Colorectal Cancer (CRC) is the cancer with the second highest incidence and is the second leading cause of cancer death in adults in Australia. There is a 1 in 11 and a 1 in 16 lifetime risk of being diagnosed with CRC in Australia for men and women respectively. CRC costs the Australian government $205 million a year in direct costs, the second highest cost from cancer, and over 92,000 Disability-Adjusted Life Years.
Despite its long natural history, taking between 5 and 10 years to develop into cancer from its benign precursors, CRC is often not diagnosed until a later stage. CRC is largely clinically asymptomatic in its early stages, demonstrating the need for a screening program to detect CRC while it is still at an early stage, and more easily treatable. CRC that is treated at a stage when it is confined to the bowel wall has a 5-year survival rate of 88%, compared to a 5-year survival rate of 7% when treated at a stage when the cancer has spread outside the colon. Overall, survival rates are slowly improving, with an increase in 5-year survival rates from 50% - 69% between 1984-1988 and 2009-2013, largely a result of better diagnosis and treatment programs.
When CRC is diagnosed, it is generally described using the 3 digit TNM system, which describes the tumour, nodes and metastasis. In each case, a number is allocated showing how advanced the cancer is. The T value, referring to the tumour size and the extent it has grown into nearbly organs, is between T1 (a smaller tumour) and T4 (a larger tumour, which has grown into another organ). The N value indicates whether the cancer has spread to nearby lymph nodes or not - N0 means the cancer has not spread at all, N1 means it has spread to 1-3 nodes, while N2, the highest rating, means that the cancer has spread into 4 or more nodes. The M value describes whether or not the cancer has metastasised, or spread to other tissues and/organs of the body, and is either M0 if it has not spread, or M1 if it has.
Research conducted by Cancer and Bowel Research Trust found that there is a significant discrepancy between the true incidence and prevalence of different types of cancer and the public's perception of the situation. The research also found that the types of cancer that the respondents knew most about, had benefited from public awareness campaigns for many years.
Cancer & Bowel Research Trust conducts awareness and prevention programs around Australia in order to reduce the incidence and mortality of bowel cancer. A large aspect of this program includes education on the facts, providing statistics, informing about the symptoms, including information on the types of check-ups, and outlining the prevention measures and procedures that a person may consider when undergoing bowel cancer treatment. Included in these programs are: internal research projects, bowel cancer awareness week, call centre, retail, and face to face promotion of bowel cancer prevention.
The lack of community awareness of bowel cancer was clearly identified in our 2003 report. In 2008 we undertook further research to determine if there were any increases in community awareness. A copy of the the latter report is available by clicking here.
Eating five or more portions a day, including two fruits and three vegetables, as well as regular servings of wholegrain cereal fibres and wheat bran are recommended as part of a healthy diet which may help prevent bowel cancer. Drinking two litres (about 8 glasses) of water also helps retain an active bowel that can effectively eliminate waste.
A 'healthy bowel' diet should include a range of low-fat, high fibre whole foods diet such as the cruciferous (leafy green) vegetables, including cabbage and broccoli, wholemeal and wholegrain products, and pulses. Calcium intake should be around 1000 to 1200mg per day for adults aged 30 and older. As a guide, one cup of skim milk provides just over 300mg of calcium. Reducing red meat, full-fat dairy products, sugar, salt, and spicy foods, controlling alcohol consumption, and avoiding becoming overweight are also recommended.
Studies have linked the consumption of charred meats with bowel cancer. Meats cooked at high temperatures undergo a chemical transformation which can create carcinogenic (cancer causing) compounds in the food. Red meats, poultry, and fish that are grilled/barbecued, broiled, or pan-fried for extended periods are the main contributors to this so it is recommended that eating charred meats be avoided.
Exercise is also considered a preventative measure that maintains a healthy bowel. A minimum of 30 minutes aerobic exercise three times a week is advised. Walking, hiking, swimming, cycling, yoga and going to the gym are highly recommended as low impact activities. Please consult a health care professional for advice on a regular updated training schedule that would suit you.Authorities recommend a digital rectal examination as part of a regular physical check-up regardless of whether or not symptoms are present, particularly if there is a family history of the disease. From age 40, a yearly faecal occult blood test is recommended. Bowel cancer-related bleeding may not be visible and this test enables doctors to determine conclusively if there is blood in the stool. From age 50, a sigmoidoscopy is recommended every 3 to 5 years.
An FOBT (faecal occult blood test) is a simple, do it yourself, test kit. It involves taking samples from 2 or 3 separate bowel motions (faeces) in the comfort of your home. Once these samples have been taken they are then sent to a laboratory for testing. An equivalent method is where 2 sepaerate brush samples are made of the stool and wiped onto a diagnosis envelope for you to then send to a laboratory for testing. General Practitioners can provide FOBTs with payment, pharmacies sell FOBTs, and some health insurance funds provide FOBTs to their clients.The FOBT analyst is looking for small traces of blood in the bowel motion. Blood can be an early sign of bowel cancer or a polyp, which is a growth on the inside of the bowel which can develop into cancer. If blood is found, further tests will be ordered to investigate the nature of the bleeding.
Persons who are over the age of 40 with a family history or people over the age of 50 without symptoms and with a family history of bowel cancer are encouraged to do an FOBT every 2 years.
From 2006, the Federal government has introduced a free bowel cancer screening program. By 2020, 2-yearly screening is offered to all Australians aged 50-74, who do not have symptoms. Those with symptoms will receive treatment directly from their GP/specialist. A free testing kit is posted to your home address, based on your Medicare or Department of Veteran's Affairs enrolment records. For more information, or if you have any questions about the program, please visit http://www.cancerscreening.gov.au/bowel or phone 1800 11 88 68.
For further information on bowel cancer please go to our 'frequently asked questions' section.
The 'embarrassment can kill' slogan is to provoke attention in regards to the benefits of early detection.
Throughout Queensland, Cancer & Bowel Research Trust regularly has information stalls set up in shopping centres, supermarkets and other retail outlets distributing information about cancer prevention. This also provides opportunity for our advocates to talk to members of the community on a face-to-face basis about preventative measures, educating the community of the benefits of early detection.
Cancer & Bowel Research Trust nationally approaches over 1 million people per annum. Our advocates promote discussion and provide information about cancer prevention, in particular the benefits of cancer preventative measures such as diet and exercise, and also the benefits of regular screening for early detection.