Information For Patients

What is bowel cancer?

Bowel cancer is also known as colon, rectal or colorectal cancer. It affects the lower part of the digestive system (gut). Bowel cancer is the second most common form of cancer among men and women in Ireland.

Bowel cancer in Ireland
In Ireland, bowel (or colon, rectal or colorectal) cancer is the second most common newly diagnosed cancer among men and women. Each year over 2,000 new cases of colorectal cancer are reported. The number of new cases is expected to increase significantly over the next 10 years, due mainly to an increasing and ageing population.

Bowel cancer is currently the second most common cause of cancer death in Ireland, and about 50 per cent of colorectal cancer patients die from the disease.

Screening aims to find bowel cancer at an early stage when it is easier to treat.

What are the symptoms of bowel cancer?
The most common symptoms of bowel cancer are:
• a change in your bowel habits such as going to the toilet more often or diarrhoea that lasts for a number of weeks
• bleeding from the back passage (also known as the rectum) for no obvious reason
• pain in your abdomen (tummy)
• a lump in your tummy
• loss of weight when you’re not trying to lose weight

A number of conditions can cause these symptoms. If you have one or more of these symptoms for four weeks or more, or you are worried about your bowel health you should see your GP (family doctor) immediately.

Risk of bowel cancer
The risk of bowel cancer increases with age. All men and women aged 60 to 69 living in Ireland should be screened. The new programme, BowelScreen will offer free bowel screening every two years to men and women aged 60 to 69 as this age group has the highest incidence of cancer within the wider age range. Over time the programme will be offered to all people aged 55 to 74.

Good bowel health

Looking after your bowel health is important and the following tips are recommended:

• Be more physically active
• Eat a diet with plenty of dietary fibre such as fruit, vegetables and wholegrain bread, brown rice and cereals
• Reduce intake of processed and red meat
• Keep a healthy weight
• Limit the amount of alcohol you take
• When rolled out, take part in the BowelScreen programme every two years

Colorectal screening
The primary objective of colorectal cancer screening is to detect pre-cancerous adenomas in the lining of the bowel, thereby making colorectal cancer screening a truly preventative health measure.

This has the effect of potentially reducing the burden of treatment on both the individual and the health system. It reduces the stress, disruption and anguish that cancer diagnoses and subsequent treatment can bring to the individual, their family and community.

About the BowelScreen programme
The primary goal of BowelScreen – the national bowel screening programme, run by the National Cancer Screening Service (NCSS), is to reduce mortality from colorectal cancer in men and women aged 55-74 in Ireland.

The BowelScreen colorectal screening programme will offer free screening to men and women aged 55-74 on a two-yearly cycle. To develop capacity for the full population, the programme will be implemented on a phased basis, starting with men and women aged 60-69. This age group has the highest incidence of cancer within the wider age range. The maximum benefit in terms of reduction in mortality and cost-effectiveness will occur when the programme targets the full 55-74 age population.

Eligible men and women who indicate they wish to take part in the screening programme will be sent a screening test kit called a faecal immunochemical test (FIT). The test looks for the presence of blood, that is not visible to the eye, in the bowel motion.

The simple and easy-to-use test kit will include step-by-step instructions for self-administration of the test at home. The completed test can then be sent by Freepost to an accredited laboratory for analysis.

Approximately 94 per cent of people will receive a normal test result and will be sent another home test kit in two years’ time while they remain within the eligible age range.
Five to six per cent of people will receive a not normal result following the home test kit and will require an additional test.

They will be offered a screening colonoscopy (an investigation of the lining of the bowel) at a hospital-based screening colonoscopy unit contracted by the NCSS to provide this service.
Each person will be contacted by a nurse, who will assess the person’s suitability for colonoscopy and then guide them through the colonoscopy process. In the event that further treatment or surgery is required, defined pathways have been developed in conjunction with the National Cancer Control Programme (NCCP).

The first round of BowelScreen
BowelScreen has begun its first round of screening. The programme is being implemented on a phased basis, starting with offering free screening nationally to men and women aged 60-69 on a two-yearly cycle. As this is the first time the programme is being introduced, it will take up to three years for all eligible people to be invited. The programme will be expanded over time until the full 55-74 age group is reached.

The purpose of the screening programme is to identify the population most at risk of colorectal cancer and most likely to benefit from early detection and treatment. The maximum benefit in terms of reduction in mortality and cost-effectiveness will occur when the programme targets the full 55-74 age population.

An organised population-based screening for colorectal cancer is a complex and layered process. This programme is based on international evidence.

The programme is being introduced on a call, re-call basis. The current initial round of screening involves a number of steps including the identification of the target population, recruitment of the target population into the programme by a proactive call, delivery of a suitable screening test, analysis of the screening test, the re-call of people whose initial screening test indicates an abnormality and the provision of diagnosis and referral for treatment where required. A Freephone information line, materials and a comprehensive website support clients of the screening programme.

Changes in your bowel can happen at any stage, so it’s important that you stay aware of your bowel health.

Source: www.bowelscreen.ie