Bowel Cancer Screening

The National Bowel Cancer Screening Program (NBCSP) uses a test (FOBT) to detect microscopic amounts of blood in the stool. The National Bowel Cancer Screening Program test kit from the Australian Government's Department of Health is simple, free and can be done in the privacy of your own home. The bowel screening program requires you to collect 2 tiny poo samples using the home test kit and mail them to the laboratory for testing. If you have trouble conducting this test, the test kit helpline is available. The bowel cancer screening test is mailed out to Australians when they turn 50 and has proven to reduce the amount of fatal bowel cancer cases in Australia and save countless lives as positive test results prompt individuals to grow concerned about their bowel health.

Bowel cancers have a variety of subtle and obvious symptoms that cause the body to shut down. A bowel cancer screening test should provide information about whether possible symptoms are dangerous in nature. You should have a screening test if you experience:

• unusual bowel motion like diarrhoea, constipation or the feeling of incomplete emptying
• inconsistent bowel movements such as thin stools
• traces of blood in the stools
• abdominal pain, bloating or cramping
• pain or lumps in the anus or rectum
• unexplained weight loss
• fatigue, tiredness and/or anaemia
• traces of blood in the urine or passing urine frequently

Family History of Bowel Cancer

One major cause of bowel cancer is its hereditary nature. If your family has a history of bowel-related illnesses you have a higher genetic risk of bowel cancer. It becomes more important for these people to take notice of their bowel habits more frequently.

Other Diseases That Can Be Detected

Discomforting, inflammatory bowel diseases like Crohn’s disease and ulcerative colitis (UC) can also be detected with a screening test by identifying blood in your stool. Understanding the signs of these illnesses can give an indication of the need to seek medical services.

If you have a positive test result your next step should be to have a blood test and colonoscopy. Contact the Centre for Gastrointestinal Health for more information and to make an appointment. If you have a negative test result, which means no blood has been detected in the samples you provided, this does not mean you do not or will not develop bowel cancer. It is recommended you remain vigilant and monitor for any symptoms of bowel cancer, and repeat the screening test in two years time. While colonoscopy is effective in reducing deaths from bowel cancer there have been limitations to its effectiveness. There has been increasing awareness of the potential for "missed lesions" but there have also been significant developments to help reduce this risk. These developments include improved preparation of the colon, use of high definition wide-angle colonoscopes and video equipment carbon dioxide insufflation of the colon, retroflexion of the endoscope to look behind folds as well as the assessment of withdrawal time and adenoma detection rates by the endoscopist. These advancements in technology will assist in reducing the amount of bowel cancer-related deaths, however, the message here should be that early intervention provides higher chances of survival.

Dr Yoganathan has incorporated all these developments into the practice of colonoscopy. All Australians at the age of 40 years should talk to their doctor about the screening options and services to prevent bowel cancer. The majority of bowel cancer (possibly up to 99%) begins in a polyp, which is a benign growth in the colon. The growth advances in between 5-7 years which gives a potential window of opportunity for removal to prevent cancer while it is still curable. Every year the chance of contracting bowel cancer increases so ensure that you are noting any changes in bowel motions. This is why testing and screening frequently is of the utmost importance.

• An “average risk” individual is recommended to have a FOBT every 2 years and should commence at the age of 50.
• Research shows that the risk of developing bowel cancer rises significantly from the age of 50.
• If you are at increased risk of developing bowel cancer, you should discuss screening options with your doctor.
• Bowel cancer has an excellent prognosis if detected in its early stages. This makes it one of the most effective screening tests available.
• If you require a replacement kit, contact your GP or visit the National Cancer Screening Register website.