Bowel Cancer Prevention and Screening. Harriet Wynne, Cancer Council Victoria

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1 Bowel Cancer Prevention and Screening Harriet Wynne, Cancer Council Victoria

2 New cases and deaths for the Victoria population in 2013 Thursfield V, et al. Cancer in Victoria: Statistics & trends Cancer Council Victoria, Melbourne 2014

3 New cases and deaths in 2013 for the leading cancers in Victorian men Thursfield V, et al. Cancer in Victoria: Statistics & trends Cancer Council Victoria, Melbourne 2014

4 New cases and deaths in 2013 for the leading cancers in Victorian women Thursfield V, et al. Cancer in Victoria: Statistics & trends Cancer Council Victoria, Melbourne 2014

5 Bowel Cancer in Australia Australia has one of the highest rates of bowel cancer in the world It is the second most common cause of cancer-related death in Australia (after lung cancer) Over 70 Australians die each week 90% of bowel cancers are curable when detected early

6 What causes bowel cancer?

7 Non-modifiable: Modifiable: Age 50 years+ Risk Factors Inflammatory bowel disease Lynch Syndrome Familial Adenomatous Polyposis (FAP): Strong family history of bowel cancer / one family member under 55 and or 2 on same blood line Diet Obesity Smoking High alcohol intake Physical inactivity Diabetes (type 2)

8 Bowel Risk Calculator THE CALCULATOR : Is an online interactive calculator to establish risk Has drop down boxes with modifiable lifestyle factors, personal history and family history Provides tailored advice on screening recommendations and lifestyle suggestions Can be printed so you can give it to your health practitioner

9 Signs and Symptoms Most early bowel cancers do not produce obvious signs and symptoms and is sometimes called the silent cancer. If present, symptoms are typical of several common conditions; however, the most common presenting ones are: Bleeding from the rectum Any sign of blood after a bowel motion Recent and persistent change in bowel habit Symptoms of anaemia Abdominal pain Unexplained weight loss

10 Bowel cancer development Polyps that grows inside large bowel Slow growing (10+ years) may never progress Usually removed when observed during colonoscopy Polyp on long stalk / mushroom cherry Flat Adenoma

11 Reducing the chance of getting Bowel Cancer 1. DO A BOWEL TEST 2. MAINTAIN A HEALTHY WEIGHT 3. EAT A HEALTHY, BALANCED DIET 4. DON T DRINK MUCH ALCOHOL 5. QUIT SMOKING 6. EXERCISE

12 Faecal Occult Blood Test (FOBT) FOBT is simple, hygienic and painless, can be done privately at home FOBT looks for invisible blood in tiny samples from two separate bowel motions Doesn t diagnose bowel cancer but can identify who needs further testing Detects both pre-cancerous polyps as well as adenomatous polyps that may develop into cancer over time Most bowel cancers take 10+ years to develop, so having an FOBT every 2 years is an appropriate interval

13 National Bowel Cancer Screening Program Eligibility Eligible men and women turning 50, 55, 60 or 65 will be sent an invitation letter, information booklet and free kit in the mail. The FOBT is completed at home then posted to pathology service with Participant Details Form

14 Budget Announcement The Budget has delivered $95.9 million dollars over 4 years to accelerate the implementation of biennial screening for all Australians aged years. The expansion will be done in stages as follows : 2015: 70 and 74 years 2016: 72 and 64 and 65 year olds will drop off 2017: 68, 58, 54 The four remaining cohorts will 52,56,62,66 will be included from 2018 to 2020

15 Results Results are sent to patient and doctor (positive result needs further follow-up; negative result means re-screen in two years) These results are captured by the national register The register has a patient follow up service (PFUP) to ensure positive results have followed the correct referral pathway ie, surveillance

16 Role of the GP Encourage participation Assess patients with a positive result and refer on for colonoscopy indicate on referral if they are coming through the national program Notify the register of referral or non-referral for colonoscopy attracts a payment Manage individuals at increased risk

17 For more

18 Harriet Wynne