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Opinion: Bowel screening is important, particularly for those over 60

Consultant Gastroenterologist Professor Pádraic Mac Mathuna is calling on those aged 60-69 to register for bowel screening.

Professor Pádraic Mac Mathuna

BOWEL CANCER IS a debilitating and painful illness that often, sadly, causes death. Also known as colon, rectal or colorectal cancer, it is the third most common of all cancers in men, and the fourth most common of all cancers in women, in Ireland.

Around 2,800 people are diagnosed with bowel cancer here every year, and over 1,000 people die of the disease.

Yet, if bowel cancer is found early, it is relatively easy to treat and there is a better chance of recovery. Around two-thirds of colorectal cancer patients are still alive five years after diagnosis. A large proportion recover fully after their treatment, but a key factor in this is often how early their illness is caught.

Screening is key

BowelScreen aims to detect bowel cancer as early as possible; and to identify and remove adenomas or polyps (abnormal tissue growths). This greatly reduces the chance of bowel cancer developing in the future.

Taking part in bowel screening is simple. Once you are on the register, and in your 60s, we send a test kit to your home. It is called the FIT (faecal immunochemical test) and is sent free of charge.

The screening test involves taking a sample of your stool (poo) using the test kit. You collect the sample by scraping the sampling stick on the stool until the end of the stick is covered.

You put the sample stick in the tube and seal it in the plastic bag provided. You post back the sample the same day, or the next day, using the pre-paid envelope provided. Our laboratory tests the sample for levels of blood.

Most people will get a normal result. That means that no blood was detected, or the level of blood was very low. Everyone aged between 60 and 69 is invited to take the test again in two years.

It is important to note that a low level of blood in the stool sample is not a guarantee that you don’t have bowel cancer. This is because not all cancers or polyps bleed all the time. This is why it is so important to have the screening test every two years.

A layer of defence

I would like to remind everyone that screening is not a diagnosis. It is a way of reducing your chance of getting bowel cancer in the future, but it doesn’t reduce your risk completely.

This means that if you show the symptoms of bowel cancer have any concerns, you should go to your GP. Symptoms include going to the toilet more often; diarrhoea that lasts for weeks; bleeding from the back passage; a pain or lump in the stomach; or loss of weight when you are not trying to lose weight.

Blood can be present in the stool sample for many non-serious reasons, but it could also be a sign that you are at risk of bowel cancer.

If the volume of blood in your sample is above a particular level, BowelScreen will refer you for a further test called a colonoscopy. This is an examination of the bowel using a small camera on the end of a thin flexible tube. The tube is inserted into your bottom and passed through the large bowel or colon. You will be offered sedation so it is not painful.

The colonoscopy looks for any polyps or signs of disease in the lining of the bowel. Polyps are small growths that are not cancer but, if not removed, might turn into cancer. If polyps are found they are usually removed during the colonoscopy. This is painless.

Out of every 1,000 people who we screen for bowel cancer, around 18 people will have polyps or signs of disease detected; and one person will be diagnosed with bowel cancer. Around two people may have signs of disease that are not detected by screening. This is one of the limitations of screening. No screening test is completely reliable.

April is Bowel Cancer Awareness Month. BowelScreen is urging everyone aged 60 to 69 to avail of its free home test. It is free, it is simple, and it could help save your life. If you, a friend, or family member are in this age group and have received an invitation to do the test, we strongly encourage you to complete it.

We encourage men especially to take up the offer of bowel screening.

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Professor Pádraic Mac Mathuna is a Consultant Gastroenterologist in the Mater Misericordiae University Hospital and is Clinical Director of BowelScreen. Everyone aged 60-69 years is urged to check that they are on the register by visiting www.bowelscreen.ie, or by calling the Freephone number 1800 45 45 55. People can also email questions to info@bowelscreen.ie.

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Professor Pádraic Mac Mathuna

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