Bowel cancer screening and surveillance

What is bowel cancer?

Bowel cancer, also known as colorectal cancer, develops from the inner lining of the bowel and is usually preceded by growths called polyps, which may become invasive cancer if undetected. Depending on where the cancer begins, bowel cancer may be called colon or rectal cancer. 

Bowel cancer is the third most common cancer in both men and women in Australia  and is more common in people over the age of 50. About 90 per cent of bowel cancers are adenocarcinomas, which start in the glandular tissues lining the bowel. Other less common types of cancer can also affect the bowel, including lymphomas and neuroendocrine tumours

Cancer can also start in the small bowel but this is a rare cancer. It is estimated that 15,540 cases of bowel cancer will be diagnosed in Australia in 2021.

Bowel cancer symptoms

Note that in many cases, bowel cancer presents without obvious symptoms. It may be picked up incidentally, for example using the faecal occult blood test through the National Bowel Cancer Screening Program.

Symptoms of bowel cancer include:

  • change in bowel habit including diarrhoea, constipation or the feeling of incomplete emptying
  • a change in the appearance or consistency of bowel movements such as thin bowel stools
  • blood in the stools
  • abdominal pain, bloating or cramping
  • anal or rectal pain
  • a lump in the anus or rectum
  • weight loss
  • unexplained fatigue
  • tiredness and/or anaemia (pale complexion, weakness and breathlessness) 
  • blood in the urine or passing urine frequently or during the nightchange in urine colour – dark, rusty or brown.

How to investigate for bowel cancer

In patients who present with symptoms, such as those described above, the most appropriate approach is to proceed directly to colonoscopy, assuming the patient is suitable for a light anaesthetic. In those patients at “average risk” of colorectal cancer, a reasonable approach is to start off with a faecal occult blood test if in the appropriate age group (currently, aged 50 to 75, however professional societies in the United States in particular are advocating for the screening age to be dropped to 45).

In those with an increased risk of cancer, such as those with a significant family history of colorectal cancer, you may well be eligible for screening for colorectal cancer via colonoscopy. If in doubt, feel free to contact our practice on (03) 9887 2777 and our administrative staff will check with Dr Gupta and get back to you.

Note that this document is a guideline and individual treatment should be discussed with your clinician. This page is in the process of being updated.