New tool to increase early diagnosis of bowel cancer in younger patients

Around 3 in 5 people under 50 who are diagnosed with bowel cancer do not have their symptoms recognised until they reach later stages of the disease, significantly hampering their chances of survival.

The charity Bowel Cancer UK worked with a number of universities to devise the new risk assessment tool, published in the British Journal of General Practice, which predicts a patient’s risk and suggests when onward referral or testing may be appropriate.

What is bowel cancer?

Bowel cancer (also known as colorectal cancer or colon cancer) is a cancer that affects the colon and rectum.

Research suggests 95% of bowel cancer cases occur in people over 50 years old. However, more than 2,500 people under the age of 50 in the UK are diagnosed with the disease every year – a 45% rise since 2004 and it is recognised that this group are less likely to get appropriate help as quickly as they need it.

Whilst the NHS provides routine screening for people between 60 and 74 every 2 years, younger sufferers do not benefit from this. Sadly experts say when it comes to those under 50, patients do not act on their symptoms quickly enough to get the help they need.

The factors that can increase the risk of bowel cancer are:

• Aged over 50;
• A family history of bowel cancer;
• A history of non-cancerous growths (polyps) in your bowel;
• Longstanding inflammatory bowel disease such as Crohn’s disease;
• Type 2 diabetes;
• An unhealthy lifestyle.

Bowel cancer is usually treatable if caught early enough so it is imperative that all individuals are aware of the signs and symptoms of the disease.

What are the symptoms?

Symptoms for any type of illness differ for each individual, and medical advice should always be sought, but the key symptoms of bowel cancer are:

•  Rectal bleeding and/or blood found in stools;
• A change in bowel habit lasting for 3 weeks or more,
• Unexplained weight loss;
• Extreme tiredness for no obvious reason;
• A pain or lump in your tummy.

These symptoms can be associated with other health issues and therefore may not always be bowel cancer, but if you have any concerns at all then you should seek medical attention.

Routine screening

Bowel cancer screening can save lives. The purpose of the screening is to detect bowel cancer at an early stage, when treatment has the best chance of working.

Initially, bowel cancer screening consists of a home test, which is quick and easy to do and is offered to people over the age of 60 in England and Wales. This is sent in the post to be completed in the comfort of the patient’s own home.  The screening works by detecting traces of blood in faeces, which may be as a result of cancer.  If the test shows blood the faeces then you will be invited to attend your local screening centre to discuss having more tests.

New bowel cancer tool to boost diagnosis in under 50s

GPs have been given access to the new risk assessment tool to help diagnose younger people at risk of bowel cancer. Sadly it is widely acknowledged that people under 50 do not act on bowel cancer symptoms quickly enough to maximise their chances of treating the condition and, staggeringly, 20% have to visit a GP 5 times before being referred to an appropriate specialist which can significantly delay vital treatment.

The new tool will help to calculate the risk of the disease based on blood tests, symptoms and GP’s examinations. This is of course excellent news as it has the potential to help GPs to decide which of their younger patients need a referral for further tests.

The new risk assessment tool, which is based on research by Bowel Cancer Research, a number of universities and funded by the Department of Health, calculates the risk of a serious disease as a percentage figure:

• Those found to be at a 3% risk or more of bowel cancer should be referred for an urgent colonoscopy.
• Those between 1% and 3% will be recommended for a faecal calprotectin test, to help diagnose conditions like irritable bowel syndrome (IBS).
• Risk at 1% or less will require no further tests. This is of course excellent news as it has the potential to help GPs to decide which of their younger patients need a referral for further tests.

Our Experience

My colleagues and I are fully supportive of the Bowel Cancer Awareness Month, and hope that increased awareness will remind people of the need to seek medical involvement at an early stage, so they can get the testing and treatment they need.

Unfortunately, we are often involved acting for individuals where there has been a delay in the condition being diagnosed, or a delay in the appropriate treatment being given. These patients often require more extensive treatment by virtue of the delay, and will have a worse long term prognosis. This is why early diagnosis is so very important and why we are hoping to spread the word, as part of Bowel Awareness Month.