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Bowel screening saves lives
Up to 75 percent of bowel cancers can be prevented by a sensible diet, says the Cancer Council - if you reduce your fat intake,[link widoczny dla zalogowanych], and eat plenty of fruit, vegetables and wholegrain cereals.
But despite a good diet, you may not be immune. Unfortunately, it's common the second most typical cause of death from cancer, after cancer of the lung. Your odds of getting bowel cancer in Australia are about one in 18 for males, and something in 26 for women.
It's really a particularly nasty cancer,[link widoczny dla zalogowanych], because of its location stashed, within the large bowel inside the abdomen, often not causing symptoms or diagnosed until it's grown and spread. If it's discovered and treated early enough,[link widoczny dla zalogowanych], solution minute rates are 90 per cent. Unfortunately, less than 40 per cent of bowel cancers are detected early.
That's why you need to for individuals to be screened for bowel cancer. Screening is really a method of identifying people with cancer at an early stage, when treatment is most likely to be successful. However when it comes to screening for bowel cancer the experts are still trying to work out exactly what the best approach is.
People at risk
Right now the best test we now have is colonoscopy. This is the insertion of a thin flexible tube having a camera about the end in to the bowel via the anus, so the bowel could be visualised and any cancer or precancerous conditions could be identified. It's not painful,[link widoczny dla zalogowanych], but isn't pleasant either. As well as in an extremely small area of cases, there are serious complications such as perforation of or haemorrhage from the bowel.
For individuals at risk of bowel cancer, the benefit outweighs the risks of these complacations and they should have the procedure. At what age and how often? Experts argue about this,[link widoczny dla zalogowanych], but most agree people who are over 50 and also have one or more relatives father, mother,[link widoczny dla zalogowanych], sister or brother with bowel cancer must have it every 5 years.
Over the past few years another kind of screening test is becoming obtainable in private radiology clinics,[link widoczny dla zalogowanych], known as a virtual colonoscopy. It requires a number of X-rays from the body at different depths and angles, and utilizes a computer to compile these into a three-dimensional image. However, it's not very sensitive test and can miss small tumours and polyps which are benign but may turn into cancers. In other cases it mistakenly shows suspicious areas that turn out to be benign although not before you have had to have a colonoscopy to locate this out. So most experts don't recommend it as being a screening test at least before technologies improve.
People not in danger
It's believed that the drawbacks of colonoscopy complications, costs and so on means the danger outweighs the advantages in individuals who aren't at high risk of bowel cancer.
But there is a another simpler and cheaper type of screening test these people can have and that is a faecal occult blood test (or FOBT).
It's a laboratory test that appears in a samples of an individual's faeces (poo), testing it for microscopic amounts of blood. This sometimes indicates that a cancer somewhere in the bowel is bleeding slowly in to the bowel passage and the blood has been expelled within the faeces.
The exam has its drawbacks; it isn't an especially accurate (blood in the bowel in most cases turns out to be for many other reason than cancer, but the person needs to go on and have a colonoscopy). And several cancers don't bleed, therefore the test may miss a cancer that is there.
But while it's not perfect, studies have consistently demonstrated screening for bowel cancer using the FOBT reduces mortality from bowel cancer by as much as 30 per cent.
There are two kinds of FOBTs. One is called a Haemoccult test, which detects the by-products of haemoglobin,[link widoczny dla zalogowanych], a compound in blood. But it will even get haemoglobin derivates in faeces from meat along with other chemicals,[link widoczny dla zalogowanych], so you have to have been in a unique diet for three days prior to the test.
The other test involves using proteins called antibodies to detect a persons haemoglobin. It doesn't need you to be on a diet and it is easier to do - you'll need only two samples rather than three as with the Haemoccult test. It isn't included in Medicare (unlike the Haemoccult), but it's cheap - about $30.
The only real trials of FOBTs to date have been receiving the Haemoccult test, but in fact experts think the antibody test is much more sensitive and can give better results. A large trial happens to be underway around australia called the Bowel Cancer Screening Pilot Program to trial the antibody test to determine whether or not this ought to be recommended for everybody using a National Screening Program and subsidised.
How frequently should you have an FOBT? The National Health and Medical Research Council (NHMRC) says when you're older than 50, you ought to have one or any other from the FOBT at least every two years. For any full listing of the NHMRC's screening recommendations,[link widoczny dla zalogowanych], follow the link below.
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