People with some conditions have a higher risk of getting bowel cancer at a younger age than usual. They might have screening earlier than the normal NHS bowel cancer screening programme. Around 5 out of 100 (5%) bowel cancers are due to conditions passed on through families (inherited). Screening aims to detect cancer at an early stage, when treatment is more likely to work. It can also help to prevent bowel cancer from developing in the first place. People at high risk of bowel cancer have screening with colonoscopy. This test looks at the inside of the whole of the large bowel (colon). A specially trained healthcare professional (endoscopist) uses a flexible thin tube with a camera on the end to look at the bowel. A number of conditions can increase your risk of bowel cancer. An inherited bowel condition called familial
adenomatous polyposis (FAP) This is a rare condition that runs in families. It causes a lot of abnormal growths called polyps in the bowel. There is a high risk that one of these polyps will become cancerous. You have colonoscopies every year, if you have FAP. Specialists often advise people with FAP to have surgery to remove their large bowel (colon). This is because there is such a high risk of getting bowel cancer. An inherited
bowel condition called Lynch syndrome Lynch syndrome is sometimes called HNPCC- hereditary non polyposis colorectal cancer. It is an inherited gene change (mutation) that increases your bowel cancer risk. You start screening when you are 25 if you have HNPCC. Or 5 years before the age of diagnosis of your youngest affected relative. You continue for every 12-24 months until you’re 75. Serrated polyposis syndrome (SPS) Serrated polyposis syndrome (sometimes called hyperplastic polyposis syndrome) is when polyps occur in the bowel with jagged edges (serrated). Research is looking into whether this is an inherited condition. If you have SPS you will be offered a colonoscopy every 1 to 3 years A strong family history of bowel cancer This means you have several relatives on the same side of your family diagnosed with bowel cancer. Or you have a close relative diagnosed at a particularly young age. If you have a strong family history of bowel cancer, but no gene for FAP or Lynch syndrome, you might have a colonoscopy between the ages of 35 to 45. If you don't have any polyps, you won't need another colonoscopy until you are 55. Talk to your GP if you think you have a strong family history of bowel cancer. They can refer you to your local genetics clinic. You'll see someone who specialises in looking at family histories and working out the likely risk of a particular disease. They can refer you to a bowel specialist for regular screening if necessary. Ulcerative colitis or Crohn's disease Ulcerative colitis and Crohn's disease cause inflammation and sores (ulceration) inside the bowel. These diseases increase your risk of bowel cancer. Your level of risk depends on:
You usually have a colonoscopy 8 to 10 years after the symptoms start. You might have colonoscopies every 1 to 5 years depending on your level of risk. Polyps in the bowel Your doctor may suggest that you have regular tests to check the inside of your bowel, if you had polyps removed from the bowel in the past. This is to find any more polyps before they develop into cancer. How often you have these tests depends on:
You might have tests every 1 to 5 years depending on your level of risk. Previous history of bowel cancer There is a risk that you could get another new bowel cancer If you have had bowel cancer in the past. You may have a colonoscopy every few years. If you are not in a high risk group There's no NHS screening available outside the age range covered by the UK bowel cancer screening programmes if you don't have a higher than average risk of bowel cancer. RELATED: Cancer News Update: Earlier May Be Better for Colorectal Cancer Screening, a New Way of Screening for Ovarian Cancer, and More Cancer News From February 2020 In the new study, Samir Gupta, MD, of the VA San Diego Healthcare System and the University of California in San Diego, examined data on people ages 40 to 49 years old; 2,473 had been diagnosed with colorectal cancer and 772 did not have the disease. He and his team used standard colorectal screening criteria to see who met the criteria for family history-based screening. The criteria state that people with a first-degree relatives with colorectal cancer start screening at age 40 or 10 years prior to the age at diagnosis of the youngest relatives with the disease. The study showed that 25 percent of the colorectal cancer patients met the family history-based criteria for screening compared with 10 percent of those without cancer. Moreover, almost every patient with colorectal cancer — 98.4 percent of the group — who met family history–based criteria should have been screened at a younger age than when their cancer was diagnosed. “In this scenario, 1 in 4 patients could have had the opportunity to have their cancer diagnosed at an earlier age,” says Dr. Gupta. The study does not address why the patients with a family history of colorectal cancer were not screened earlier, Gupta says. It could be that patients don’t know their family history or don’t share it with their healthcare providers. Providers may not recommend screening or patients fail to follow through on a doctor’s recommendation. RELATED: Never Too Young: A 30-Something Battles Hereditary Colon Cancer Colorectal Cancer: The Cost of Delayed DiagnosisA delay in finding cancer can mean the disease is detected when it’s more advanced. A study published in March 2020 in the journal CA: A Cancer Journal for Clinicians found that colorectal cancer patients ages 40 to 49 are more likely to be misdiagnosed, leading to a delay in the correct diagnosis of cancer and the start of treatment. The study also found that at least 63 percent of patients delayed going to a doctor after first experiencing symptoms because they didn’t suspect colorectal cancer. Two-thirds of the patients saw at least two doctors before receiving the correct diagnosis. A majority of the patients were diagnosed at a late stage. Another study, published in July of 2019 in the journal Cancer, found a higher rate of patients under age 50 had more advanced cancer — stages 3 and 4 — compared with patients 50 and older (51.6 percent compared with 40 percent). The new study findings lend support to the idea of starting screening for people considered a normal risk at age 45, Gupta says. “We could consider screening people at an earlier age, such as 45. But the other option is to come up with better strategies to identify risk,” including information on gender, diet, exercise, and lifestyle factors, he says. More research is also underway to identify additional genetic mutations that increase the risk of colorectal cancer, he says. Meanwhile, he says, it’s important to inquire among family members about family history, and share any relevant information with your doctor. “It could save your life or the life of one of your relatives,” he says. RELATED: Cancer Society Now Says Screening for Colon and Rectal Cancer Should Begin at 45 — Not 50 What are the chances of getting colon cancer if it runs in your family?If you have familial risk, a single first degree family member (parent or sibling) with colon or endometrial cancer under age 50, your lifetime risk increases to 10-20%. Family history is an important indicator not only because of shared genes, but similar lifestyles too.
What age is family history of colon cancer?If family history increases your risk, your doctor will recommend earlier and more frequent screening. People with a family history of cancer should get screened at age 40 or 10 years before the youngest case in your immediate family, whichever is earlier.
How early do you need to detect colon cancer?You should begin screening for colorectal cancer soon after turning 45, and then continue getting screened at regular intervals. When colon cancer is found in early stages, the 5 year survival rate is at about 90%.
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When to get screened for colon cancer if family history
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