Bowel cancer affecting more and more Australians

By Dr. Ananya Mandal, MDJun 6 2010

Dr Ananya Mandal, MD

Bowel cancer or colon cancer was till now considered a disease that affected elderly men. Recent trends however show that it is affecting more and more Australians in a younger age group. Some are presenting with this disease even in their 20’s and 30’s. At present bowel cancer ranks as the top most internal cancer affecting Australians of both sexes killing 4,500 people each year. A little fewer than 13,000 bowel cancers are detected each year. Similar trends among younger people is seen in America too says bowel surgeon Professor Graeme Newstead. “The figures now show that the age of onset of bowel cancer is no longer thought to be in the 60s, 70s and 80s as traditionally taught, but in the 30s 40s and certainly the 50s,” he explained. This week is national Bowel Cancer Awareness Week.

Screening

One of the best methods to curb the death toll is early detection of the cancer. Earlier routine tests for all after the age of 50 were recommended. According to Professor Newstead tests need to begin earlier. He explained the tests and their significance saying, “In a perfect world everybody would have a colonoscopy - that is a telescope around the bowel to look for polyps to remove them…And at age 40 it would be therefore important to talk to your GP about the options for screening and considering commencing that screening at age 40 rather than at age 50.” Since provision of colonoscopy is expensive when applied to all people over 40, a simple test of the feces for appearance of blood could be enough. If any abnormality is detected the person can be asked to get themselves a colonoscopy. The Cancer Council also emphasized on early diagnosis of bowel cancer. Its director of education and research, Terry Slevin feels that the present policy of screening only those over 50 or 55 or 65 needs to be amended. He suggested that each individual needs to be checked two yearly after 50.

The Federal Government has a national bowel cancer screening program in place. The funding for the program expires next year and The Bowel Cancer Foundation is urging the government to continue its support in light of the present trends.

Surgery

Bowel surgery traditionally has been a major surgery where a large part of the abdomen needed to be opened up. Now many Australians will be offered minimally invasive latest keyhole operations or laparoscopic operations for bowel surgery. This surgery will have an approximate 4 centimeter cut compared to the 30 centimeter cut with the traditional method. Dr Andrew Stevenson, from the Sydney-based GI Cancer Institute said that in their observation of a large number of keyhole surgeries, results have been encouraging with faster and event free recovery. The risk of organ and nerve damage during surgery was also less. He said that new trial with the latest technique is going on in NSW and further financial aid from the Federal government could aid spreading it in other states. “The latest keyhole surgery techniques may offer a better chance of survival, with far fewer risks than existing surgery for bowel cancer,” Dr Stevenson said. The Cancer Council welcomed this development but said early detection provided better chance for survival and screening programs can help on that account.