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National Bowel Cancer Screening Program

All of us experience some sort of personal tragedy at various points in our lives, but as we get older, they become more frequent and more understandable, as most would accept that things “go wrong” when we get old. But it’s always shocking when people in their 20’s 30’s or even 40’s die, and it reminds us of just how precious life is. I vividly remember a dear friend of mine who lived in the UK, he went to his local GP whom he described as “a good bloke”, and mentioned that he’d noticed some blood in his stools when he went to the toilet. The GP noted it down and must have made some sort of examination before saying that it was probably bleeding piles because he was far too young for it to be anything serious.

Six months later and 12kilos lighter, my now jaundiced friend went back because he now knew that there was something seriously wrong, and he was right! He had advanced metastatic cancer of the bowel from which he died some three months later leaving a young wife and three small children. When his wife rang me in Australia with the terrible news, I was literally flattened when she related the story to me. This should never have happened, especially as my friend’s father had also died in his late 30’s from bowel cancer, and that surely should have sounded alarms loud and clear in any medical ears.

In this case I think that the GP in the UK erred because he missed something or failed to do something, but my friend would also have known that something was not right. Especially as his Dad had died from bowel cancer, and should have been more persistent and asked for a second opinion, which all of us are entitled to.

Bowel cancer is one of those cancers that when picked up early has an extremely good outcome, and we have excellent ways of screening those who are at higher risk and thus being able to find, and treat early cancers before they begin to spread.

Doctors know that certain people are at higher risk than others of developing bowel cancer and these include:

1. People with a parent, siblings or children who have had colon cancer.
2. Those who have previously had bowel cancer or a bowel polyp.
3. If there is a history of inflammatory bowel disease such as Crohn’s disease or Ulcerative Colitis.
4. Obesity is a risk factor, as is Diabetes, smoking, a sedentary lifestyle and a high intake of red or processed meat.

But in the vast majority of cases, bowel cancer is a disease of aging with greater than 90% of cases occurring in people over the age of 50yrs. That’s why there is a real need for effective screening tools for this preventable disease in the older population. Screening for any cancer should not stop us from being aware that, as many researchers believe, a lot of today’s cancers are lifestyle related and that the incidence of these cancers, including bowel cancer, could be significantly reduced if smoking stopped, obesity was better managed and that everyone was involved in daily physical activity. But until that happens, a national screening strategy seems to be a positive step in the right direction.

Between January 2008 and December 2010, 2.5million Australians turning 50, 55 or 65 years of age were invited to take part in screening for bowel cancer as a part of the National Bowel Cancer Screening Program, and the program is still ongoing. The screening test is simple and is one step along the way to diagnosing if someone has bowel cancer or not. The test, called a Faecal Occult Blood Test (FOBT), is designed to see if you have microscopic amounts of blood in your stool that might be associated with an early bowel cancer. If the test is positive, it does not mean you have cancer, but that there is an increased risk that there may be a cancer in your bowel. You will then be referred to a Specialist who will perform a Colonoscopy - a test that investigates the part of the bowel where these cancers are found - and this will determine whether the patient has bowel cancer or not.

The National Screening Program is not compulsory and you can decline to have the test, but currently the test is being offered to those who are turning 50, 55 or 65 this year with the results being sent to you and your GP. In an ideal world people over the age of 50 would be screened every 2 years, but the simple fact is that we don’t have the manpower to follow up abnormal results by specialists who can perform the colonoscopies that are essential for accurate diagnosis of bowel cancer. So my recommendation is that if you are one of the lucky ones who gets sent a FOBT pack, don’t miss this opportunity - it could literally save your life!

Article written by Dr. Duncan Jefferson. For more articles by Dr. Duncan, click here. For more information on healthcare and private health cover, visit HBF Insurance at www.hbf.com.au.

The content of these articles is not tailored for any particular individual's circumstances. The author does not take into account your physical condition, medical history or any medication you may be taking. Any advice or information provided by the author cannot replace the advice of your health care professional. The views expressed in this article are those of the author and do not represent those of HBF unless clearly indicated.