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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.

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

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	          •	         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

	          •	         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

	          •          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
                      - 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
                      - 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:                                                          London SW6 1RU                                  Edinburgh EH2 1JX
Website:                                                             Tel: 020 7381 9711                              Tel: 0131 225 5333
Registered Charity Number: 1071038
                                                                                              Fax: 020 7381 5752                              Fax: 0131 225 2206

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