Bowel Cancer Screening involves a test for bowel cancer in people who do not have any obvious symptoms of the disease. The aim is to find any polyps or to find cancer early when they are easier to treat and cure.
Bowel cancer can develop without any early warning signs. The cancer can grow on the inside wall of the bowel for several years before spreading to other parts of the body. Often very small amount of blood leak from these growth and pass into the bowel motion before any symptoms are noticed.
A bowel cancer screening test called a Faecal Occult Blood Test (FOBT) can detect these small amounts of blood in your bowel motion. The FOBT looks for blood in your bowel motion, but not for bowel cancer itself.
The FOBT is a simple bowel cancer screening test that you can do at home. It involves placing small samples of stool on special cards and sending them to a pathology laboratory for analysis. The results are then sent back to you and your doctor.
Faecal Occult Blood Test (FOBT) kit to check for blood in stool.
Image courtesy of the National Cancer Institute.
Your FOBT result is negative if no blood is found in your samples and it is recommended that you repeat a FOBT every 1 to 2 years. However, this does not mean that you do not have, or can never develop, bowel cancer, since some bowel cancers do not bleed or only bleed on and off.
In between times, if you develop any symptoms of bowel cancer, see your doctor immediately.
Your FOBT result is positive if blood is present in your samples. If blood is detected, you should contact your doctor immediately to discuss the result. The presence of blood may be due to conditions other than cancer, such as polyps, haemorrhoids, or inflammation of the bowel, but the cause of bleeding needs to be investigated.
There are currently two types of FOBT available. One type, called guaiac FOBT, uses the chemical guaiac to detect heme in the stool. Heme is the iron-containing component of the blood protein haemoglobin.
The other type of FOBT, called immunochemical FOBT, uses antibodies to detect human haemoglobin protein in the stool.
Studies have shown that FOBT, when performed at least every 2 years in people aged 50 and over, can reduce your risk of dying from bowel cancer by 15 to 33 percent.
The immunochemical FOBT has been selected as the preferred testing method for BowelScreen Australia™, in contrast to the guaiac FOBT, as it has no restrictions on diet or medication.
We encourage all Australians who are aged 50 and over, who do not have symptoms
or a family history of bowel cancer, to undertake bowel cancer screening.
BowelScreen Australia™ is an awareness, education and screening program for the Australian community using a clinically proven, sensitive and reliable faecal immunochemical test (FIT).
- aged 50 years and over;
- with no bowel cancer symptoms; and
- no personal/family history of bowel cancer or polyps.
or purchase a test online or by calling 1800 555 494.
We encourage Australians to participate in appropriate screening for bowel cancer. The pathway below sets out your bowel cancer screening options.
Most people who develop bowel cancer have no family history of bowel cancer. However, people with a history of bowel cancer or in one or more first degree relatives (parents, siblings, children) are at an increased risk.
This risk is increased even further in people with a history of bowel cancer in:
- one or more first degree relatives (parents, siblings, children) younger than age 55
- two or more first degree relatives (parents, siblings, children) at any age
Do you know if anyone in your family has had bowel cancer?
Talk to your family and make sure you all know your family history.
In addition to families where bowel cancer “runs in the family”, there are also people who have an inherited, genetic susceptibility to bowel cancer. The two most common inherited syndromes linked with bowel cancers are:
Familial adenomatous polyposis (FAP)
FAP is an inherited condition which affects the large bowel. It is a serious condition unless it is detected early when it can be treated. People with FAP develop hundreds of polyps (which are like small cherries on stalks) inside their large bowel. There are different types of polyps but these particular polyps are called adenomas, which in time, will almost certainly turn into cancer (usually by the age of 50). This is why it is so important to make sure anyone at risk of inheriting FAP is examined by a specialist. Appropriate treatment can be undertaken early as a preventative measure before bowel cancer can develop.
Hereditary non-polyposis colorectal cancer (HNPCC)
HNPCC (also known as Lynch syndrome) pre-disposes people due to a mutation in certain genes, to bowel cancer as well as a number of other cancers.
Each person inherits genes from both their parents. HNPCC is caused by a fault in one of the genes known as the ‘mismatch repair’ genes. Someone who inherits HNPCC from their parents has a normal gene and a ‘faulty’ gene, which increases their risk of developing bowel cancer and other types of cancer.
HNPCC accounts for 1-5% of bowel cancers and the criteria for identifying families at risk of having HNPCC are:
- Three or more relatives with confirmed bowel or other HNPCC related cancer (endometrial, ovarian, some urinary), one being a first degree relative (parent, child or sibling) of the other two.
- At least two consecutive generations affected.
- At least one bowel or related cancer diagnosed before the age of 50.
Think you have a strong family history of bowel cancer?
If you think that you have a strong family history of bowel cancer, you should make an appointment with your doctor to talk about your concerns. If your doctor agrees with you, they will refer you to a specialist genetics service. The genetic specialist will go through your family history with you in great detail and ask you to provide accurate information about who has been affected, how old they were when they were diagnosed, and the site where their cancer developed. You may also have to have blood tests as part of this investigation.
If the genetic specialist agrees you are at increased risk, you will be referred to a bowel specialist to talk about what types of screening and/or surveillance they would recommend, at what age you (and/or other family members) should commence screening and/or surveillance and how often. Regular screening and/or surveillance will ensure that any signs of bowel cancer are picked at the earliest possible stage.
The National Bowel Cancer Screening Program is being phased in over a number of years by the Australian Government.
Free bowel cancer screening tests are being offered to Australians turning 50, 55, 60 or 65.
People eligible to participate in the Program will receive an invitation through the mail to complete a simple test called a Faecal Occult Blood Test (FOBT) in the privacy of their home and mail it to a laboratory for analysis.
The immunochemical FOBT has been selected as the preferred testing method for the National Bowel Cancer Screening Program, in contrast to the guaiac FOBT, as it has no restrictions on diet or medication. The type of immunochemical FOBT being used in the Program is called Detect™ (Siemens Medical), but is not available for purchase by the public.
The test looks for blood in bowel motions, which may be a sign of bowel cancer.
These bowel cancer screening tests have been shown in overseas clinical trials and in the Bowel Cancer Screening Pilot Program to be simple to use and highly effective.
Participants with a positive FOBT will be advised to discuss the result with their doctor, who will generally refer them for further investigations, usually a colonoscopy.
Please see below, as you may be eligible to participate in the Program and receive a free bowel cancer screening test kit.
- If you are turning 50, 55 or 65 between January 2011 and December 2014 (or turning 60 between January 2013 and December 2014), you are eligible to receive a free bowel cancer screening test kit from the Australian Government’s National Bowel Cancer Screening Program. The test should arrive in the mail around the time of your birthday. If not, contact the Program on 1800 118 868.
- If you are not yet eligible to receive a free bowel cancer screening test, see above about how to obtain a BowelScreen Australia™ test kit.