Bowel cancer 


Bowel cancer

Find out who's most at risk of bowel cancer, the questions to ask if you're diagnosed and the treatment options available.

Media last reviewed: 21/02/2013

Next review due: 21/02/2015

NHS cancer screening

There are some types of cancers you can get free routine screening for

Bowel cancer is a general term for cancer that begins in the large bowel. Depending on where the cancer starts, bowel cancer is sometimes called colon or rectal cancer.

Cancer can sometimes start in the small bowel (small intestine), but small bowel cancer is much rarer than large bowel cancer.

Bowel cancer is one of the most common types of cancer diagnosed in the UK, with around 40,000 new cases diagnosed every year.

About one in every 20 people in the UK will develop bowel cancer during their lifetime.

Signs and symptoms

The three main symptoms of bowel cancer are blood in the stools (faeces), changes in bowel habit (such as to more frequent, looser stools) and abdominal (tummy) pain. However, these symptoms are very common and most people with them do not have bowel cancer.

For example, blood in the stools is more often caused by haemorrhoids (piles), and a change in bowel habit or abdominal pain is usually due to something you have eaten.

As almost nine out of 10 people with bowel cancer are over 60 years old, these symptoms are more important as people get older. They are also more significant when they persist despite simple treatments.

Most people who are eventually diagnosed with bowel cancer have one of the following symptom combinations:

  • a persistent change in bowel habit causing them to go to the toilet more often and pass looser stools, usually together with blood on or in their stools
  • a persistent change in bowel habit without blood in their stools, but with abdominal pain
  • blood in the stools without other haemorrhoid symptoms such as soreness, discomfort, pain, itching or a lump hanging down outside the back passage
  • abdominal pain, discomfort or bloating always provoked by eating, sometimes resulting in a reduction in the amount of food eaten and weight loss

The symptoms of bowel cancer can be subtle and don’t necessarily make you feel ill.

Read more about the symptoms of bowel cancer.

When to seek medical advice

Try the bowel cancer symptom checker for advice on treatments you can try to see if your symptoms get better and when you should see your GP to discuss whether any tests are necessary.

Your doctor will probably carry out a simple examination of your tummy and bottom to make sure you have no lumps, and they may arrange a simple blood test to check for iron deficiency anaemia (as this can indicate whether there is any bleeding from your bowel that you haven’t been aware of).

In some cases, your doctor may decide it is best for you to have a simple test in hospital to make sure there is no serious cause for your symptoms.

Make sure you return to your doctor if your symptoms persist or keep coming back after stopping treatment, regardless of their severity or your age.

Read more about diagnosing bowel cancer.

Who's at risk?

It's not known exactly what causes bowel cancer, but there are a number of things that can increase your risk. These include:

  • age – almost nine in 10 cases of bowel cancer occur in people aged 60 or over
  • diet – a diet high in red or processed meats and low in fibre can increase your risk
  • weight – bowel cancer is more common in people who are overweight or obese
  • exercise – being inactive increases the risk of getting bowel cancer
  • alcohol and smoking – a high alcohol intake and smoking may increase your chances of getting bowel cancer
  • family history – having a close relative (mother or father, brother or sister) who developed bowel cancer below 50 years of age puts you at a greater lifetime risk of developing the condition

Some people are also at an increased risk of bowel cancer because they have another condition that affects their bowel, such as severe ulcerative colitis or Crohn's disease over a long period of time.

Read more about the causes of bowel cancer and preventing bowel cancer.

Bowel cancer screening

Everyone between the ages of 60 and 69 in England is offered bowel cancer screening every two years, and the screening programme is currently being extended to those aged 70 to 74.

Screening is carried out by taking a small stool sample and testing it for the presence of blood that isn’t visible. This is known as the faecal occult blood test.

Screening plays an important part in the fight against bowel cancer because it can help detect bowel cancer before it causes obvious symptoms, which increases the chances of surviving the condition.

Read more about screening for bowel cancer.

Treatment and outlook

Bowel cancer can be treated using a combination of different treatments, depending on where the cancer is in your bowel and how far it has spread.

The main treatments are:

  • surgery to remove the cancerous section of bowel, this is the most effective way of curing bowel cancer and is all that many people need
  • chemotherapy – where medication is used to kill cancer cells 
  • radiotherapy – where radiation is used to kill cancer cells
  • biological treatments – a newer type of medication that increase the effectiveness of chemotherapy and prevent the cancer from spreading

As with most types of cancer, the chance of a complete cure depends on how far the cancer has advanced by the time it is diagnosed. If the cancer is confined to the bowel then surgery will usually be able to completely remove it.

Overall, between seven and eight in every 10 people with bowel cancer will live at least one year after diagnosis and more than half of those diagnosed will live at least another 10 years.

Every year, around 16,000 people die as a result of bowel cancer.

Read more about how bowel cancer is treated and living with bowel cancer.

Page last reviewed: 02/09/2014

Next review due: 02/09/2016


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The 20 comments posted are personal views. Any information they give has not been checked and may not be accurate.

Makemjohn said on 26 June 2014

PS forgot to say does anyone from the NHS read these comments or is it just a sham page for disgruntled people, as nobody from the NHS has responded to my first comments but again they have the tick in the right boxes

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Makemjohn said on 26 June 2014

Further to my post 18th June saw my own doctor who treat the need for an urgent appoinment with the seriousness it deserved and has arranged a Colonscopy before my appointment with the screening practitioner. Told the bowel screening programme to cancel my appointment have recieved letter from them thanking me for cancelling and saying I have now been taken out of the screening programme. Might as well talk to a brick wall for all the sense you get from this screening team in Rugby, usual dogs bodys with idiot boards for the answers, divert from that and they are lost. Try talking to the programme Hub Director is like looking for hens teeth immpossable, still as I said before the ticks are in the right boxes who cares about the patient

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Makemjohn said on 18 June 2014

Tested Positive on first and second screening was offered an appointment to see a screening practitioner at 9.00am at a hospital over one and a half hour car journey away (thats if you have a car) immpossible for me to attend,rang and was given an alternative appointment at my local hospital on 2nd July (2 weeks wait) having suffered from prostrate cancer and a rare cancer called Mucdepidermoid carinoma within Hyperplasia oncocytic (salivery gland cancer) I am naturally worried sick with this two week wait just to see someone, god knows how long I will then have to wait for a colonoscopy. Still the NHS has got the right ticks in the right boxes, What about the Paitent, who!!! oh them who cares as long as the ticks are in the right boxes.

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Piano legs said on 15 June 2014

Recently had a colonoscopy due to me having more bowel movements than normal. I was a once a week girl! However, a few months back I started going more often, good I thought as I usually felt bloated . However, I was starting to have permanent cramps which peaked and ebbed. My GP referred me and the day came 4 days ago! I was informed there and then that there was a tumour in my sigmoid colon. Was taking up 2 thirds of the circumference, this is what has been causing my constipation! They believe it's took 5 to 10yrs to get to this and are convinced its malignant. Awaiting pathology results and to have a ct scan to see if it's contained within the bowel. Also to see a colorectal surgeon to have this removed. 41 yrs old. Heathy diet, not overweight . I'm shocked at the diagnosis, but I'm changing nothing! I feel great and the only difference form today and last week is a word.....cancer! I'm doing race for life today also. Not sure what the prognosis will be but I will face it head on and deal with whatever faces me.

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jen35 said on 18 October 2013

I had a colonoscopy on mon and they removed a 3cm polyp. The doctor said he was concerned about one side of the polyp and has sent it for biopsy. He has also arranged for a ct scan on tue which he said on the report was due to variable.crypt pattern? I have no idea what this means. Im scared to death i have cancer. Im a 35 year old female x

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Ashley1919 said on 07 June 2013

I am 21 years old and am having a colonoscopy on Wednesday. I have had problems with me bowels all my life and only have bowel movements every 3 weeks sometimes longer. My stomach is very swollen and hard it feels tight all the time. I get extreme pain in my stomach that comes like contractions. Doctors suspected I had ovarian cancer but scans showed I haven't. I'm very worried and would like to know what the symptoms were like for others? Please help I know my own body and I know something's wrong...

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Vaileria said on 12 December 2012

I was having difficulty in passing complete colon.I felt pain in the middle of stomach.I had several different assessments but only the colonoscopy test recognized my tumor. My age made physicians look for other factors than colon cancer, but as long as you got utilizing, a process of test eliminations will find it.

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martin111 said on 05 December 2012

The people have spoken:

Being told to you need a bowel cancer screening means less embarrassment and more pressure to have it done. If it saves lives, which it will, perhaps there should be screening for many types of cancer in the same appointment?

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johnnya said on 19 January 2012

I had a Colonoscopy in Sept 2011 4 days after my son got married and a 6cm long polyp was found. Biopsies were taken but I was told there and then that I had Cancer. The results from biopsies came back benign.
I had a second colonoscopy in Sept when I was told that it still looked suspicious and could be cancer in its early stages. Then I had an operation to remove the polyp in October. After 4 weeks of waiting the results were benign!!
What a terrible couple of months me, my wife and family went through all because "someone jumped the gun" with my diagnosis.

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muppetmagic said on 24 July 2011

well guys! its now a year since i got my diagnosis of terminal im still on chemo but im still here! i was given some great words of comfort from my friends about this horrible disease and it was that although it is a parasitic disease you should live with it rather than let it take over your life! good luck.

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Marinamagic said on 20 July 2011

Went for the results of my colonoscopy today(,as it was 6 weeks ago I felt very up beat as I was sure that if they had found anything my appointment would have been much sooner.) Good news I do not have bowel cancer,but where do we go from here as the symptoms are still the same??So we talk about medication ,which the consultant was not very happy about ,and on to diet.So it was suggested that after a chat with my doctor,that I consider leaving out,for a 2 week period ,each,various foods.i.e.carbs,if no change then protein etc etc. So intend to give all this a try and will come back with any positive ideas at a later date.I hope this helps anyone looking for the same answers as me and wish all good luck for the future.

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Marinamagic said on 07 June 2011

I had the colonoscopy yesterday with some sedation,so I was aware and looking at the screen but felt nothing.Looking back I'm not sure I was awake all the time.
The worse part was the day before when you have to drink 4 litres of a preparation (to totally clear the bowels. )at set times.8am/10am/6pm/8pm.Nothing happened 'til 9.30am .I did as suggested put some fruit squash in the liquid but NOT blackcurrant.I suppose it is a good way to detox.!!
4 specimens were taken for biopsy and a wait of 2/3/weeks for results.I was told that it looked pretty good,so I'm thinking positive.

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Marinamagic said on 07 May 2011

I had a sigmoidoscopy yesterday,not painful,and am to be referred for a colonoscopy.Consultant said he did not think it was cancer but there were significant changes to warrant further investigation.
I am an optimist so am concerned but not too worried.Symptoms are the same,still have constant discomfort in my stomach and abdomen,but not what I would call pain.I do not eat large meals and don't snack......have not lost any weight!!

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Marinamagic said on 13 March 2011

I have had stomach pains and constant discomfort in my bowels since July 2010,after having a seafood meal.4 days of chronic pain,no food just sips of water and no bowel movement.Took senacot,which worked.Since then I have had bowels open 3--4 times a day.I eat a high fibre diet,don't drink or smoke,am fairly active and fit otherwise.I did the NHS bowel cancer check(which incidentaly was very easy to do at home once I had the "bits" set up)The reply came back within 14 days as clear,but if symptoms persisted to see the doctor.I did and she recommended a colonoscopy,so I'm waiting for appointment.I have left it this long as my husband had been diagnosed with prostate cancer in March'10 an thought he did not need the extra stress.Will be in touch.

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Nellwyn Stellens said on 21 February 2011

My main symptom was constant nausea that got worse when eating and worse still when opening bowels. I didn't start to lose weight or pass blood or anything until it was almost too late.

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muppetmagic said on 08 February 2011

i was admitted to hospital on 13 june 2010 wih constipation the doctors could feel that i had a massive blockage in my bowels so they did ct scan. by fluke they found 2 massive tumors in my liver on doing another ct scan they found speckles all over my lungs i was told these were not primary and the doctors thought that it was in my bowels. on 2nd july i was rushed in for emergency surgery before my bowels burst and killed me. they gave me a colostomy. if that was my only problem i would be over the moon. since then i have had 8 cycles of chemotherapy my prognosis is still terminal.i have also since found that i have a massive tumour wich comes out into my pelvic cavitiy.
it really annoys me that i have been dealt this hand in life because i am now only 37years old i have five children ranging from 20 down to 6years old.and a grandaughter. i worked am a nonsmoker, dont drink or smoke or eat processed food to have found out all this by accident. generally i had a really happy healthy life. i was told last week that the cancer is no longer shrinking and that i should live the life that ihave left. this is heart breaking to my husband and babies.

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homsey said on 25 November 2010

I had early stage bowel cancer, one tumour in lower left hand side, was told i would be in hospital for upto 10 days, infact was in 33 days with a spell in intensive care, was also told at the time that it was a straight forward op and would be reversed in 6 months however have been told now that it cannot be reversed and i am stuck with a stoma on my right side and one on my left side, to say i am dissapointed is an understatement.....regards h

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Hamcatsmammy said on 03 November 2010

I had no idea i had bowel cancer, i was 51 worked full time, fit & active, my family health history came up in conversation during a consultation for my daughter! lucky for me the consultant insisted i should have screening has my father & grandfather both had bowel cancer. I reluctantly had a colonoscope only to discover i had polyps that had turned cancerous. 2 weeks later after scans, blood test etc, i had surgery. I was so relieved to find it was caught early so no chemo, or rad, treatment was needed but best of all no stoma. So if you have any close family history of bowel cancer please get checked. I later found out that my cancer is genetic so all my family are now aware and are being tested to see if they carry the gene.

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sujabi said on 13 July 2010

I had been experiencing irregular bowel movements (I am 82) and had been to two doctors (I live in Jersey and UK). I said that the discharges had been frequent and mucus. No pain at all presented. Stools were taken in both case. I doubted the findings and browsed nhsdierct symptoms for bowel cancer. They were so relevant I requested colonoscpy. The results found a cancer (Dukes B) in the lower bowel which was excised - a reversal of my ileostomy is due shortly. On enquiring how long I must have had this tumour I was told - about 7 years! I feel somewhat aggrieved that we are told so much about prostate, strokes, smoking, drinking etc but nothing, until recently, about bowel cancer - the third most dangerous form. Had I had an examination ten years ago I might only have had some polyps to excise.

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Helen M W said on 02 April 2010

My husband & I have both undergone the NHS screening for bowel cancer and were found to be "clear".
Two weeks ago my husband (aged underwent emergency surgery for a "blockage" when 2 tumours were discovered, one where the small intestine joins the colon and one in the colon. Faecal screening does not detect everything it seems.
Be very aware of any stomach pain, bloating, burping & difficulty in eating. His tumours were found in the nick of time after he vomited bile violently after having the sympoms above.
Take unexplained stomach ache which comes & goes very seriously.

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