Survival from bowel cancer is very stage-specific – early detection substantially improves survival.
- Lifetime risk is about 1 : 18 for men, 1 : 23 for women.
|If a person
|Risk in the next|
|5 years*||1o years||15 years||20 years|
|30||1 in 7,000||1 in 2,000||1 in 700||1 in 350|
|40||1 in 1,200||1 in 400||1 in 200||1 in 90|
|50||1 in 300||1 in 100||1 in 50||1 in 30|
|60||1 in 100||1 in 50||1 in 30||1 in 20|
|70||1 in 65||1 in 30||1 in 20||1 in 15|
|80||1 in 50||1 in 25|
- Average Risk: people who are aged 50 or more with no symptoms and no risk factors
- Above Average Risk:
- Personal History: Inflammatory Bowel disease, previous polyps removed
- Family history:
- Slightly increased risk: one relative dx’d over 55: 2 fold increase
- Moderately increased risk: one first degree relative diagnosed at <55, or two family members on same side at any age: 6 fold increase
- High Risk: HNPCC ( Hereditary Non Polposis colorectal cancer) ( Lynch Syndrome): 50% of children, FAP : 50% of affected children.
- Foecal Occult Blood Tests ( FOBT’s):
- In screening: a +ve test gives a 30 – 45 % chance of having an adenoma
- Any positive test should be followed up with colonoscopy.
- Colonoscopy: is the most accurate procedure.
- The CEA blood test is not suitable for early diagnosis.
- Virtual Colonoscopy, – still in early stages
- There is level I evidence of a 15 – 33% reduction in mortality from bowel cancer for FOBT testing of asymptomatic patients
- Sxcsreening colonoscopies for high risk groups