A real problem down under
About one in 10 Australian men and one in 15 women will be diagnosed with bowel cancer before the age of 85. So why aren't more of us using free screening tests?
A surprise best seller in Germany last year was the book Darm mit Charme [Charming bowels], by medical student Giulia Enders. The book covers ingestion, elimination and everything in between, along with valuable health care advice. It's sold over 1 million copies in Germany, and is now available in English, under the more prosaic title, Gut: The Inside Story of Our Body's Most Underrated Organ.
While not a traditional area of interest for Australians, any opportunity for a little toilet humour is always welcome. And given Australia's high rate of bowel cancer, if it gets people more interested in looking after their bowel health, so much the better.
Australia has one of the highest rates of bowel cancer in the world, ranking eighth overall, eighth for men and sixth for women.
Germany, incidentally, doesn't even make the top 20, which is dominated by eastern and northern European countries, with South Korea topping the list overall.
The bottom line: experts back screening
June is Bowel Cancer Awareness month, and health experts are promoting the national free screening program.
"Bowel cancer is the second biggest cancer killer in Australia but it hasn't had as much publicity as some other cancers, which could be why people underestimate it," says the Cancer Institute of NSW's director of screening and prevention, Sarah McGill.
And while most people are aware that screening is available, many don't take it up when offered. A survey by Cancer Institute of NSW found that 86% of people surveyed were aware of screening, and almost all said they'd do the screening test if recommended by their doctor. Yet only one third of people actually take part in the free National Bowel Cancer Screening Program, which mails free test kits to people aged 50–74.
"Bowel cancer is the second biggest cancer killer in Australia but it hasn't had as much publicity as some other cancers, which could be why people underestimate it."
Ageing is the greatest risk factor for developing bowel cancer, and McGill is concerned that few people are aware of this.
"This thinking needs to shift so that once people hit their fifties they start screening regularly, even if they feel well, have a healthy lifestyle and no family history," Ms McGill said.
Prevention and lifestyle
Lifestyle factors also play a role. It's estimated almost half of bowel cancers can be prevented with a healthy diet, regular physical activity and by maintaining a healthy weight.
According to World Cancer Research Fund International, red meat, processed meat and alcohol are associated with an increased risk of bowel cancer, as are overall body fat, abdominal fat and adult height. Conversely, there's good evidence that fibre and physical activity protect against bowel cancer, and garlic, milk and calcium probably protect against it.
"Bowel cancer is one of the most treatable cancers when diagnosed at an early stage. A simple and quick screening test can help detect bowel cancer early and can even find changes that can be treated before cancer develops," Ms McGill said.
"Anyone aged 50 or over should speak to their GP about bowel cancer screening and should take the National Bowel Screening Test when it arrives in their letter box."
For more information, including useful links, see Cancer Council Australia's page on bowel cancer.
See more of our information on cancer screening, and direct-to-consumer screening tests.