When should you be screened for gastrointestinal cancer?

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The gut cancers are quite high on the incidence list. It’s actually quite prevalent. If we talk about bowel cancer, it’s the second biggest killer in the UK. And this really is a preventable disease. Bowel cancer tends to grow from very small polyps over a long period of time.

Screening means that you’re evaluated for bowel cancer when you have no symptoms and the rationale behind that is if we can pick up cancers early, they are far more treatable and in fact can be curable. Currently, we’re lucky in the NHS in the UK, we have two kinds of screening methods.

There’s the bowel cancer screening programme, which starts at the age of 60 and you’re sent out a kit every two years to look for blood in the stools. This kit is becoming far more sensitive.

There’s a kit called FIT now, which increases the sensitivity by only detecting human haemoglobin. So, there’s no dietary restrictions required. Also introduced is the one-off bowel scope screening, which is at the age of 55. Everyone’s offered a flexible sigmoidoscopy, which is a camera test to look at the left side of the bowel, and this has been shown to reduce the mortality from colorectal cancer by 30%.

When should you be screened for gastrointestinal cancer
When should you be screened for gastrointestinal cancer

We are lucky if we think about an ideal world, perhaps the best test one could do is a colonoscopy which is entire examination of the bowel from the age of 45. We’re finding that there are some younger people now being affected with bowel cancer. So it’s really important that if you have bleeding or pain that goes on for more than a couple of weeks, you should see your doctor because there’s been a great increase of the number of younger people with bowel cancer who are not eligible for screening. So, staying vigilant about your bowel health is really important.

There’s one other cohort of people called Lynch syndrome, which is a genetic inherited propensity to develop many cancers, including bowel cancer, stomach, ovarian, and breast.

We’re not diagnosing these people very well. We’re only picking up a small percentage of them and it is thought to affect about one in 350 people. If you feel that you have quite a significant family history not only of bowel cancer, but of other cancers also, it’s worth bringing up with your doctor, as this may need further screening options.

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