowel cancer is one of the most common cancers, so screening is offered routinely to older adults.

It mainly affects adults over 50. In some countries, screening starts at age 50 or 60 and continues to around age 74. If you have a strong family history, your doctor may suggest earlier or more frequent checks.

Symptoms

Common symptoms

• a persistent change in your normal bowel habit – more frequent or looser stools
• blood in your stool or bleeding from your bottom
• unexplained weight loss
• tummy (abdominal) pain or a lump

Causes

Main causes

• Most bowel cancers develop from small growths called polyps that are not cancer at first.
• Over time, some polyps can turn into cancer if they are not removed.
• The exact cause is not fully understood, but it involves a combination of genetic and environmental factors.

Risk factors

• age – most cases are in people over 50
• a family history of bowel cancer or inherited conditions such as Lynch syndrome
• a personal history of inflammatory bowel disease (such as ulcerative colitis or Crohn’s disease)
• being overweight or inactive
• smoking and drinking alcohol
• a diet high in processed or red meat and low in fibre

When to see a doctor

See a doctor urgently if:

• If you notice any blood in your stool, or a change in bowel habit that lasts more than 3 weeks, contact your doctor quickly.
• If you are over 50 and have never been screened, ask your doctor about it at your next visit.

Book a routine appointment if:

• If you have a family history of bowel cancer, talk to your doctor about whether to start screening earlier.
• If you have a condition that raises your risk, such as inflammatory bowel disease, you may need regular checks.

Diagnosis

Screening usually starts with a home test kit. You collect a small stool sample and send it to a laboratory. The test checks for tiny amounts of blood that are invisible to the eye. If this test is abnormal, or if you have symptoms, a doctor will usually recommend a colonoscopy.

Tests that may be done

• Faecal immunochemical test (FIT) – a stool sample test for hidden blood
• Colonoscopy – a camera tube that looks at the whole bowel, with samples (biopsies) taken if needed
• Sigmoidoscopy – a shorter tube that looks at the lower part of the bowel
• CT colonography (virtual colonoscopy) – a special x-ray scan to view the colon from outside

What to expect at your appointment

If you need a colonoscopy, you will be asked to follow a special clear liquid diet and drink a laxative to clean your bowel. You will be given a sedative to help you relax. The test usually takes 15–30 minutes. Most people find it uncomfortable rather than painful. You can usually go home the same day.

Treatment

If screening finds cancer or a high-risk polyp, your team will explain the options. The stage of the cancer – how far it has spread – determines the best treatment. Early cancer is very treatable, and many people are cured.

Self-care at home

• Follow the advice your care team gives you about resting and recovery after tests or treatment.
• Keep a record of symptoms and any questions to ask at appointments.
• Reach out to family, friends, or a patient support group – you do not have to manage alone.

Medical treatments

Depending on the stage, treatment may include surgery to remove the cancer and some surrounding bowel, chemotherapy (anti-cancer medicines) given through a drip or as tablets, radiotherapy using targeted radiation, and newer targeted therapies that help the immune system attack cancer cells. Your doctor will explain which are right for your situation.

When is surgery considered?

Surgery is the most common first treatment for bowel cancer that has not spread. In some cases, the surgeon removes a section of bowel and joins the healthy ends back together. Some people need a temporary or permanent stoma (a bag outside the body to collect waste).

Living with this condition

After a cancer diagnosis, life can feel uncertain. Try to keep some routine, accept help from others, and attend all follow-up appointments. After treatment, you will have regular check-ups, including further screening tests.

Lifestyle tips

• Stay as active as you can – even a short daily walk helps.
• Eat a balanced diet with plenty of fibre, fruit, and vegetables.
• Limit alcohol and avoid smoking.

Diet and exercise

Eat a variety of whole grains, legumes, fruits, and vegetables. Limit processed and red meats. Exercise for at least 30 minutes on most days, but adjust to your energy levels during treatment.

Mental health and emotional wellbeing

A cancer diagnosis can trigger anxiety, sadness, and fear. It is normal to feel this way. Tell your care team how you are feeling. Many hospitals have counselling available, and patient groups allow you to talk with others who understand.

Prevention

Screening can prevent bowel cancer by finding and removing polyps before they turn into cancer. A healthy lifestyle also reduces risk.

Vaccines

There is currently no vaccine for bowel cancer.

Screening programmes

Programmes vary by country. In the UK, the NHS offers bowel cancer screening to everyone aged 60–74 every two years. Some countries start at 50. Talk to your local health service about when you are eligible.

Complications

If left untreated

• Cancer can grow through the bowel wall and spread to lymph nodes or other organs.
• A blocked bowel (bowel obstruction) can cause severe pain and requires emergency treatment.
• Untreated cancer can cause weight loss, anaemia, and severe tiredness.

Long-term outlook

If bowel cancer is found at an early stage, treatment is successful for most people. That is the whole point of screening. Even if cancer is diagnosed later, treatments have improved greatly. Don’t postpone screening – early detection truly saves lives.

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