Bowel cancer

Bowel cancer is a general term for cancer that begins in the large bowel. Depending on where the cancer starts, bowel cancer is sometimes called colon or rectal cancer.

Bowel cancer is one of the most common types of cancer diagnosed in the UK. Most people diagnosed with it are over the age of 60.

Symptoms of bowel cancer

The three main symptoms of bowel cancer are:

• persistent blood in the stools – that occurs for no obvious reason or is associated with a change in bowel habit
• a persistent change in your bowel habit – which usually means going more often, with looser stools
• persistent lower abdominal (tummy) pain, bloating or discomfort – that's always caused by eating and may be associated with loss of appetite or significant unintentional weight loss

Most people with these symptoms do not have bowel cancer. Other health problems can cause similar symptoms. For example:

• blood in the stools when associated with pain or soreness is more often caused by piles (haemorrhoids)
• a change in bowel habit or abdominal pain is usually the result of something you've eaten
• a change in bowel habit to going less often, with harder stools, is not usually caused by any serious condition – it may be worth trying laxatives before seeing your GP

These symptoms should be taken more seriously as you get older and when they persist despite simple treatments.

Read about the symptoms of bowel cancer.

When to seek medical advice

If you have one or more of the symptoms of bowel cancer and they have persisted for more than four weeks, see your GP.

Your doctor may decide to:

• carry out a simple examination of your tummy and bottom to make sure you have no lumps
• arrange for a simple blood test to check for iron deficiency anaemia – this can indicate whether there's any bleeding from your bowel that you haven't been aware of
• arrange for you to have a simple test in hospital to make sure there's no serious cause of your symptoms

Make sure you see your doctor if your symptoms persist or keep coming back after stopping treatment, regardless of their severity or your age. You'll probably be referred to hospital.

Read about diagnosing bowel cancer.

Causes of bowel cancer

It's not known exactly what causes bowel cancer, but there are a number of things that can increase your risk.

These include:

• age – almost 9 in 10 cases of bowel cancer occur in people aged 60 or over
• diet – a diet high in red or processed meats and low in fibre can increase your risk
• weight – bowel cancer is more common in people who are overweight or obese
• exercise – being inactive increases your risk of getting bowel cancer
• alcohol and smoking – a high alcohol intake and smoking may increase your chances of getting bowel cancer
• family history – having a close relative (mother or father, brother or sister) who developed bowel cancer under the age of 50 puts you at a greater lifetime risk of developing the condition; screening is offered to people in this situation, and you should discuss this with your GP

Some people also have an increased risk of bowel cancer because they have another condition, such as extensive ulcerative colitis or Crohn's disease in the colon for more than 10 years.

Although there are some risks you can't change, such as your family history or your age, there are several ways you can lower your chances of developing the condition.

Read about:

Red meat and bowel cancer risk

Eating good food and a healthy diet

Losing weight

Health and fitness

Stopping smoking

Tips on cutting down on alcohol

Read more about the causes of bowel cancer.

Bowel cancer screening

To detect cases of bowel cancer sooner, the NHS offers two types of bowel cancer screening to adults registered with a GP in England:

• All men and women aged 60 to 74 are invited to carry out a faecal occult blood (FOB) test. Every two years, they're sent a home test kit, which is used to collect a stool sample. If you're 75 or over, you can ask for this test by calling the freephone helpline on 0800 707 60 60.
• An additional one-off test called bowel scope screening is gradually being introduced in England. This is offered to men and women at the age of 55. It involves a doctor or nurse using a thin, flexible instrument to look inside the lower part of the bowel.

Taking part in bowel cancer screening reduces your chances of dying from bowel cancer. Removing any polyps found in bowel scope screening can prevent cancer.

However, all screening involves a balance of potential harms, as well as benefits. It's up to you to decide if you want to have it.

To help you decide, read our pages on bowel cancer screening, which explain what the two tests involve, what the different possible results mean, and the potential risks for you to weigh up.

Read more about screening for bowel cancer.

Treatment for bowel cancer

Bowel cancer can be treated using a combination of different treatments, depending on where the cancer is in your bowel and how far it has spread.

The main treatments are:

• surgery – the cancerous section of bowel is removed; it's the most effective way of curing bowel cancer and in many cases is all you need
• chemotherapy – where medication is used to kill cancer cells 
• radiotherapy – where radiation is used to kill cancer cells
• biological treatments – a newer type of medication that increases the effectiveness of chemotherapy and prevents the cancer spreading

As with most types of cancer, the chance of a complete cure depends on how far it has advanced by the time it's diagnosed. If the cancer is confined to the bowel, surgery is usually able to completely remove it.

Keyhole or robotic surgery is being used more often, which allows surgery to be performed with less pain and a quicker recovery.

Read more about how bowel cancer is treated.

Living with bowel cancer

Bowel cancer can affect your daily life in different ways, depending on what stage it's at and the treatment you're having.

How people cope with their diagnosis and treatment varies from person to person. There are several forms of support available if you need it:

• talk to your friends and family – they can be a powerful support system
• communicate with other people in the same situation – for example, through bowel cancer support groups
• find out as much as possible about your condition
• don't try to do too much or overexert yourself
• make time for yourself

You may also want advice on recovering from surgery, including diet and living with a stoma, and any financial concerns you have.

If you're told there's nothing more that can be done to treat your bowel cancer, there's still support available from your GP. This is known as palliative care.

Read about living with bowel cancer.