Screening is the broad term used to describe testing for bowel cancer or its precursor (polyps) before symptoms occur. Regular screening is important because bowel cancer can develop without any early warning signs.
Bowel cancer can usually be treated successfully if detected in its early stages.
Cancer and polyps can develop on the inside lining of the bowel for a number of years, and often during this time, minute amounts of blood can leak from the growths, and present in the bowel motion. Screening can detect traces of blood that are invisible to the eye.
There are a number of screening tools used, and your GP can help you determine the best method of screening for you based on your medical history.
All Australian men & women over the age of 50 who do not have symptoms or a family history of bowel cancer are encouraged to undertake screening annually.
Important: if you have had recent changes in your bowel habits, blood in the stool or any direct family history of bowel disease or polyps please see your GP as soon as possible.
There is a simple test you can do in the privacy of your own home. Known as a Faecal Occult Blood Test (FOBtest), this test is used to detect invisible bleeding in the lower bowel. Various companies produce these tests, which can be completed in the privacy of your home and posted in the mail. The results will be mailed confidentially to you and your nominated GP.
It is important to remember that a FOBtest detects traces of blood in the bowel motion, but cannot detect bowel cancer itself.
There are a number of ways to obtain a home FOBtest kit…
- CLICK HERE to order an InSure® Bowel Cancer home test kit online now.
To find out more about this kit, please see ‘What FOBtest products are available in Australia?’ below. - CALL 9508 1016 to order an InSure® Bowel Cancer home test kit.
To find out more about this kit, please see ‘What FOBtest products are available in Australia?’ below. - CLICK HERE to order an Eiken BowelCheck home test kit online now.
To find out more about this kit, please see ‘What FOBtest products are available in Australia?’ below. - The Australian Government’s “National Bowel Cancer Screening Program” offers free FOBtest screening to Australian’s turning 50, 55 or 65 between 1 January 2008 and 31 December 2010.
- These free tests are sent out to eligible Australians.
- If you have received a free screening kit from the Australian Government, you are encouraged to complete the test.
- Australian’s who are not yet eligible for the program at this time are encouraged to purchase a screening kit and undergo screening annually.
- Ask your pharmacist about BowelScreen Australia™ – a pharmacy-based bowel cancer awareness, education and screening program which uses the InSure® Bowel Cancer home test. For more information and to use the online locator tool to find your nearest participating pharmacy please click here.
Two products currently available for purchase in Australia are the InSure® Bowel Screening Test and the Eiken BowelCheck…
Insure® Bowel Screening Test
The InSure® Bowel Screening Test is an Australian-made test that uses a convenient sampling method to test at home. Called an Immunochemical FOB test and made by Enterix Australia, the test requires no faecal handling, and no diet or medication changes.
The cost of the kit is $35.95 including the pathology fee. A private health fund rebate may be available (a receipt is required to make a claim). Results are posted to the patient and nominated GP within 2 weeks.
Neither Let’s Beat Bowel Cancer nor Cabrini Health, receive any benefit, financial or otherwise, for promoting the InSure® test.
To order an InSure® test online now please click here.
To order an InSure® test over the phone please call us on 9508 1016.
Eiken BowelCheck
This is an Immunochemical FOB test distributed by ProHealth Asia Pacific P/L.The test requires no contact with the bowel motion sample, has no smell and no special diets are required.
The cost of the kit is $35.95 including the pathology fee. A private health fund rebate may be available (a receipt is required to make a claim). Results are posted to the patient and nominated GP within 2-4 weeks.
Neither Let’s Beat Bowel Cancer nor Cabrini Health, receive any benefit, financial or otherwise, for promoting the Eiken BowelCheck test.
To order an Eiken BowelCheck test online now please click here to visit their website.
• If you see blood in the toilet bowl
• If you have any haemorrhoids that are actively bleeding.
• Three days before, during, or three days after your period.
You can perform the test if someone else in the house is menstruating, provided that you flush the toilet twice before beginning your sample collection process.
- Rectal Examination
A simple test where the doctor inserts a gloved finger into the anus to feel for anything unusual in the lower part of the bowel.
- Barium Enema & X-ray
A small tube is inserted into the rectum and a liquid called barium is delivered. With air added, the barium is forced into the creases of the bowel wall and allows the bowel lining to be seen clearly when x-rays are taken. This method is less accurate than a colonoscopy as it can easily miss smaller cancers and polyps.
- CT scans and ultrasounds
The technique for constructing pictures from cross-sections of the body, by x-raying the part of the body to be examined from many angles. The use of soundwaves to build up a picture of internal parts of the body. Ultrasound can be used to measure the size and position of a tumour.
- Sigmoidoscopy
This test involves a rigid or flexible lighted telescope (sigmoidoscope) being inserted into the anus to examine the lining of the lower bowel.
- Colonoscopy
An examination using a flexible telescope passed into the bowel through the rectum, which enables the lining of the large bowel to be examined. Unlike x-rays, which take photographs, colonoscopy allows direct visual examination of the interior of the bowel and, in most instances, can provide substantially more detail and accuracy than an x-ray. Sometimes small samples (biopsies) are removed from the lining of the bowel so that they can be examined under a microscope to determine of there is any abnormality or pathology. In addition, if early growths called polyps are present in the bowel, they will usually be removed at the time of the colonoscopy.
Click here to read more about colonoscopy.
Click here to read more about polypectomy.
- Faecal Occult Blood Test (FOBTest)
Used to detect the presence of hidden blood in the faeces, which may be an indication of a polyp or a cancer. False negative and false positive results can occur.
- Virtual Colonoscopy
A new screening tool currently undergoing evaluation for accuracy and efficacy. The colon is inflated with air and a CT scanner image is taken. Virtual reality techniques construct a 3 dimensional image. If a polyp or growth is detected, a colonoscopy will be required to remove them.
A relatively safe and common day procedure, a colonoscopy is an internal examination of the lining of the colon and rectum (large bowel) using a special instrument called a colonoscope, which is slowly and carefully passed into the bowel through the back passage.
Essentially a long, flexible tube (about the thickness of a finger) with a light and a tiny video camera at one end, the colonoscope enables the specialist to see any unusual growths or inflammations, ulcers, polyps or bleeding, which might require further analysis.
The test requires special dietary preparation, is usually done in a hospital or day clinic, and generally takes between 20 to 60 minutes to complete.
If any inflammations or abnormalities are detected, a sample of tissue may be taken (using a special instrument passed through the colonoscope) and later sent for examination in a pathology laboratory.
It is important to remember that the taking of a biopsy does not necessarily mean you have bowel cancer, or that cancer is suspected. It is also vital to keep in mind that if the early signs of bowel cancer are detected and treated early, it can be prevented.
A colonoscope is also used to locate and remove polyps. To find out more, please see What is a polypectomy?
The colonoscopy is usually performed in a hospital or day clinic by a specialist, following referral from a doctor.
Usually you will be provided with a ‘preparation kit’, which will include full instructions on how to prepare for your colonoscopy during the 48 hours prior to the procedure. The kit will also contain a special drink designed to help empty the bowel. Usually you will also be instructed to drink lots of clear liquid, take laxatives and refrain from solid food for up to 48 hours prior to the test. This preparation can be done at home.
In the six hours immediately prior to your colonoscopy, you must refrain from all food and drink (except for a sip of water with your regular medications).
You should tell you doctor well in advance of the test what regular medicines or vitamins you are taking, as some have the potential to cause complications. For example, most doctors advise you to stop taking aspirin and other blood-thinning medicines, certain arthritis treatments and iron pills at least seven days prior to your colonoscopy. Be sure to also tell you doctor if you have any of the following:
- A disease of the heart valve
- A pacemaker
- Diabetes
In some rare instances, you might pass a small amount of blood due to the biopsies that might have been taken, or the result of polyp removal during the procedure. After the two-hour recovery period you should be okay to go home. However, as there will still be some residual anaesthetic/sedatives in your system for a period, you should not drive, drink alcohol, travel alone on public transport, sign legal documents or operate machinery on the same day after the procedure, but instead arrange for a friend or relative to take you home and stay with you.
Polyps are removed using a specially designed wire that is passed down the colonoscope (avoiding the necessity for a major operation). The wire has a loop at the end that can be snared around the ‘stem’ of a polyp and charged with a painless electric current that cuts the polyp away from the bowel wall. The early removal of polyps stops them from becoming malignant, making it a key way to protect people from bowel cancer.
To view an image of a polyp click here
- Localised, temporary irritation of the arm at the site of sedative injections
- Bleeding from the back passage as a result of a biopsy or polyp removal, which is usually minimal and will stop of its own accord, although occasionally bleeding might require cauterisation (via the colonoscope). Very rarely surgery or a blood transfusion might be required.
- While great care is always taken during the colonoscopy, very rarely a perforation of bowel wall can occur, which will necessitate abdominal surgery to rectify the tear.
- An adverse reaction to the sedatives or anaesthetic – of particular concern for people with severe lung or heart problems.
- An adverse reaction to the bowel preparation resulting in headaches, vomiting or dizziness.
- As with any surgical procedure involving anaesthetic, death is a very remote possibility.
In the hours and days after a colonoscopy you should immediately tell your doctor or specialist if you are experiencing persistent bleeding from the back passage, fever, strong abdominal pain, black motions or any other side effects that concern you.
A clear colonoscopy generally means that no polyps or cancerous growths were detected. This means that there is a low risk of developing bowel cancer within the next 10 years. However, it should be noted that while a colonoscopy is considered to be the most accurate test of the colon, no test is 100% accurate and there is a risk that an abnormality may not be detected. So even if you’ve had an ‘all clear’ we recommend that you still complete an annual FOBtest (a simple screening test for bowel cancer). If you develop any symptoms of bowel cancer at any time, even after a clear colonoscopy, you should consult your doctor as soon as possible.
References: 1. Mandel JS, Bond JH, Church TR et al. Reducing mortality from bowel cancer by screening for faecal occult blood. Minnesota Colon Cancer Control Study. N Engl J Med. 1993;328:1365-1371.2. Hardcastle JD, Chamberlain JO, Robinson MH, et al. Randomised controlled trial of faecal-occult-blood screening for bowel cancer. Lancet. 1996;348:1472-1477. 3. Kronborg O, Fenger C, Olsen J, et al. Randomised study of screening for bowel cancer with faecal-occult-blood test. Lancet. 1996;348:1467-1471.
Disclaimer
The FOBtest screening kits referred to on this site - and any subsequent pathology reports - are offered only by third-party suppliers and as such, we cannot warrant the accuracy of the tests or the results. Neither Let's Beat Bowel Cancer nor Cabrini Health or its agencies are liable for services, products or reports provided by these third-party test providers. Neither Let’s Beat Bowel Cancer nor Cabrini Health receive any financial benefit from assisting to distribute the FOBtest screening kits.