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class="cpd-display-item"><div _ngcontent-ausmed-cpd-state-c3257604799>CPDTime.</div></div><div _ngcontent-ausmed-cpd-state-c3257604799 class="cpd-display-count">13m</div></div></cpd-badge></div><span _ngcontent-ausmed-cpd-state-c4044900820 class="resource-detail-header__meta-item"> Updated 07 Feb 2024 </span></div><div _ngcontent-ausmed-cpd-state-c4044900820 class="resource-detail-header__actions"><app-backdrop-spotlight _nghost-ausmed-cpd-state-c4169711516><div _ngcontent-ausmed-cpd-state-c4169711516><button role="button" id="headerCPDBtn" class="btn-primary mr-sm-2"><ui-streamline-icon name="add" size="f-caption" theme="bold" class="sl-icon sl-btn-icon" _nghost-ausmed-cpd-state-c1746938471></ui-streamline-icon> Document (it's free) </button></div></app-backdrop-spotlight></div><div _ngcontent-ausmed-cpd-state-c4044900820 class="resource-detail-header__bg"><img width="140%" style="margin: -3rem;" src="https://ausmed-images.s3.ap-southeast-2.amazonaws.com/ausmed.com/ausmed-articles/20220210_cover_v2.jpg"></div></div></resource-detail-shared-header><div class="d-flex flex-column flex-xl-row gap-7 mt-6 mb-6 mb-lg-7"><article class="mt-3 mx-7 mx-md-11 mx-xl-6"><section><div longcontentevent class="page-article--document"></div><div><p style="font-size:20px"><strong>Bowel cancer</strong>, also known as <strong>colorectal cancer</strong>, is an umbrella term used to describe cancers of the large bowel/intestine (colon and rectum) (Cancer Council Victoria 2021).</p> <p>Depending on which part of the large bowel is affected, the cancer may be referred to more specifically as <strong>colon cancer</strong> or <strong>rectal cancer</strong>, although the two are often grouped together due to their similarities (ACS 2020).</p> <p>It’s the <strong>fourth most common type of cancer in Australia</strong> (excluding non-melanoma skin cancers) after prostate cancer, <a href="https://www.ausmed.com.au/cpd/articles/breast-cancer/view" target="_blank">breast cancer</a> and <a href="https://www.ausmed.com.au/cpd/articles/melanoma/view" target="_blank">melanoma of the skin</a>, with about 15,400 diagnoses made annually (AIHW 2023).</p> <h2>The Colon and Rectum</h2> <p>The colon and rectum, which together form the large bowel, are part of the <strong>gastrointestinal system</strong> (ACS 2020).</p> <p>The <strong>colon</strong> is a 1.5-metre-long muscular tube that absorbs water and nutrients from partially digested food, leaving behind waste (faeces) that is then passed into the <strong>rectum</strong>. Faeces is stored in the rectum until it is excreted through the anus during a bowel movement (ACS 2020; Better Health Channel 2021).</p> <h2>Causes of Bowel Cancer</h2> <div class="embed-responsive embed-responsive-16by9 mb-3"> <iframe class="embed-responsive-item" src="https://www.youtube.com/embed/rgKvqjbxzT4"></iframe> </div> <p>Most bowel cancers develop from <strong>polyps</strong> - clumps of cells that form on the intestinal mucosa (Cancer Council Victoria 2021; Mayo Clinic 2023).</p> <p>Polyps are common, developing in about 25% of people aged over 50 (NHS 2023). While polyps are initially benign, and most remain harmless, some - particularly <strong>adenomatous polyps (adenomas)</strong> - may become cancerous if left alone (Cancer Council Victoria 2021; ACS 2020).</p> <p>Polyps may resemble flat spots on the intestinal lining or raised growths that appear to be suspended by a ‘stalk’ (Better Health Channel 2021; Bowel Cancer Australia 2018).</p> <p>While 90% of bowel cancers are caused by <strong>adenocarcinomas</strong> (adenomas that become cancerous) (Better Health Channel 2021; Cleveland Clinic 2021), there are other rare types of bowel cancer, including:</p> <ul> <li>Squamous cell cancers</li> <li>Neuroendocrine tumours (NETs)</li> <li>Small bowel cancer</li> <li>Gastrointestinal stromal tumours</li> <li>Lymphoma.</li> </ul> <p><small>(Better Health Channel 2021)</small></p> <figure> <center><img src="https://ausmed-images.s3.ap-southeast-2.amazonaws.com/ausmed.com/ausmed-articles/20220210_body_1.jpg" alt="bowel cancer polyps"> <figcaption>Most bowel cancers develop from polyps.</figcaption> </center> </figure> <h2>Risk Factors for Bowel Cancer</h2> <p>Risk factors include:</p> <ul> <li>Older age (over 50)</li> <li>Inflammatory bowel disease (<a href="https://www.ausmed.com.au/cpd/articles/crohns-disease" target="_blank">Crohn's disease</a> or ulcerative colitis), especially if the patient has had it for over eight years</li> <li>Previous adenomas or polyps in the bowel</li> <li>Previous bowel, ovarian or endometrial cancer</li> <li>Family history of bowel cancer or polyps</li> <li>Being overweight or obese</li> <li>High consumption of red meat, especially processed red meats (e.g. salami, ham, bacon, sausages)</li> <li>Smoking</li> <li>High alcohol intake</li> <li>Rare genetic disorders such as Lynch syndrome.</li> </ul> <p><small>(Better Health Channel 2021; Cancer Council Victoria 2021)</small></p> <h2>Symptoms of Bowel Cancer</h2> <p>Bowel cancer may cause no symptoms in its early stages. When symptomatic, it may cause:</p> <ul> <li>Blood present in faeces, on toilet paper or in the toilet bowl</li> <li>Bowel habit changes such as <a href="https://www.ausmed.com.au/cpd/articles/diarrhoea" target="_blank">diarrhoea</a>, <a href="https://www.ausmed.com.au/cpd/articles/constipation-in-the-older-adult" target="_blank">constipation</a> or more frequent, smaller bowel movements</li> <li>Changes in the appearance of faeces (e.g. narrower, presence of mucous)</li> <li>Abdominal fullness, bloating, or a strange sensation in the rectum during bowel movements</li> <li>Feeling like the bowel hasn’t been completely emptied after a bowel movement</li> <li>Unplanned and unexplained weight loss</li> <li>Weakness or fatigue</li> <li>Rectal or anal pain</li> <li>A lump in the anus or rectum</li> <li>Abdominal pain or swelling</li> <li>Anaemia or iron deficiency</li> <li>Blockage in the bowel.</li> </ul> <p><small>(Cancer Council Victoria 2021)</small></p> <figure> <center><img src="https://ausmed-images.s3.ap-southeast-2.amazonaws.com/ausmed.com/ausmed-articles/20220210_body_2.jpg" alt="bowel cancer symptoms abdominal pain"> </center> </figure> <p>It’s important to note that changes in bowel movements are normal, and these symptoms don’t necessarily indicate cancer. Differential diagnoses include haemorrhoids, diverticulitis, inflammatory bowel disease and anal fissure. However, <strong>any amount of bleeding is a red flag</strong> and should be escalated (Cancer Council Victoria 2021).</p> <h2>The National Bowel Cancer Screening Program</h2> <p><strong>About half of all bowel cancer cases in Australia aren’t detected early enough for treatment to be successful.</strong> This is a major reason why bowel cancer is the second biggest cause of cancer deaths in Australia (Healthdirect 2020).</p> <p>The <a href="https://www.health.gov.au/initiatives-and-programs/national-bowel-cancer-screening-program" target="_blank"><strong>National Bowel Cancer Screening Program</strong></a> uses an <strong>immunochemical faecal occult blood test (iFOBT)</strong> to detect traces of blood in stools, which is a potential sign of bowel cancer even before the onset of symptoms (DoHaAC 2023).</p> <p>The screening test is free and can be performed at home. It’s mailed to all eligible Australian people between the ages of 50 and 74 every two years, with the aim of identifying possible bowel cancer cases early (DoHaAC 2023).</p> <h2>Bowel Cancer Diagnosis</h2> <p>If a patient returns a positive bowel screening test or is experiencing symptoms of bowel cancer, the following diagnostic tests may be performed:</p> <ul> <li>Physical and rectal examination</li> <li>Blood tests (e.g. testing for anaemia)</li> <li><a href="https://www.ausmed.com.au/cpd/articles/colonoscopy" target="_blank">Colonoscopy</a></li> <li>Biopsy</li> <li><a href="https://www.ausmed.com.au/cpd/articles/medical-imaging-types-and-modalities" target="_blank">Imaging tests</a> (PET-CT scan, CT scan, MRI scan, CT colonography, x-ray)</li> <li>Molecular testing on the biopsy sample</li> <li>CT colonography</li> <li>Flexible sigmoidoscopy.</li> </ul> <p><small>(Better Health Channel 2021; Cancer Council Victoria 2021)</small></p> <h2>Bowel Cancer Staging</h2> <p>Bowel cancer typically doesn’t spread quickly. Polyps may take several years to become cancerous (Healthdirect 2020).</p> <p>In Australia, the most commonly used staging system is <strong>TNM (tumour-nodes-metastasis)</strong>. The Australian Clinico-Pathological Staging (ACPS) system may also be used (Cancer Council NSW 2023).</p> <table> <thead> <tr> <th>TNM</th> <th>Description</th> </tr> </thead> <tbody> <tr> <td>Stage I</td> <td>Cancerous cells are only present in the inner layers of the bowel wall.</td> </tr> <tr> <td>Stage II</td> <td>Cancerous cells have spread deeper into the layers of the bowel wall.</td> </tr> <tr> <td>Stage III</td> <td>Cancerous cells are present in any layer of the bowel wall and have spread to nearby lymph nodes.</td> </tr> <tr> <td>Stage IV</td> <td>Cancerous cells have spread to other parts of the body (e.g. lungs, liver or distant lymph nodes).</td> </tr> </tbody> </table> <p><small>(Adapted from Cancer Council NSW 2023)</small></p> <h2>Bowel Cancer Treatment</h2> <p>Treatment depends on how far cancer has already progressed, as well as the patient’s health status and preferences (Healthdirect 2020).</p> <p>Colon cancer and rectal cancer are also treated differently (Cancer Council Victoria 2021).</p> <h3>Early Colon Cancer</h3> <p>Colon cancer is best treated surgically if at an early or locally advanced stage. The patient will typically undergo a <strong>colectomy</strong>, wherein the cancerous area, as well as a normal area of the bowel and nearby lymph nodes, are surgically removed (Cancer Council Victoria 2021).</p> <p>During the procedure, the bowel will be cut on either side of the cancerous portion along with a border of healthy tissue. The two remaining ends will then be joined together (a procedure known as <strong>anastomosis</strong>) (Cancer Council Victoria 2021).</p> <p>There are different types of colectomies that can be performed depending on what part of the colon needs to be removed. In some cases, the entire colon and rectum will be excised (Cancer Council Victoria 2021).</p> <p>Some patients may also need to undergo a <a href="https://www.ausmed.com.au/cpd/articles/psychological-impacts-of-a-stoma" target="_blank">colostomy or ileostomy</a> (Cancer Council Victoria 2021). The stoma may be temporary or permanent (Better Health Channel 2021).</p> <p>If the cancer has already spread to the lymph nodes, the patient might need to undergo chemotherapy after the colectomy (Cancer Council Victoria 2021).</p> <figure> <center><img src="https://ausmed-images.s3.ap-southeast-2.amazonaws.com/ausmed.com/ausmed-articles/20220210_body_3.jpg" alt="bowel cancer colostomy"> <figcaption>Some patients may need to undergo a colostomy or ileostomy after a colectomy.</figcaption> </center> </figure> <h3>Early Rectal Cancer</h3> <p>Early rectal cancer is also typically treated surgically. However, if cancer has spread beyond the rectal wall and into nearby lymph nodes, the patient may need to undergo chemotherapy or chemoradiation (combined chemotherapy and radiation therapy) before surgery. There may also be further chemotherapy or radiation therapy after the surgery (Cancer Council Victoria 2021).</p> <p>The exact surgical procedure will depend on where the cancer is located and whether the bowel can be rejoined. It will be performed as either an open or keyhole surgery (Cancer Council Victoria 2021).</p> <p>The most common procedures are anterior resection and abdominoperineal resection. If the cancer is in a very early stage or the patient is unable to undergo major surgery, a local excision might be performed instead via an instrument inserted into the anus (Cancer Council Victoria 2021).</p> <h3>Advanced Colon and Rectal Cancer</h3> <p>Advanced bowel cancer (i.e. stage IV) may require a combination of chemotherapy, targeted therapy, radiation therapy, surgery and <a href="https://www.ausmed.com.au/cpd/articles/palliative-care" target="_blank">palliative care</a> (Cancer Council Victoria 2021).</p> <h2>Prognosis</h2> <p>The most recent statistics indicate that in Australia, <strong>about 71% of people will survive for at least five years after their bowel cancer diagnosis</strong> (relative to the general Australian population) (Cancer Australia 2023).</p> <p>The patient’s exact prognosis will depend on a number of factors, including:</p> <ul> <li>Type of bowel cancer</li> <li>Staging of the cancer</li> <li>Rate and extent of cancer spread</li> <li>How well the patient responds to treatment</li> <li>Factors such as age, fitness and general health.</li> </ul> <p><small>(Cancer Council Victoria 2021)</small></p> <p><strong>If detected early, bowel cancer can be successfully treated in over 90% of cases</strong> (DoHaAC 2023).</p> <p>Therefore, initiatives like the National Bowel Cancer Screening Program are crucial in ensuring bowel cancer is caught as early as possible.</p> <h2>Caring for Patients With Bowel Cancer</h2> <p><strong>About 32 to 44% of people with bowel cancer experience psychological distress following their diagnosis, especially those with a stoma in situ</strong> (Cancer Council VIC & DoH VIC 2021).</p> <p>This can be caused by a variety of factors, including the physical symptoms of the illness (e.g. pain), low self-esteem due to having a stoma and distress related to the diagnosis and treatment (Cancer Council VIC & DoH VIC 2021).</p> <p>It’s important to consider the psychological impact a diagnosis of bowel cancer may have on the patient and their family, be open and encouraging of discussion related to this and provide support where necessary. You should also ensure patients and their families are appropriately informed about their diagnosis, symptoms and treatment options (Cancer Council VIC & DoH VIC 2021).</p> <p>Keep in mind, also, that patients with bowel cancer may require supportive care related to:</p> <ul> <li>Emotional and psychological distress (e.g. anxiety, depression, body image)</li> <li>Isolation from support networks, especially if the patient is receiving treatment away from home</li> <li>Physical symptoms (e.g. pain, weight loss, fatigue, bowel function)</li> <li>Gastrointestinal symptoms</li> <li>Odours and flatus</li> <li>Medicines</li> <li>Reduced mobility or functional status</li> <li>Reduced sexual interest or sexual dysfunction</li> <li>Fertility</li> <li>Exercise.</li> </ul> <p><small>(Cancer Council VIC & DoH VIC 2021)</small></p> <h2>Bowel Cancer Prevention</h2> <p>The risk of bowel cancer can be reduced by:</p> <ul> <li>Regular physical activity</li> <li>Maintaining a healthy weight</li> <li>Avoiding processed meats</li> <li>Reducing red meat intake</li> <li>Reducing alcohol intake</li> <li>Avoiding smoking</li> <li>Eating whole grains, dietary fibre and dairy foods.</li> </ul> <p><small>(Cancer Council Victoria 2021)</small></p></div><resource-detail-overview _nghost-ausmed-cpd-state-c3044419385><div _ngcontent-ausmed-cpd-state-c3044419385 class="d-flex flex-column gap-7"><section _ngcontent-ausmed-cpd-state-c3044419385></section><section _ngcontent-ausmed-cpd-state-c3044419385><h3 _ngcontent-ausmed-cpd-state-c3044419385 class="mt-0 mb-3"> Topics <a _ngcontent-ausmed-cpd-state-c3044419385 href="/learn/all-topics"><ui-streamline-icon _ngcontent-ausmed-cpd-state-c3044419385 name="arrow-right-1" theme="bold" size="f-caption" color="text-neutral-700" class="ml-1" _nghost-ausmed-cpd-state-c1746938471></ui-streamline-icon></a></h3><resource-topics _ngcontent-ausmed-cpd-state-c3044419385 class="resource-topics" _nghost-ausmed-cpd-state-c2546394269><button _ngcontent-ausmed-cpd-state-c2546394269 class="btn btn-sm topic__container border-neutral-300"><div _ngcontent-ausmed-cpd-state-c2546394269 class="fw-medium f-small">Anatomy and Physiology</div></button><button _ngcontent-ausmed-cpd-state-c2546394269 class="btn btn-sm topic__container border-neutral-300"><div _ngcontent-ausmed-cpd-state-c2546394269 class="fw-medium f-small">Chemotherapy</div></button><button _ngcontent-ausmed-cpd-state-c2546394269 class="btn btn-sm topic__container border-neutral-300"><div _ngcontent-ausmed-cpd-state-c2546394269 class="fw-medium f-small">Chronic Illness</div></button><button _ngcontent-ausmed-cpd-state-c2546394269 class="btn btn-sm topic__container border-neutral-300"><div _ngcontent-ausmed-cpd-state-c2546394269 class="fw-medium f-small">Clinical Assessment</div></button><button _ngcontent-ausmed-cpd-state-c2546394269 class="btn btn-sm topic__container border-neutral-300"><div _ngcontent-ausmed-cpd-state-c2546394269 class="fw-medium f-small">Gastroenterology</div></button><button _ngcontent-ausmed-cpd-state-c2546394269 class="btn btn-sm topic__container border-neutral-300"><div _ngcontent-ausmed-cpd-state-c2546394269 class="fw-medium f-small">Imaging</div></button><button _ngcontent-ausmed-cpd-state-c2546394269 class="btn btn-sm topic__container border-neutral-300"><div _ngcontent-ausmed-cpd-state-c2546394269 class="fw-medium f-small">Loss and Grief</div></button><button _ngcontent-ausmed-cpd-state-c2546394269 class="btn btn-sm topic__container border-neutral-300"><div _ngcontent-ausmed-cpd-state-c2546394269 class="fw-medium f-small">Ostomy</div></button><button _ngcontent-ausmed-cpd-state-c2546394269 class="btn btn-sm topic__container border-neutral-300"><div _ngcontent-ausmed-cpd-state-c2546394269 class="fw-medium f-small">Palliative Care</div></button><button _ngcontent-ausmed-cpd-state-c2546394269 class="btn btn-sm topic__container border-neutral-300"><div _ngcontent-ausmed-cpd-state-c2546394269 class="fw-medium f-small">Preventative Health</div></button></resource-topics></section><section _ngcontent-ausmed-cpd-state-c3044419385 class="d-flex flex-column gap-4"><div class="d-flex flex-column border border-neutral-300" style="border-radius: 0.5rem;"><div class="d-flex flex-row align-items-center justify-content-between p-4"><h3 class="mb-0">References</h3><div><ui-streamline-icon name="arrow-down-1" theme="bold" size="f-paragraph" _nghost-ausmed-cpd-state-c1746938471></ui-streamline-icon></div></div><div class="p-4" hidden><div></div><div><ul class="list-group list-group-references"> <li class="list-group-item">American Cancer Society 2020, <em>What Is Colorectal Cancer?</em>, ACS, viewed 5 February 2024, <a href="https://www.cancer.org/cancer/colon-rectal-cancer/about/what-is-colorectal-cancer.html" target="_blank">https://www.cancer.org/cancer/colon-rectal-cancer/about/what-is-colorectal-cancer.html</a></li> <li class="list-group-item">Australian Institute of Health and Welfare 2023, <em>Cancer Data in Australia</em>, Australian Government, viewed 5 February 2024, <a href="https://www.aihw.gov.au/reports/cancer/cancer-data-in-australia/contents/overview-of-cancer-in-australia-2023" target="_blank">https://www.aihw.gov.au/reports/cancer/cancer-data-in-australia/contents/overview-of-cancer-in-australia-2023</a></li> <li class="list-group-item">Better Health Channel 2021, <em>Bowel Cancer</em>, Victoria State Government, viewed 5 February 2024, <a href="https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/bowel-cancer" target="_blank">https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/bowel-cancer</a></li> <li class="list-group-item">Bowel Cancer Australia 2018, <em>What is Bowel Cancer?</em>, Bowel Cancer Australia, viewed 5 February 2024, <a href="https://www.bowelcanceraustralia.org/what-is-bowel-cancer" target="_blank">https://www.bowelcanceraustralia.org/what-is-bowel-cancer</a></li> <li class="list-group-item">Cancer Australia 2023, <em>Bowel Cancer (Colorectal Cancer) in Australia Statistics</em>, Australian Government, viewed 5 February 2024, <a href="https://www.canceraustralia.gov.au/cancer-types/bowel-cancer/statistics" target="_blank">https://www.canceraustralia.gov.au/cancer-types/bowel-cancer/statistics</a></li> <li class="list-group-item">Cancer Council NSW 2023, <em>Staging and Prognosis for Bowel Cancer</em>, Cancer Council NSW, viewed 5 February 2024, <a href="https://www.cancercouncil.com.au/bowel-cancer/diagnosis/staging-prognosis/" target="_blank">https://www.cancercouncil.com.au/bowel-cancer/diagnosis/staging-prognosis/</a></li> <li class="list-group-item">Cancer Council Victoria 2021, <em>Bowel Cancer</em>, Cancer Council Victoria, viewed 5 February 2024, <a href="https://www.cancervic.org.au/cancer-information/types-of-cancer/bowel_cancer/bowel-cancer.html" target="_blank">https://www.cancervic.org.au/cancer-information/types-of-cancer/bowel_cancer/bowel-cancer.html</a></li> <li class="list-group-item">Cancer Council Victoria and Department of Health Victoria 2021, <em>Optimal Care Pathway For People With Colorectal Cancer</em>, 2nd edn, Cancer Council Victoria, viewed 5 February 2024, <a href="https://www.cancer.org.au/assets/pdf/colorectal-cancer-optimal-cancer-care-pathway" target="_blank">https://www.cancer.org.au/assets/pdf/colorectal-cancer-optimal-cancer-care-pathway</a></li> <li class="list-group-item">Cleveland Clinic 2021, <em>Adenocarcinoma Cancers</em>, Cleveland Clinic, viewed 5 February 2024, <a href="https://my.clevelandclinic.org/health/diseases/21652-adenocarcinoma-cancers" target="_blank">https://my.clevelandclinic.org/health/diseases/21652-adenocarcinoma-cancers</a></li> <li class="list-group-item">Department of Health and Aged Care 2023, <em>About the National Bowel Cancer Screening Program</em>, Australian Government, viewed 5 February 2024, <a href="https://www.health.gov.au/initiatives-and-programs/national-bowel-cancer-screening-program/about-the-national-bowel-cancer-screening-program" target="_blank">https://www.health.gov.au/initiatives-and-programs/national-bowel-cancer-screening-program/about-the-national-bowel-cancer-screening-program</a></li> <li class="list-group-item">Healthdirect 2020, <em>Bowel Cancer (Colon and Rectal Cancer)</em>, Australian Government, viewed 5 February 2024, <a href="https://www.healthdirect.gov.au/bowel-cancer" target="_blank">https://www.healthdirect.gov.au/bowel-cancer</a></li> <li class="list-group-item">Mayo Clinic 2023, <em>Colon Polyps</em>, Mayo Clinic, viewed 5 February 2024, <a href="https://www.mayoclinic.org/diseases-conditions/colon-polyps/symptoms-causes/syc-20352875" target="_blank">https://www.mayoclinic.org/diseases-conditions/colon-polyps/symptoms-causes/syc-20352875</a></li> <li class="list-group-item">National Health Service 2023, <em>Bowel Polyps</em>, NHS, viewed 5 February 2024, <a href="https://www.nhs.uk/conditions/bowel-polyps/" target="_blank">https://www.nhs.uk/conditions/bowel-polyps/</a></li> </ul></div></div></div><div class="d-flex flex-column border border-neutral-300" style="border-radius: 0.5rem;"><div class="d-flex flex-row align-items-center justify-content-between p-4"><h3 class="mb-0">Additional Resources</h3><div><ui-streamline-icon name="arrow-down-1" theme="bold" size="f-paragraph" _nghost-ausmed-cpd-state-c1746938471></ui-streamline-icon></div></div><div class="p-4" hidden><div></div><div><ul class="list-group"> <li class="list-group-item"><a href="https://www.cancer.org.au/" target="_blank">Cancer Council Australia</a></li> <li class="list-group-item"><a href="https://www.cancer.org.au/assets/pdf/colorectal-cancer-optimal-cancer-care-pathway" target="_blank">Optimal Care Pathway For People With Colorectal Cancer | Cancer Council Victoria and Department of Health Victoria</a></li> <li class="list-group-item"><a href="https://www.health.gov.au/initiatives-and-programs/national-bowel-cancer-screening-program" target="_blank">National Bowel Cancer Screening Program | Department of Health</a></li> <li class="list-group-item"><a href="https://www.ausmed.com.au/cpd/articles/psychological-impacts-of-a-stoma" target="_blank">Living Well With a Stoma | Ausmed Article</a></li> </ul></div></div></div></section></div></resource-detail-overview><section class="mb-4"><learning-assessment _nghost-ausmed-cpd-state-c1282328874><div _ngcontent-ausmed-cpd-state-c1282328874 class="d-flex flex-column border border-neutral-300 p-4" style="border-radius: 0.5rem;"><div _ngcontent-ausmed-cpd-state-c1282328874 class="d-flex align-items-sm-center flex-column flex-sm-row justify-content-between"><div _ngcontent-ausmed-cpd-state-c1282328874 class="d-block d-sm-flex align-items-center order-2 order-md-1"><h3 _ngcontent-ausmed-cpd-state-c1282328874 class="mr-sm-2">Test Your Knowledge</h3></div><p _ngcontent-ausmed-cpd-state-c1282328874 class="f-4 mb-0 d-flex justify-content-end text-neutral-800 fw-normal order-1 order-md-2">Question 1 of 3</p></div><div _ngcontent-ausmed-cpd-state-c1282328874 class="mt-4"><p _ngcontent-ausmed-cpd-state-c1282328874 class="f-4 mb-4 fw-normal text-dark">True or false: Most bowel polyps are harmless.</p><div _ngcontent-ausmed-cpd-state-c1282328874><div _ngcontent-ausmed-cpd-state-c1282328874 class="form-check"><input _ngcontent-ausmed-cpd-state-c1282328874 type="radio" name="mcqRadios" class="form-check-input" id="0opt0" value="True"><label _ngcontent-ausmed-cpd-state-c1282328874 class="form-check-label" for="0opt0">True</label></div></div><div _ngcontent-ausmed-cpd-state-c1282328874><div _ngcontent-ausmed-cpd-state-c1282328874 class="form-check"><input _ngcontent-ausmed-cpd-state-c1282328874 type="radio" name="mcqRadios" class="form-check-input" id="0opt1" value="False"><label _ngcontent-ausmed-cpd-state-c1282328874 class="form-check-label" 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</div></section><section _ngcontent-ausmed-cpd-state-c127922729 class="my-2"><div _ngcontent-ausmed-cpd-state-c127922729 class="d-flex flex-column"><div _ngcontent-ausmed-cpd-state-c127922729 class="f-small"><div _ngcontent-ausmed-cpd-state-c127922729 class="d-flex justify-content-between my-2"><span _ngcontent-ausmed-cpd-state-c127922729 class="fw-medium">Last updated</span><span _ngcontent-ausmed-cpd-state-c127922729>07 Feb 2024</span></div><hr _ngcontent-ausmed-cpd-state-c127922729 class="content-integrity__divider"><div _ngcontent-ausmed-cpd-state-c127922729 class="d-flex justify-content-between my-2"><span _ngcontent-ausmed-cpd-state-c127922729 class="fw-medium">Due for review</span><span _ngcontent-ausmed-cpd-state-c127922729>09 Feb 2026</span></div></div></div></section><section _ngcontent-ausmed-cpd-state-c127922729 class="my-2"><div _ngcontent-ausmed-cpd-state-c127922729 class="content-integrity-detail__container"> Cite this resource <ui-streamline-icon 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Care","activityType":"blog","min":13,"categories":["0e9c78c5-925b-4ae0-9640-870472ad9a91","720dbc81-0555-402b-af7b-231f805bef0e","7ce2666f-1c9b-4882-90be-2cf097b776f0","8a51f6e9-0d70-4aff-9f74-2b89b57f9561","f5e9bf36-9d3e-4b8b-9f76-08fc71170f19"],"topics":["f7a65f9d-96c1-4943-96b6-a89f59151a51","e11ebc58-35b2-429a-b0fc-4442fb6da6e1","187f0dd2-05b7-40cb-8fa3-6c7edd1e247d","c4c3836d-b231-4593-ab0f-6eece20f9bea","de7e2426-07be-4bb5-a229-d3e3f9934969","f006ff63-f56a-4233-956c-f6920137d92d","31a5590b-3fbe-4559-afda-376cf35f3bbe","21ee5ec7-c32a-4019-a22a-3a3dab0e333b","4b7d5a36-0163-4e88-9a7c-d5ff5a7d48ef","22146b27-7f36-4806-9f46-b6080cb7b621"],"keywords":["Anatomy and Physiology","Chemotherapy","Chronic Illness","Clinical Assessment","Gastroenterology","Imaging","Loss and Grief","Ostomy","Palliative Care","Preventative Health"],"professions":["Nurse Practitioner","Other","Registered Nurse","Enrolled Nurse","Non-Practising","Student Nurse or Midwife","Other Profession","Community Care Worker","Health Care Worker","Personal Care Assistant (PCA)","Assistant in Nursing (AIN)","Direct Care Worker","Ward Assistant","Other Profession"],"educatorNames":["Ausmed Editorial Team"],"createDate":"2022-02-10T01:53:27.000Z","updateDate":"2024-02-07T22:44:49.000Z","availableDate":"2024-02-07T13:00:00.000Z","expiryDate":"2026-02-09T13:00:00.000Z","bundles":["1abae61e-91eb-4813-81a1-22acf58c6691","33cce188-ee06-4ac8-a185-82c4efd472ba"],"blogDetail":{"resourceID":"8395741a-9674-47e7-bd2e-04c5e63a80c3","status":"Published","providerName":"Ausmed Education","content":"\u003Cp style=\"font-size:20px\">\u003Cstrong>Bowel cancer\u003C/strong>, also known as \u003Cstrong>colorectal cancer\u003C/strong>, is an umbrella term used to describe cancers of the large bowel/intestine (colon and rectum) (Cancer Council Victoria 2021).\u003C/p>\n\n \u003Cp>Depending on which part of the large bowel is affected, the cancer may be referred to more specifically as \u003Cstrong>colon cancer\u003C/strong> or \u003Cstrong>rectal cancer\u003C/strong>, although the two are often grouped together due to their similarities (ACS 2020).\u003C/p>\n\n \u003Cp>It’s the \u003Cstrong>fourth most common type of cancer in Australia\u003C/strong> (excluding non-melanoma skin cancers) after prostate cancer, \u003Ca href=\"https://www.ausmed.com.au/cpd/articles/breast-cancer/view\" target=\"_blank\">breast cancer\u003C/a> and \u003Ca href=\"https://www.ausmed.com.au/cpd/articles/melanoma/view\" target=\"_blank\">melanoma of the skin\u003C/a>, with about 15,400 diagnoses made annually (AIHW 2023).\u003C/p>\n\n \u003Ch2>The Colon and Rectum\u003C/h2>\n\n \u003Cp>The colon and rectum, which together form the large bowel, are part of the \u003Cstrong>gastrointestinal system\u003C/strong> (ACS 2020).\u003C/p>\n\n \u003Cp>The \u003Cstrong>colon\u003C/strong> is a 1.5-metre-long muscular tube that absorbs water and nutrients from partially digested food, leaving behind waste (faeces) that is then passed into the \u003Cstrong>rectum\u003C/strong>. Faeces is stored in the rectum until it is excreted through the anus during a bowel movement (ACS 2020; Better Health Channel 2021).\u003C/p>\n\n \u003Ch2>Causes of Bowel Cancer\u003C/h2>\n\n\u003Cdiv class=\"embed-responsive embed-responsive-16by9 mb-3\">\n\t\u003Ciframe class=\"embed-responsive-item\" src=\"https://www.youtube.com/embed/rgKvqjbxzT4\">\u003C/iframe>\n\u003C/div>\n\n \u003Cp>Most bowel cancers develop from \u003Cstrong>polyps\u003C/strong> - clumps of cells that form on the intestinal mucosa (Cancer Council Victoria 2021; Mayo Clinic 2023).\u003C/p>\n\n \u003Cp>Polyps are common, developing in about 25% of people aged over 50 (NHS 2023). While polyps are initially benign, and most remain harmless, some - particularly \u003Cstrong>adenomatous polyps (adenomas)\u003C/strong> - may become cancerous if left alone (Cancer Council Victoria 2021; ACS 2020).\u003C/p>\n\n \u003Cp>Polyps may resemble flat spots on the intestinal lining or raised growths that appear to be suspended by a ‘stalk’ (Better Health Channel 2021; Bowel Cancer Australia 2018).\u003C/p>\n\n \u003Cp>While 90% of bowel cancers are caused by \u003Cstrong>adenocarcinomas\u003C/strong> (adenomas that become cancerous) (Better Health Channel 2021; Cleveland Clinic 2021), there are other rare types of bowel cancer, including:\u003C/p>\n\n \u003Cul>\n \u003Cli>Squamous cell cancers\u003C/li>\n \u003Cli>Neuroendocrine tumours (NETs)\u003C/li>\n \u003Cli>Small bowel cancer\u003C/li>\n \u003Cli>Gastrointestinal stromal tumours\u003C/li>\n \u003Cli>Lymphoma.\u003C/li>\n \u003C/ul>\n\n \u003Cp>\u003Csmall>(Better Health Channel 2021)\u003C/small>\u003C/p>\n\n\u003Cfigure>\n\u003Ccenter>\u003Cimg src=\"https://ausmed-images.s3.ap-southeast-2.amazonaws.com/ausmed.com/ausmed-articles/20220210_body_1.jpg\" alt=\"bowel cancer polyps\">\n\u003Cfigcaption>Most bowel cancers develop from polyps.\u003C/figcaption>\n\u003C/center>\n\u003C/figure>\n\n \u003Ch2>Risk Factors for Bowel Cancer\u003C/h2>\n\n \u003Cp>Risk factors include:\u003C/p>\n\n \u003Cul>\n \u003Cli>Older age (over 50)\u003C/li>\n \u003Cli>Inflammatory bowel disease (\u003Ca href=\"https://www.ausmed.com.au/cpd/articles/crohns-disease\" target=\"_blank\">Crohn's disease\u003C/a> or ulcerative colitis), especially if the patient has had it for over eight years\u003C/li>\n \u003Cli>Previous adenomas or polyps in the bowel\u003C/li>\n \u003Cli>Previous bowel, ovarian or endometrial cancer\u003C/li>\n \u003Cli>Family history of bowel cancer or polyps\u003C/li>\n \u003Cli>Being overweight or obese\u003C/li>\n \u003Cli>High consumption of red meat, especially processed red meats (e.g. salami, ham, bacon, sausages)\u003C/li>\n \u003Cli>Smoking\u003C/li>\n \u003Cli>High alcohol intake\u003C/li>\n \u003Cli>Rare genetic disorders such as Lynch syndrome.\u003C/li>\n \u003C/ul>\n\n \u003Cp>\u003Csmall>(Better Health Channel 2021; Cancer Council Victoria 2021)\u003C/small>\u003C/p>\n\n \u003Ch2>Symptoms of Bowel Cancer\u003C/h2>\n\n \u003Cp>Bowel cancer may cause no symptoms in its early stages. When symptomatic, it may cause:\u003C/p>\n\n \u003Cul>\n \u003Cli>Blood present in faeces, on toilet paper or in the toilet bowl\u003C/li>\n \u003Cli>Bowel habit changes such as \u003Ca href=\"https://www.ausmed.com.au/cpd/articles/diarrhoea\" target=\"_blank\">diarrhoea\u003C/a>, \u003Ca href=\"https://www.ausmed.com.au/cpd/articles/constipation-in-the-older-adult\" target=\"_blank\">constipation\u003C/a> or more frequent, smaller bowel movements\u003C/li>\n \u003Cli>Changes in the appearance of faeces (e.g. narrower, presence of mucous)\u003C/li>\n \u003Cli>Abdominal fullness, bloating, or a strange sensation in the rectum during bowel movements\u003C/li>\n \u003Cli>Feeling like the bowel hasn’t been completely emptied after a bowel movement\u003C/li>\n \u003Cli>Unplanned and unexplained weight loss\u003C/li>\n \u003Cli>Weakness or fatigue\u003C/li>\n \u003Cli>Rectal or anal pain\u003C/li>\n \u003Cli>A lump in the anus or rectum\u003C/li>\n \u003Cli>Abdominal pain or swelling\u003C/li>\n \u003Cli>Anaemia or iron deficiency\u003C/li>\n \u003Cli>Blockage in the bowel.\u003C/li>\n \u003C/ul>\n\n \u003Cp>\u003Csmall>(Cancer Council Victoria 2021)\u003C/small>\u003C/p>\n\n\u003Cfigure>\n\u003Ccenter>\u003Cimg src=\"https://ausmed-images.s3.ap-southeast-2.amazonaws.com/ausmed.com/ausmed-articles/20220210_body_2.jpg\" alt=\"bowel cancer symptoms abdominal pain\">\n\u003C/center>\n\u003C/figure>\n\n \u003Cp>It’s important to note that changes in bowel movements are normal, and these symptoms don’t necessarily indicate cancer. Differential diagnoses include haemorrhoids, diverticulitis, inflammatory bowel disease and anal fissure. However, \u003Cstrong>any amount of bleeding is a red flag\u003C/strong> and should be escalated (Cancer Council Victoria 2021).\u003C/p>\n\n \u003Ch2>The National Bowel Cancer Screening Program\u003C/h2>\n\n \u003Cp>\u003Cstrong>About half of all bowel cancer cases in Australia aren’t detected early enough for treatment to be successful.\u003C/strong> This is a major reason why bowel cancer is the second biggest cause of cancer deaths in Australia (Healthdirect 2020).\u003C/p>\n\n \u003Cp>The \u003Ca href=\"https://www.health.gov.au/initiatives-and-programs/national-bowel-cancer-screening-program\" target=\"_blank\">\u003Cstrong>National Bowel Cancer Screening Program\u003C/strong>\u003C/a> uses an \u003Cstrong>immunochemical faecal occult blood test (iFOBT)\u003C/strong> to detect traces of blood in stools, which is a potential sign of bowel cancer even before the onset of symptoms (DoHaAC 2023).\u003C/p>\n\n \u003Cp>The screening test is free and can be performed at home. It’s mailed to all eligible Australian people between the ages of 50 and 74 every two years, with the aim of identifying possible bowel cancer cases early (DoHaAC 2023).\u003C/p>\n\n \u003Ch2>Bowel Cancer Diagnosis\u003C/h2>\n\n \u003Cp>If a patient returns a positive bowel screening test or is experiencing symptoms of bowel cancer, the following diagnostic tests may be performed:\u003C/p>\n\n \u003Cul>\n \u003Cli>Physical and rectal examination\u003C/li>\n \u003Cli>Blood tests (e.g. testing for anaemia)\u003C/li>\n \u003Cli>\u003Ca href=\"https://www.ausmed.com.au/cpd/articles/colonoscopy\" target=\"_blank\">Colonoscopy\u003C/a>\u003C/li>\n \u003Cli>Biopsy\u003C/li>\n \u003Cli>\u003Ca href=\"https://www.ausmed.com.au/cpd/articles/medical-imaging-types-and-modalities\" target=\"_blank\">Imaging tests\u003C/a> (PET-CT scan, CT scan, MRI scan, CT colonography, x-ray)\u003C/li>\n \u003Cli>Molecular testing on the biopsy sample\u003C/li>\n \u003Cli>CT colonography\u003C/li>\n \u003Cli>Flexible sigmoidoscopy.\u003C/li>\n \u003C/ul>\n\n \u003Cp>\u003Csmall>(Better Health Channel 2021; Cancer Council Victoria 2021)\u003C/small>\u003C/p>\n\n \u003Ch2>Bowel Cancer Staging\u003C/h2>\n\n \u003Cp>Bowel cancer typically doesn’t spread quickly. Polyps may take several years to become cancerous (Healthdirect 2020).\u003C/p>\n\n \u003Cp>In Australia, the most commonly used staging system is \u003Cstrong>TNM (tumour-nodes-metastasis)\u003C/strong>. The Australian Clinico-Pathological Staging (ACPS) system may also be used (Cancer Council NSW 2023).\u003C/p>\n\n \u003Ctable>\n \u003Cthead>\n \u003Ctr>\n \u003Cth>TNM\u003C/th>\n \u003Cth>Description\u003C/th>\n \u003C/tr>\n \u003C/thead>\n \u003Ctbody>\n \u003Ctr>\n \u003Ctd>Stage I\u003C/td>\n \u003Ctd>Cancerous cells are only present in the inner layers of the bowel wall.\u003C/td>\n \u003C/tr>\n \u003Ctr>\n \u003Ctd>Stage II\u003C/td>\n \u003Ctd>Cancerous cells have spread deeper into the layers of the bowel wall.\u003C/td>\n \u003C/tr>\n \u003Ctr>\n \u003Ctd>Stage III\u003C/td>\n \u003Ctd>Cancerous cells are present in any layer of the bowel wall and have spread to nearby lymph nodes.\u003C/td>\n \u003C/tr>\n \u003Ctr>\n \u003Ctd>Stage IV\u003C/td>\n \u003Ctd>Cancerous cells have spread to other parts of the body (e.g. lungs, liver or distant lymph nodes).\u003C/td>\n \u003C/tr>\n \u003C/tbody>\n \u003C/table>\n\n \u003Cp>\u003Csmall>(Adapted from Cancer Council NSW 2023)\u003C/small>\u003C/p>\n\n \u003Ch2>Bowel Cancer Treatment\u003C/h2>\n\n \u003Cp>Treatment depends on how far cancer has already progressed, as well as the patient’s health status and preferences (Healthdirect 2020).\u003C/p>\n\n \u003Cp>Colon cancer and rectal cancer are also treated differently (Cancer Council Victoria 2021).\u003C/p>\n\n \u003Ch3>Early Colon Cancer\u003C/h3>\n\n \u003Cp>Colon cancer is best treated surgically if at an early or locally advanced stage. The patient will typically undergo a \u003Cstrong>colectomy\u003C/strong>, wherein the cancerous area, as well as a normal area of the bowel and nearby lymph nodes, are surgically removed (Cancer Council Victoria 2021).\u003C/p>\n\n \u003Cp>During the procedure, the bowel will be cut on either side of the cancerous portion along with a border of healthy tissue. The two remaining ends will then be joined together (a procedure known as \u003Cstrong>anastomosis\u003C/strong>) (Cancer Council Victoria 2021).\u003C/p>\n\n \u003Cp>There are different types of colectomies that can be performed depending on what part of the colon needs to be removed. In some cases, the entire colon and rectum will be excised (Cancer Council Victoria 2021).\u003C/p>\n\n \u003Cp>Some patients may also need to undergo a \u003Ca href=\"https://www.ausmed.com.au/cpd/articles/psychological-impacts-of-a-stoma\" target=\"_blank\">colostomy or ileostomy\u003C/a> (Cancer Council Victoria 2021). The stoma may be temporary or permanent (Better Health Channel 2021).\u003C/p>\n\n \u003Cp>If the cancer has already spread to the lymph nodes, the patient might need to undergo chemotherapy after the colectomy (Cancer Council Victoria 2021).\u003C/p>\n\n\n\u003Cfigure>\n\u003Ccenter>\u003Cimg src=\"https://ausmed-images.s3.ap-southeast-2.amazonaws.com/ausmed.com/ausmed-articles/20220210_body_3.jpg\" alt=\"bowel cancer colostomy\">\n\u003Cfigcaption>Some patients may need to undergo a colostomy or ileostomy after a colectomy.\u003C/figcaption>\n\u003C/center>\n\u003C/figure>\n\n \u003Ch3>Early Rectal Cancer\u003C/h3>\n\n \u003Cp>Early rectal cancer is also typically treated surgically. However, if cancer has spread beyond the rectal wall and into nearby lymph nodes, the patient may need to undergo chemotherapy or chemoradiation (combined chemotherapy and radiation therapy) before surgery. There may also be further chemotherapy or radiation therapy after the surgery (Cancer Council Victoria 2021).\u003C/p>\n\n \u003Cp>The exact surgical procedure will depend on where the cancer is located and whether the bowel can be rejoined. It will be performed as either an open or keyhole surgery (Cancer Council Victoria 2021).\u003C/p>\n\n \u003Cp>The most common procedures are anterior resection and abdominoperineal resection. If the cancer is in a very early stage or the patient is unable to undergo major surgery, a local excision might be performed instead via an instrument inserted into the anus (Cancer Council Victoria 2021).\u003C/p>\n\n \u003Ch3>Advanced Colon and Rectal Cancer\u003C/h3>\n\n \u003Cp>Advanced bowel cancer (i.e. stage IV) may require a combination of chemotherapy, targeted therapy, radiation therapy, surgery and \u003Ca href=\"https://www.ausmed.com.au/cpd/articles/palliative-care\" target=\"_blank\">palliative care\u003C/a> (Cancer Council Victoria 2021).\u003C/p>\n\n \u003Ch2>Prognosis\u003C/h2>\n\n \u003Cp>The most recent statistics indicate that in Australia, \u003Cstrong>about 71% of people will survive for at least five years after their bowel cancer diagnosis\u003C/strong> (relative to the general Australian population) (Cancer Australia 2023).\u003C/p>\n\n \u003Cp>The patient’s exact prognosis will depend on a number of factors, including:\u003C/p>\n\n \u003Cul>\n \u003Cli>Type of bowel cancer\u003C/li>\n \u003Cli>Staging of the cancer\u003C/li>\n \u003Cli>Rate and extent of cancer spread\u003C/li>\n \u003Cli>How well the patient responds to treatment\u003C/li>\n \u003Cli>Factors such as age, fitness and general health.\u003C/li>\n \u003C/ul>\n\n \u003Cp>\u003Csmall>(Cancer Council Victoria 2021)\u003C/small>\u003C/p>\n\n \u003Cp>\u003Cstrong>If detected early, bowel cancer can be successfully treated in over 90% of cases\u003C/strong> (DoHaAC 2023).\u003C/p>\n\n \u003Cp>Therefore, initiatives like the National Bowel Cancer Screening Program are crucial in ensuring bowel cancer is caught as early as possible.\u003C/p>\n\n \u003Ch2>Caring for Patients With Bowel Cancer\u003C/h2>\n\n \u003Cp>\u003Cstrong>About 32 to 44% of people with bowel cancer experience psychological distress following their diagnosis, especially those with a stoma in situ\u003C/strong> (Cancer Council VIC & DoH VIC 2021).\u003C/p>\n\n \u003Cp>This can be caused by a variety of factors, including the physical symptoms of the illness (e.g. pain), low self-esteem due to having a stoma and distress related to the diagnosis and treatment (Cancer Council VIC & DoH VIC 2021).\u003C/p>\n\n \u003Cp>It’s important to consider the psychological impact a diagnosis of bowel cancer may have on the patient and their family, be open and encouraging of discussion related to this and provide support where necessary. You should also ensure patients and their families are appropriately informed about their diagnosis, symptoms and treatment options (Cancer Council VIC & DoH VIC 2021).\u003C/p>\n\n \u003Cp>Keep in mind, also, that patients with bowel cancer may require supportive care related to:\u003C/p>\n\n \u003Cul>\n \u003Cli>Emotional and psychological distress (e.g. anxiety, depression, body image)\u003C/li>\n \u003Cli>Isolation from support networks, especially if the patient is receiving treatment away from home\u003C/li>\n \u003Cli>Physical symptoms (e.g. pain, weight loss, fatigue, bowel function)\u003C/li>\n \u003Cli>Gastrointestinal symptoms\u003C/li>\n \u003Cli>Odours and flatus\u003C/li>\n \u003Cli>Medicines\u003C/li>\n \u003Cli>Reduced mobility or functional status\u003C/li>\n \u003Cli>Reduced sexual interest or sexual dysfunction\u003C/li>\n \u003Cli>Fertility\u003C/li>\n \u003Cli>Exercise.\u003C/li>\n \u003C/ul>\n\n \u003Cp>\u003Csmall>(Cancer Council VIC & DoH VIC 2021)\u003C/small>\u003C/p>\n\n \u003Ch2>Bowel Cancer Prevention\u003C/h2>\n\n \u003Cp>The risk of bowel cancer can be reduced by:\u003C/p>\n\n \u003Cul>\n \u003Cli>Regular physical activity\u003C/li>\n \u003Cli>Maintaining a healthy weight\u003C/li>\n \u003Cli>Avoiding processed meats\u003C/li>\n \u003Cli>Reducing red meat intake\u003C/li>\n \u003Cli>Reducing alcohol intake\u003C/li>\n \u003Cli>Avoiding smoking\u003C/li>\n \u003Cli>Eating whole grains, dietary fibre and dairy foods.\u003C/li>\n \u003C/ul>\n\n \u003Cp>\u003Csmall>(Cancer Council Victoria 2021)\u003C/small>\u003C/p>","thumbnailImages":["https://ausmed-images.s3.ap-southeast-2.amazonaws.com/ausmed.com/ausmed-articles/20220210_cover_v2.jpg"],"excerpt":"Bowel cancer is the fourth most common type of cancer in Australia (excluding non-melanoma skin cancers) after prostate cancer, breast cancer and melanoma of the skin, with about 15,400 diagnoses made annually.","reviewDate":"2026-02-09T13:00:00.000Z","publishDate":"2022-02-09T13:00:00.000Z","guidelines":["dcaed7e0-6d01-4740-9a68-e3ad3719e49d","40a58630-3c02-4196-89c7-15b794b961e1","123b576d-3c12-4a5d-8dbd-9bcfca3732a6"],"references":"\u003Cul class=\"list-group list-group-references\">\n \u003Cli class=\"list-group-item\">American Cancer Society 2020, \u003Cem>What Is Colorectal Cancer?\u003C/em>, ACS, viewed 5 February 2024, \u003Ca href=\"https://www.cancer.org/cancer/colon-rectal-cancer/about/what-is-colorectal-cancer.html\" target=\"_blank\">https://www.cancer.org/cancer/colon-rectal-cancer/about/what-is-colorectal-cancer.html\u003C/a>\u003C/li>\n \u003Cli class=\"list-group-item\">Australian Institute of Health and Welfare 2023, \u003Cem>Cancer Data in Australia\u003C/em>, Australian Government, viewed 5 February 2024, \u003Ca href=\"https://www.aihw.gov.au/reports/cancer/cancer-data-in-australia/contents/overview-of-cancer-in-australia-2023\" target=\"_blank\">https://www.aihw.gov.au/reports/cancer/cancer-data-in-australia/contents/overview-of-cancer-in-australia-2023\u003C/a>\u003C/li>\n \u003Cli class=\"list-group-item\">Better Health Channel 2021, \u003Cem>Bowel Cancer\u003C/em>, Victoria State Government, viewed 5 February 2024, \u003Ca href=\"https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/bowel-cancer\" target=\"_blank\">https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/bowel-cancer\u003C/a>\u003C/li>\n \u003Cli class=\"list-group-item\">Bowel Cancer Australia 2018, \u003Cem>What is Bowel Cancer?\u003C/em>, Bowel Cancer Australia, viewed 5 February 2024, \u003Ca href=\"https://www.bowelcanceraustralia.org/what-is-bowel-cancer\" target=\"_blank\">https://www.bowelcanceraustralia.org/what-is-bowel-cancer\u003C/a>\u003C/li>\n \u003Cli class=\"list-group-item\">Cancer Australia 2023, \u003Cem>Bowel Cancer (Colorectal Cancer) in Australia Statistics\u003C/em>, Australian Government, viewed 5 February 2024, \u003Ca href=\"https://www.canceraustralia.gov.au/cancer-types/bowel-cancer/statistics\" target=\"_blank\">https://www.canceraustralia.gov.au/cancer-types/bowel-cancer/statistics\u003C/a>\u003C/li>\n \u003Cli class=\"list-group-item\">Cancer Council NSW 2023, \u003Cem>Staging and Prognosis for Bowel Cancer\u003C/em>, Cancer Council NSW, viewed 5 February 2024, \u003Ca href=\"https://www.cancercouncil.com.au/bowel-cancer/diagnosis/staging-prognosis/\" target=\"_blank\">https://www.cancercouncil.com.au/bowel-cancer/diagnosis/staging-prognosis/\u003C/a>\u003C/li>\n \u003Cli class=\"list-group-item\">Cancer Council Victoria 2021, \u003Cem>Bowel Cancer\u003C/em>, Cancer Council Victoria, viewed 5 February 2024, \u003Ca href=\"https://www.cancervic.org.au/cancer-information/types-of-cancer/bowel_cancer/bowel-cancer.html\" target=\"_blank\">https://www.cancervic.org.au/cancer-information/types-of-cancer/bowel_cancer/bowel-cancer.html\u003C/a>\u003C/li>\n \u003Cli class=\"list-group-item\">Cancer Council Victoria and Department of Health Victoria 2021, \u003Cem>Optimal Care Pathway For People With Colorectal Cancer\u003C/em>, 2nd edn, Cancer Council Victoria, viewed 5 February 2024, \u003Ca href=\"https://www.cancer.org.au/assets/pdf/colorectal-cancer-optimal-cancer-care-pathway\" target=\"_blank\">https://www.cancer.org.au/assets/pdf/colorectal-cancer-optimal-cancer-care-pathway\u003C/a>\u003C/li>\n \u003Cli class=\"list-group-item\">Cleveland Clinic 2021, \u003Cem>Adenocarcinoma Cancers\u003C/em>, Cleveland Clinic, viewed 5 February 2024, \u003Ca href=\"https://my.clevelandclinic.org/health/diseases/21652-adenocarcinoma-cancers\" target=\"_blank\">https://my.clevelandclinic.org/health/diseases/21652-adenocarcinoma-cancers\u003C/a>\u003C/li>\n \u003Cli class=\"list-group-item\">Department of Health and Aged Care 2023, \u003Cem>About the National Bowel Cancer Screening Program\u003C/em>, Australian Government, viewed 5 February 2024, \u003Ca href=\"https://www.health.gov.au/initiatives-and-programs/national-bowel-cancer-screening-program/about-the-national-bowel-cancer-screening-program\" target=\"_blank\">https://www.health.gov.au/initiatives-and-programs/national-bowel-cancer-screening-program/about-the-national-bowel-cancer-screening-program\u003C/a>\u003C/li>\n \u003Cli class=\"list-group-item\">Healthdirect 2020, \u003Cem>Bowel Cancer (Colon and Rectal Cancer)\u003C/em>, Australian Government, viewed 5 February 2024, \u003Ca href=\"https://www.healthdirect.gov.au/bowel-cancer\" target=\"_blank\">https://www.healthdirect.gov.au/bowel-cancer\u003C/a>\u003C/li>\n \u003Cli class=\"list-group-item\">Mayo Clinic 2023, \u003Cem>Colon Polyps\u003C/em>, Mayo Clinic, viewed 5 February 2024, \u003Ca href=\"https://www.mayoclinic.org/diseases-conditions/colon-polyps/symptoms-causes/syc-20352875\" target=\"_blank\">https://www.mayoclinic.org/diseases-conditions/colon-polyps/symptoms-causes/syc-20352875\u003C/a>\u003C/li>\n \u003Cli class=\"list-group-item\">National Health Service 2023, \u003Cem>Bowel Polyps\u003C/em>, NHS, viewed 5 February 2024, \u003Ca href=\"https://www.nhs.uk/conditions/bowel-polyps/\" target=\"_blank\">https://www.nhs.uk/conditions/bowel-polyps/\u003C/a>\u003C/li>\n\u003C/ul>","additionalResources":"\u003Cul class=\"list-group\">\n\t\u003Cli class=\"list-group-item\">\u003Ca href=\"https://www.cancer.org.au/\" target=\"_blank\">Cancer Council Australia\u003C/a>\u003C/li>\n\t\u003Cli class=\"list-group-item\">\u003Ca href=\"https://www.cancer.org.au/assets/pdf/colorectal-cancer-optimal-cancer-care-pathway\" target=\"_blank\">Optimal Care Pathway For People With Colorectal Cancer | Cancer Council Victoria and Department of Health Victoria\u003C/a>\u003C/li>\n\t\u003Cli class=\"list-group-item\">\u003Ca href=\"https://www.health.gov.au/initiatives-and-programs/national-bowel-cancer-screening-program\" target=\"_blank\">National Bowel Cancer Screening Program | Department of Health\u003C/a>\u003C/li>\n\t\u003Cli class=\"list-group-item\">\u003Ca href=\"https://www.ausmed.com.au/cpd/articles/psychological-impacts-of-a-stoma\" target=\"_blank\">Living Well With a Stoma | Ausmed Article\u003C/a>\u003C/li>\n\u003C/ul>","blogEducators":[{"relationID":"9be96610-fc2d-4255-b5b3-07305506afa1","resourceID":"8395741a-9674-47e7-bd2e-04c5e63a80c3","educatorID":"19d618b9-9e1b-421d-9b09-7ad56a48ba40","educatorModel":{"educatorID":"19d618b9-9e1b-421d-9b09-7ad56a48ba40","email":"ausmed.@ausmed.com.au","firstName":" ","lastName":"Ausmed","createDate":"2019-05-29T15:03:17.000Z","updateDate":"2024-10-28T01:59:23.000Z","alias":"ausmed-editorial-team","contactDetail":{"position":"Editorial Team","department":"","organisation":"","qualifications":"","photoURL":"https://ausmed-images.s3.amazonaws.com/ausmed.com/ausmed-educator/Ausmed-logo-square.jpg?stamp=1690771155383","country":"AUS","allowPost":true,"allowEmail":true,"allowTextMsg":true},"eventDetail":{"topics":["e6279e61-739d-4009-ac7c-2531b49a2425"],"biographyNames":["Default",""],"biographies":["Ausmed’s editorial team is committed to providing high-quality, well-researched and reputable education to our users, free of any commercial bias or conflict of interest. All education produced by Ausmed is developed in consultation with healthcare professionals and undergoes a rigorous review process to ensure the relevancy of all healthcare information and updates to changes in practice. If you have identified an issue with the education offered by Ausmed or wish to submit feedback to Ausmed's editorial team, please email ausmed@ausmed.com.au with your concerns.",""],"extraBio":"","brochureBio":""},"types":"Educator"}}],"blogExtraDetail":{"resourceID":"8395741a-9674-47e7-bd2e-04c5e63a80c3","videoNum":1}},"aliasObject":{"resourceID":"8395741a-9674-47e7-bd2e-04c5e63a80c3","resourceType":"blog","alias":"bowel-cancer","metaTitle":"Bowel (Colorectal) Cancer and Care | Ausmed","metaDescription":"Bowel cancer, also known as colorectal cancer, is an umbrella term used to describe cancers of the large bowel/intestine (colon and rectum). Depending on which part of the large bowel is affected, the cancer may be referred to more specifically as colon cancer or rectal cancer, although the two are often grouped together due to their similarities. "},"assessment":{"assessmentID":"1649f76f-7407-41da-91de-0ff40873cbfa","resourceID":"8395741a-9674-47e7-bd2e-04c5e63a80c3","passMark":100,"isRandom":true,"questions":[{"questionID":"86b92066-ffae-47cf-acae-2408f9d52b9c","assessmentID":"1649f76f-7407-41da-91de-0ff40873cbfa","qType":"Multiple Choice","order":3,"text":"Cancerous cells that have spread to nearby lymph nodes would be at what stage?","options":["Stage I/A","Stage II/B","Stage III/C","Stage IV/D"],"answer":2},{"questionID":"51774f50-c57a-4e76-ba39-eca13e1c844c","assessmentID":"1649f76f-7407-41da-91de-0ff40873cbfa","qType":"Multiple Choice","order":3,"text":"True or false: Most people who are diagnosed with bowel cancer survive for at least five years after their diagnosis.","options":["True","False"],"answer":0},{"questionID":"a072fca5-067a-4aac-8646-e639434d14b2","assessmentID":"1649f76f-7407-41da-91de-0ff40873cbfa","qType":"Multiple Choice","order":2,"text":"True or false: Most bowel polyps are harmless.","options":["True","False"],"answer":0}]},"source":"ausmed"}}</script></body></html>