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Knowing the Symptoms and Who is at Risk This factsheet has been written to help you understand some of the symptoms of bowel cancer and which groups of people are at a higher risk of developing the disease. If you would like further information on symptoms and risks or if you have any other concerns regarding bowel cancer, please call our Bowel Cancer Advisory Service on freephone 0800 8 40 35 40. Symptoms Problems of the bowel (colon and rectum) are very common but most symptoms do NOT turn out to be bowel cancer. However, if any of the following symptoms persist for more than a few weeks, talk to your GP: • Any change in your usual bowel habit that lasts four weeks or more. For example, diarrhoea (loose stools, poo) or constipation (too solid) or going a lot more or less than usual • Bleeding from the bottom or blood in your stools (poo) • Pain or lump in the abdomen (belly) • Unexplained extreme tiredness and/or unexplained weight loss Why do I need to know the symptoms? Patients whose cancer has not spread beyond the inner lining of the bowel have a much higher chance of successful treatment compared to those whose cancer has become more widespread. Early diagnosis is important - it can literally save lives. Who is at risk? The exact cause of bowel cancer remains unknown. However there are certain factors that contribute to a higher risk: • Age Bowel cancer can develop in men and women of any age but it tends to be a disease of middle and old age. In the UK, around 97% of cases occur in people over the age of 50. The vast majority, 90%, have no particular family history that would influence their risk of developing bowel cancer • Inflammatory bowel disease People who have inflammatory bowel diseases such as ulcerative colitis or Crohn’s disease, or those who have a tendency to develop polyps may have an increased susceptibility to developing bowel cancer check it • Diet and lifestyle Increasing evidence shows that a diet high in saturated fat, red meat and/or processed meat and low in fibre (i.e. a lack of fruit, vegetables and wholegrains) increases the risk of developing the disease. Obesity, lack of exercise and high alcohol consumption are also risk factors • Obesity Several research studies have demonstrated that overweight or obese people have an increased risk of bowel cancer. A recent European study found that obese men are approximately 50% more likely to develop bowel cancer compared to men with a healthy weight . Risk is particularly linked with weight around the middle of the body, as opposed to a more general measure of weight such as the Body Mass Index (weight divided by height squared) • Family history It is important you talk to your GP if you know that any of the following family cancer histories apply to you: - One first degree relative (i.e. mother/father/brother/sister/child) in your family was diagnosed with bowel cancer under the age of 45 Or - Two first degree relatives and/or one first degree and one second degree relative (i.e. grandparent, aunt, uncle) on the same side of your family have had bowel cancer Or - There are cases of bowel cancer and also endometrial, ovarian, stomach, pancreatic and biliary or kidney cancer within the family There are two rare genetic conditions in which people have a high risk of developing bowel cancer. With Familial Adenomatous Polyposis (FAP), many benign tumours, called polyps, are found in the lining of the bowel. People with FAP have a high risk of developing bowel cancer. In another inherited genetic condition known as Hereditary Non-Polyposis Colon Cancer (HNPCC), bowel cancers develop at an early age, sometimes in more than one place in the bowel. If you notice any symptoms that concern you, please make a note of them and discuss these with your GP or one of our Advisory Nurses. If you think you may be at higher risk because of a family history of bowel cancer, discuss with your GP the possibility of being referred to a family cancer clinic. You may find the following additional factsheets helpful: • Reducing Your Risk • Diet, Nutrition And Bowel Cancer • Understanding Bowel Cancer Information correct as at date of publication (March 2009) For further information contact the Bowel Cancer London office Edinburgh Office Advisory Service on: (Freephone) 0800 8 40 35 40 7 Rickett Street 20 Queen Street Email: firstname.lastname@example.org London SW6 1RU Edinburgh EH2 1JX Website: www.bowelcanceruk.org.uk Tel: 020 7381 9711 Tel: 0131 225 5333 Registered Charity Number: 1071038 Fax: 020 7381 5752 Fax: 0131 225 2206