In this article we hear from leading Gastroenterologist and Bowel Cancer Australia spokesperson A/Professor John Ding, on how men can modify the risk of bowel cancer and be proactive with their gut health.
Discussing bowel habits can be awkward for some men as it may seem unnecessary or uncomfortable. However, as men move into middle age (from 45 years of age), bowel cancer is one of those men’s health conditions which become a focus for health professionals the older a man gets.
Bowel Cancer & Men’s Health
According to Bowel Cancer Australia, there are really good reasons why Australian men should be aware of bowel cancer risks as they age.
- 1 in 13 Australian men (or one man per Rugby League team) will develop bowel cancer in their lifetime.
- Bowel cancer is the third deadliest cancer in men, claiming 2,838 lives each year, including 159 (5.6%) under age 50.
- Around 8,463 men are diagnosed with bowel cancer each year, including 844 (10%) under age 50.
- Around 54.5% of all Australians diagnosed with bowel cancer are men.
What is Bowel Cancer?
Bowel cancer (also commonly known as colorectal cancer) develops from the inner lining of the bowel.
Cancer is usually preceded by growths in the bowel or rectum called polyps. Polyps are caused by abnormal growth of cells. What causes polyps is still unclear.
What are the modifiable risk factors for bowel cancer?
Bowel Cancer Australia have included a list of what they term ‘modifiable risk factors’ to consider in relation to overall risk (excluding family genetics).
Alcohol– bowel cancer risk accelerates when 2 or more alcoholic drinks are consumed per day according to research.
Red & Processed Meat– eating processed meats such as bacon, ham, salami and sausages has been strongly linked with an increased risk of bowel cancer.
Smoking – smoking 40 cigarettes per day increases the risk of bowel cancer by 40%.
Waist Circumference & BMI– bowel cancer risk rises with increased body fatness, as marked by body mass index (BMI), waist circumference or waist-hip ratio.
Lowering the risk of bowel cancer
Wholegrains- recent data indicates that eating at least 90 grams of wholegrains a day, such as brown rice or wholemeal bread, can reduce the risk of bowel cancer by 17%.
Dairy products and Calcium Supplements- consuming 400 grams of dairy products per day decreases risk by 15%.
Physical activity- recreational physical activity can reduce colon (not rectal) cancer by 16%.
Aspirin– taking aspirin every day for at least 5 years decreases the risk of developing bowel cancer as well as dying from bowel cancer. Aspirin can have side-effects, so please consult your GP before initiating regular aspirin use.
Polyp removal- people with cancers diagnosed through the National Bowel Cancer Screening Program had a 40% lower risk of dying than people who had not been screened.
What are the symptoms of bowel cancer?
There are a range of symptoms that can (but not always) be experienced. These can include-
- Changes in bowel habits (diarrhoea, constipation)
- Bloating or cramping discomfort to the abdomen
- Blood in faeces (usually seen in the toilet bowl)
- Changes in urination- colour or frequency.
- Anal or rectal discomfort.
- Unexplained weight loss.
- Fatigue, including new breathlessness.
How is bowel cancer diagnosed?
There are a series of tests which may be required to determine a diagnosis of bowel cancer. However, anyone with symptoms should speak with their healthcare professional.
Blood tests- are taken to check your red blood cell count and iron studies. If these are low or deficient, it warrants further investigations.
Immunochemical fecal occult blood test (iFOBT)- If you’re aged 45-74, you are eligible to receive a iFOBT test (also known as a bowel screening test) as part of the National Bowel Cancer Screening Program. For those 45-50, you will still need to opt in and request the free kit from the government (include the link to the NBCSP free kit)
Colonoscopy- is the gold standard test used to determine bowel cancer. This is undertaken under deep sedation and requires a bowel preparation before which may seem very invasive but is worthwhile and has been shown to save lives.
Flexible sigmoidoscopy- is used to examine the rectum and left side of the lower colon. Any unusual tissue can be removed for further examination.
Additional tests can include CT scans, PET scans and MRI depending on the results of the colonoscopy and blood tests.
What are the treatments for bowel cancer?
There are several treatments for bowel cancer, depending on the stage of the disease.
Surgery– the most common treatment for early-stage bowel cancer is surgery.
Radiation therapy– can be used before or after the surgery for locally advanced rectal cancer or may be used in combination with chemotherapy for more advanced cancer.
Chemotherapy – is treatment that may be required following surgery. The decision to use chemotherapy is determined by your Medical Oncologist after reviewing your test results.
Fertility: some treatments for bowel cancer can cause infertility for some men. If you receive a diagnosis of bowel cancer and you wish to conceive children in the future- please discuss this with your specialist team prior to treatment.
Bowel cancer prognosis: the 5-year relative survival rate for bowel cancer in Australia is 70.9% with increasing rates in those between the ages of 25-49yo.
When should I consider bowel cancer screening?
From the age of 45 years, men ought to be speaking with their GP about bowel cancer screening.
If you have a family history of either bowel or prostate cancer- these conversations should be commenced from age 40 years.
Expert Opinion: A/Prof John Nik Ding (St Vincent’s Hospital Melbourne) (MBBS, FRACP, PhD)
Bowel cancer, also known as colorectal cancer, is a major health concern for men, particularly those over the age of 50. It is one of the most common types of cancer in men and is linked to several risk factors, many of which are lifestyle-related.
Diets high in red and processed meats, alcohol consumption, smoking, and a sedentary lifestyle all increase the risk of developing bowel cancer. Men with a family history of colorectal cancer or inherited conditions like Lynch syndrome are at even higher risk. Symptoms such as persistent changes in bowel habits, rectal bleeding, abdominal pain, and unexplained weight loss should be taken seriously, as they could signal early stages of the disease.
Early detection through regular screening can dramatically improve survival rates, as bowel cancer is often highly treatable when caught in its early stages. Colonoscopies are the gold standard for screening, as they allow for the detection and removal of precancerous polyps before they develop into cancer.
Men are encouraged to begin screening from the age of 45 through the bowel cancer screening program, or earlier if they have a family history or other risk factors. Despite its effectiveness, many men delay screening, often due to embarrassment or fear, which can lead to late-stage diagnoses and poorer outcomes.
Prevention strategies play a critical role in reducing the risk of bowel cancer in men. Simple lifestyle changes such as increasing intake of fibre-rich fruits and vegetables, exercising regularly, reducing red meat consumption, quitting smoking, and moderating alcohol intake can significantly lower the risk by adopting these healthy habits and staying vigilant with screenings, men can greatly reduce their chances of developing bowel cancer.
Real Men’s Health thanks Bowel Cancer Australia for the development of this article.
