June is bowel cancer awareness month. Bowel cancer is the third most common cancer affecting people in Australia. There are many things that can increase your risk of bowel cancer; some you can change and others you cannot. Having type 2 diabetes is one such risk factor that you cannot change.

Other risk factors you can’t change:

• Your age (being 50 years or older)
• Your ethnic background
• A personal or family (a first degree relative) history of bowel polyps or bowel cancer
• Having an inflammatory bowel disease, for example ulcerative colitis or Crohn’s disease
• Having an inherited syndrome like Lynch syndrome, Peutz-Jeghers syndrome or MYH-associated polyposis

Risk factors you can change:

• Your level of activity
• Your weight and waist circumference
• Smoking
• Heavy alcohol use
• Diet

How can you reduce your chances of developing bowel cancer?

Be physically active

Physical activity helps your food pass through the bowel faster to reduce the time potential carcinogens in the food are in contact with the bowel wall, it also helps to achieve a healthy weight and reduces insulin resistance. Thirty to 60 minutes of exercise daily is recommended.

Watch your weight

Being a healthy weight for your age, height and ethnicity along with having a healthy waist circumference can reduce your risk too. Having higher levels of body fat is associated with higher levels of insulin which promotes cell growth and the body’s inflammatory response, both of which promote bowel cancer. Your GP, diabetes educator, dietitian and exercise physiologist can work out what weight and waistline is ideal for you. Your dietitian can help you make small changes to your eating to reduce your weight.

Stop smoking

The longer you smoke, the more you increase your risk of getting bowel cancer. As to the safety of e-cigarettes, more research is needed. Your GP can assess your nicotine dependence, discuss medications eg patches, gums, and explore your barriers to quitting. Or give Quitline a call on 137848 or our psychologist on 1300 136 588 for help in quitting smoking.

Alcohol

Cut out alcohol entirely or reduce your daily alcohol use – the more you drink the greater your risk.

Limit red meat

Avoid large amounts of red meat (the World Cancer Research Fund recommends a maximum of 50g/day which equals a maximum of 350g/week) and avoid processed, cured and preserved meats. Meats cooked at high temperature can create carcinogenic chemicals that could increase your risk so choose low temperature cooking methods.

More fibre

Eat foods high in dietary fibre including wholegrains, fruit, vegetables and legumes as the fibre, vitamins, bioactive compounds and antioxidants are protective for the bowel. Five serves of vegetables and two serves of fruit each day are recommended by the Australian Dietary Guidelines.

Keep up the calcium

Eat foods containing calcium such as dairy products or supplements. Check with your doctor before taking calcium supplements.

Bowel cancer symptom checker

In Australia, 98% of bowel cancers can be treated if detected early. Since some people don’t get any signs or symptoms screening tests have been developed. If you have one of these symptoms for more than two weeks than you should see your GP:

• Blood in the stool or rectal bleeding
• Abdominal pain or swelling
• A change in bowel habits that is recent and persistent
• Pain or a lump in the anus or rectum
• Unexplained anaemia – low red blood cell count
• A feeling that the bowel has not emptied completely after a bowel motion.

When should you start tests to diagnoses bowel cancer?

1. If you are 50 years of age
2. If you are 45 years of age with a relative with bowel cancer at 55 years or older.

Talk with your GP as to how often you should have a screening test done as risk factors are considered. A faecal immunochemical test (FIT) is recommended for those with type 2 diabetes every one to two years. Call the Bowel Cancer Australia helpline on 1800 555 494 for more information on how to order this FIT test if you do not receive one in the mail during your 50^th year.

Amanda Callaghan RN CDE