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 is aged |
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