Clinical tips: Bowel cancer screening

toilet with raised seat,

So, when was the last time you checked your poo? Checking your poo – it probably is not a conversation many patients want to have with their pharmacists. But bowel cancer screening remains an important tool in cancer detection.

Having a bowel cancer screening test every one to two years after the age of 50 can save many lives. In 2012, bowel cancer was responsible for the second highest number of cancer related deaths after lung cancer.

Bowel cancer screening tests look for small amounts of blood in bowel movements.

Small samples of toilet water or stools are collected on a special test card that is sent away for analysis. These screening tests are commonly known as a Faecal Immunochemical Test, or an Immunochemical Faecal Occult Blood Test; and abnormal test results are usually followed up with a colonoscopy.

The risk of bowel cancer increases significantly after the age of 50, so the government funds a National Bowel Cancer Screening Program, with the aim of providing free screening tests to all Australians between the ages of 50 to 74 years by 2020.

However, with that statistic in mind, people should never be told they are too young to have bowel cancer. Other risk factors for bowel cancer include:

  • a significant family history of bowel cancer or polyps i.e. a direct relative having developed bowel cancer under the age of 55 years, or having more than one relative on the same side of the family having bowel cancer;
  • inflammatory bowel disease; and/or
  • previous adenomas in the bowel.

Bowel cancer is one of the most curable cancers, so early detection is key for reducing mortality and morbidity. However, bowel cancer can develop with little or no early warning symptoms, hence the importance of the screening test, and using the screening test properly according to the instructions.

Pharmacists are well placed to encourage patients to take up the free screening tests. For people who may benefit from the screening test but are not yet eligible for the free tests, the pharmacist can assist with providing information and perhaps assist with purchasing a test.

Where appropriate, pharmacists can also play an important role in encouraging patients to have conversations with their doctor to assess their risk, and plan for screening and other tests.

June is Bowel Cancer Awareness Month, so it is timely to start having conversations with patients about bowel cancer screening today.

by Dr Esther Lau and Professor Lisa Nissen, School of Clinical Sciences, Queensland University of Technology

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