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Why are there frequently delays in diagnosing Bowel Cancer?

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    A bowel cancer charity recently reported that over 3,000 lives each year could be saved if those suffering from bowel cancer were diagnosed and treated early enough. This blog considers potential reasons why bowel cancer in particular is frequently diagnosed later and how such delays could be limited.

    By Rebecca Callard

What is bowel cancer and how does it develop?

Cancer develops as a result of abnormal cells and the way in which they reproduce.  Bowel cancer affects the large bowel (colon) and rectum, and can develop from small benign growths which can appear in the bowel.  If it is left undetected it can spread to other parts of the body.

There are some things that we can do to control exposure to the risks of getting bowel cancer, and some things that we cannot change.  Not getting enough exercise, having a poor diet, smoking and generally having a high alcohol intake are all reported to potentially increase the risk of developing bowel cancer.  Pre-existing medical history, pre-existing family history and age can also all increase our risks of getting bowel cancer, although these things cannot be controlled by us.

Why are there delays in diagnosing bowel cancer?

This is an interesting question and there is probably not just one answer:

Patients not taking up screening opportunities:

According to a leading bowel cancer charity, more than 7 out of 10 people diagnosed with bowel cancer in the UK are aged 65 and over.  There is a bowel-cancer screening program in England which is aimed at regularly screening everyone aged 60 and over for bowel cancer.  However, a recent study has shown that part of the problem in allowing cancer to go undiagnosed is that not everybody eligible for the screening program are putting themselves forward for regular checks.  The report shows that only around 60% of those eligible between 60-74 years of age were taking up the screening program.

Long waiting times for investigations:

In addition to this however another bowel cancer charity recently stated that the waiting times for bowel cancer testing in Wales alone were poor, with 15% of patients waiting 8-14 weeks for investigative treatment, and 26% of patients waiting more than 4 weeks following a referral by their GP.  The NHS Guidelines for referring patients with suspected bowel cancer are just 6 weeks.  In my opinion, if people are waiting significant lengths of time for their referral appointments, this is going to potentially affect any treatment that may be available and therefore long-term prognosis.

Patients not recognising symptoms and seeking medical advice:

If patients are not seeking the advice of their GPs when symptoms initially arise this could also affect the long-term prognosis for them.

Medical negligence:

Unfortunately I have also had experience of acting for patients who, despite seeking advice from their GP at an early stage, suffered as their GP then negligently failed to refer them for further investigations.  In other cases clients have been referred for investigations which have been inadequately performed or interpreted.  Such negligence can also lead to delays in diagnosis and treatment and a worse outcome.

What symptoms should we be looking for?

Symptoms for any type of illness can differ from person to person, but the main symptoms that we should be looking out for, according to the charity Beating Bowel Cancer, are:

• Bleeding from the bottom;
• Any change in bowel habits lasting more than 3 weeks;
• Any abdominal pain;
• A lump in the stomach area;
• Any weight loss and tiredness.

What treatment can you receive for bowel cancer?

It is evident that early detection of bowel cancer is vital to ensure the appropriate treatment can be provided.  If the cancer is diagnosed at the earliest possible opportunity then it is reported that there is a 97% chance of survival.  In most cases, bowel cancer can be successfully treated if diagnosed early.

Treatment for bowel cancer consists usually of surgery, chemotherapy or specialist radiotherapy, and the treatment that is given to each patient depends on the stage and location of the cancer.

What more can be done to prevent delays?

It seems as though the responsibility for improving delays in diagnosing bowel cancer rests not only with the NHS but us as patients.  I believe that there most definitely need to be improvements made in the screening process of patients with suspected bowel cancer, and in ensuring that GPs refer patients for further investigations appropriately to avoid delay.  However, those with symptoms relating to bowel cancer need to ensure that they are also seeking the advice from their GPs as soon as they need it.

In my opinion, further improvements are needed to raise greater awareness of signs and symptoms of bowel cancer both for doctors and patients to try and limit these delays occurring.

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