In the current pandemic we are desperate to find an easy and affordable way to prevent COVID-19. Yet, we know how to prevent another lethal disease, bowel cancer, and many are not taking that opportunity.
Part of preventing bowel cancer may be as simple as taking aspirin. Recently the 10–year follow-up of people who had inherited a high risk of developing bowel cancer showed they reduced that risk by 40% by taking 2 aspirin each day. The aspirin was well tolerated and did not cause excess bleeding.
Other studies included people taking low dose aspirin to prevent heart disease who also showed that it reduced their risk of bowel cancer. People between 50 and 70 years with a lower risk of bowel cancer can consider taking low dose aspirin which may help prevent both conditions.
We can be more definite about lifestyle choices, such as diet that will reduce the risk of bowel cancer. Increased risk has been linked to heavy consumption of red meat, particularly when barbequed, and eating high amounts of smoked, cured or salted meats. The risk is reduced by eating a high-fibre diet. People who are overweight have a higher risk of bowel cancer. Lesser known is that bowel cancer is one of the cancers linked to tobacco smoking and alcohol consumption. Regular physical exercise reduces the risk of bowel cancer.
Screening for bowel cancer is also part of prevention since it not only detects very early disease prior to symptoms when it is curable, but alerts to the presence of benign growths in the bowel wall, called polyps, that can become cancerous over several years unless they are removed. The screening test is a simple kit which enables people to sample their bowel motion and mail it to a pathology service to test for microscopic blood. A positive test means that the bowel lining should be visually inspected by colonoscopy. Most positives will not be cancer but the chance of detecting it will increase with continued testing.
The Federal Government has played its part and completes a bowel screening program started in 2006. From this year free kits will be mailed every two years to all 50 to 74–year old’s. The problem is that only 4 of every 10 kits are returned, despite the fact that it is estimated that at least 90,000 lives could be saved over the next 40 years, with greater participation. Younger people, not part of screening, can develop bowel cancer and may be advised by their GP to be tested if they have risk factors such as a strong family history or inflammatory bowel disease.
We may have to wait to prevent COVID-19, but we should all be preventing bowel cancer right now.
Ian Olver AM
Professorial Research Fellow
University of Adelaide
Jodi Lee Foundation Board Member