Bowel cancer

Also called Colorectal cancer, Colon cancer, Rectal cancer

The fourth most common cancer in the UK, and one of the most survivable when caught early. The screening kit is the whole point.

What it is

Around 44,000 people are diagnosed with bowel cancer in the UK each year. Caught at the earliest stage, more than nine in ten people survive five years. Caught at the latest, around one in ten does.

That gap is the largest of almost any cancer, and it is why the NHS bowel cancer screening kit matters more than any advice in this entry. It is a home test, it takes minutes, and uptake is well short of where it should be.

The programme is being extended down to age 50 across England, and the kit arrives by post.

Cases in younger adults have been rising, so symptoms in somebody under 50 should never be dismissed on grounds of age.

Signs you might notice

A change in bowel habit lasting three weeks or more: looser stools, going more often, or constipation.

Blood in the stool, or bleeding from the bottom.

Abdominal pain, bloating, or a lump.

Unexplained weight loss.

Tiredness and breathlessness from iron deficiency anaemia, which is often the first sign in men and in women past the menopause.

Unexplained iron deficiency in those groups always needs the bowel investigated.

How it can affect day-to-day life

Embarrassment is the barrier. People delay presenting with rectal bleeding for months, and the delay is measured in survival.

The screening kit gets put in a drawer. A phone reminder, or somebody sitting with the person while they do it, changes completion rates.

In care settings, blood in the stool gets recorded and not escalated, and a change in bowel habit gets attributed to diet or medication.

Supporting someone well

Do the screening kit when it arrives. Same day. This is the single most useful sentence in this entry.

Support people to complete it: read the instructions with them, and do not treat it as a private matter to be left to them if they need help.

Escalate blood in the stool and any persistent change in bowel habit rather than monitoring it.

Investigate unexplained iron deficiency properly.

For anyone with a learning disability, screening uptake is much lower and reasonable adjustments and support to complete the kit are required, not optional.

Where to get help

See a GP for any of the symptoms above, and ask about the two-week wait pathway.

Bowel Cancer UK run an ask-the-nurse service and campaign on screening age.

The NHS screening helpline can send a replacement kit.