Kate Byford The Cancer Council Victoria

Bowel Cancer Screening and Education Prevention and Screening

Thursfield V,et al Cancer in Victoria : Statistics & trends 2012. Cancer Council ,

Melbourne 2013

New cases and deaths for the Victoria population in 2012

New cases and deaths in 2012 for the leading cancers in Victorian men

4764

1920

1573

1278

790735

1161

0

1,000

2,000

3,000

4,000

5,000

6,000

Prostate Bowel Lung Melanoma

Ne

w c

ase

s/d

ea

ths

in 2

01

2

Type of Cancer

New cases

Deaths

210

Victorian Cancer Registry 2012

New cases and deaths in 2012 for the leading cancers in Victorian women

Victorian Cancer Registry 2012

1713

1003883

698616

765

105

0

1,000

2,000

3,000

Breast Bowel Lung Melanoma

Ne

w c

ase

s/d

ea

ths

in 2

01

2

Type of Cancer

New cases Deaths3748

Key facts about Australia

• Australia has one of the highest rates of bowel cancer in the world

• It is the second most common cause of cancer-related death in Australia (after lung cancer)

• Over 70 Australians die each week

• Affects men and women. Lifetime average risk is 1:10 for males and 1:14 for females to the age of 85

90% of bowel cancers are curable when detected early

How bowel cancer starts

• Polyps that grows inside large bowel

• Slow growing (10+ years)may never progress or benign adenomas

may become malignant over time – bleed

• Usually removed when observed during colonoscopy

Polyp on long stalk /

mushroom cherry

Flat Adenoma

Signs and Symptoms

Most early bowel cancers do not produce obvious signs and symptoms and is sometimes called the silent cancer

If present, symptoms are typical of several common conditions; however, the most common presenting ones are:

• Bleeding from the rectum, mixed with or separate from faeces

• Persistent change in bowel habit

• Symptoms of anaemia

• Colicky lower abdominal pain

• Unexplained weight loss

Anyone with symptoms should talk to their G.P

Risk Factors

Non-modifiable:

• Age 50 years+

• Inflammatory bowel disease

• Lynch Syndrome

• Familial Adenomatous Polyposis (FAP):

• Strong family history of bowel cancer / one family member under 55 and or 2 on same blood line

Modifiable:

• Diet

• Obesity

• Smoking

• High alcohol intake

• Physical inactivity

• Diabetes (type 2)

Bowel Risk Calculator

THE CALCULATOR : www.cancervic.org.au/bowel-cancer-risk-calculator

• Is an online interactive calculator to establish risk

• Has drop down boxes with modifiable lifestyle factors, personal

history and family history

• Provides tailored advice on screening recommendations ,

improvements in lifestyle and

• Can be printed so you can give it to your health practitioner

Faecal Occult Blood Test (FOBT)

• Immunochemical (antibodies to human globin)

• FOBT is simple, hygienic and painless, can be done privately at home

• FOBT looks for invisible blood in tiny samples from two separate bowel motions

• Doesn’t diagnose bowel cancer but can identify who needs further testing

• Detects both pre-cancerous polyps as well as adenomatous polyps that may develop into cancer over time

•

Most bowel cancers take 10+ years to develop, so having an FOBT every 2 years is an appropriate interval

National Bowel Cancer Screening Program

• Eligible men and women turning 50, 55, 60 or 65 will be sent an invitation letter, information booklet and free kit in the mail.

• The FOBT is completed at home then posted to pathology service with Participant Details Form

National Bowel Cancer Screening Program

• Results are sent to patient and doctor (positive result needs further follow-up; negative result means re-screen in two years) These results are captured by the national register

• Referral pathway normally a referral from the G.P for a colonoscopy. Important that the G.P has +FOBT on referral form. This means they will be triaged i.e., Category 1. There are 19 preferred providers.

• The register has a patient follow up service (PFUP) to ensure positive results have followed the correct referral pathway ie, surveillance

Budget Announcement

The 2014-15 Budget has delivered $95.9 million dollars over 4 years to accelerate the implementation of biennial screening for all Australians aged 50-74 years.

The expansion will be done in stages as follows :

2015: 70 and 74 years

2016: 72 and 64

2017: 68, 58, 54

The four remaining cohorts will 52,56,62,66 will be included from 2018 to 2020

NBCSP phases and target populationsPhase Start date End date Target ages

1 7 August 2006 30 June 2008 55 and 65

2 1 July 2008 30 June 2011(a) 50, 55 and 65

2(b) 1 July 2011 30 June 2013 50, 55 and 65

3 1 July 2013 Ongoing 50, 55, 60 and 65

3 1 July 2015 50, 55, 60, 65, 70 and 74

3 1 July 2016 50, 55, 60, 64, 65, 70, 72 and 74

3 1 July 2017 50, 54, 55, 58, 60, 64, 68, 70, 72 and 74

3 1 July 2018 50, 54, 58, 60, 62, 64, 66, 68, 70, 72 and 74

3 1 July 2019 50, 52, 54, 56, 58, 60, 62, 64, 66, 68, 70, 72 and 74

Links

Visit

• http://www.cancerscreening.gov.au/internet/screening/publishing.nsf/Content/bowel-about

• http://www.cancervic.org.au/preventing-cancer/attend-screening/bowel_cancer_screening

• http://bowelcancer.org.au/

• http://www.cancervic.org.au/how-we-can-help/family-cancer/genetics-bowel-cancer#FAP

• www.cancervic.org.au/bowel-cancer-risk-calculator

Contacts

Kate Byford

Bowel Cancer Program Coordinator

The Cancer Council Victoria

Email. Kate.byford@cancervic.org.au

T. + 61 3 9514 6431

615 St Kilda Road Melbourne

www.cancervic.org.au