Headlines last week reported on research revealing a predicted rise in UK bowel cancer deaths in 25–49-year-olds when compared with other European countries. Researchers predicted a 26% rise in deaths in men and nearly 39% in women in 2024 as compared to 2018.
Across all ages, death rates for the UK are predicted to remain stable or decline, due to better screening and treatments. These statistics warrant close attention, and coverage was quick to highlight alcohol and obesity as reasons for the rise. As always, it is more complex than this. Alcohol and obesity play a role, as they do in most diseases, but there are other factors driving up diagnoses and deaths in younger people.
In recent decades, it’s been recognised that more younger people who would not usually be considered to be at risk of bowel cancer have been receiving diagnoses. Research has shown that antibiotic use is associated with an increased risk of colon cancer, but not rectal cancer, indicating that this medication could be damaging the protective microbiome, which resides in the colon – increasing the risk of cancer from a younger age.
We also know that high profile cases like Dame Deborah James have contributed to better awareness of bowel cancer – the NHS reported a tenfold increase in people checking bowel cancer symptoms online immediately after she died, aged 40, potentially further increasing diagnoses in younger people who may not have considered themselves to be at risk.
While it’s important we look closely at these figures and prioritise prevention of bowel cancer at a younger age, it’s also crucial we recognise these statistics also represent a huge rise in cases in the under 50s and therefore a similar rise in numbers of people surviving the disease.
That’s why we’re investing in research to help people manage life after treatment for bowel cancer and other bowel disorders, especially as people continue to be diagnosed at a younger age and live longer as survivors of the disease.
A major issue that needs tackling is treating conditions like low anterior resection syndrome (LARS), which leaves patients with little or no bowel control after surgery. Of the 43,000 UK bowel cancer patients each year, around 8,680 patients will go on to have an anterior resection each year – and many more will experience these sorts of post-surgery issues from other types of bowel disorders. Our POLARiS study is set to investigate different methods of improving continence after bowel cancer surgery – a study that we know our patient supporters think is crucial work.
We are also funding research to improve the lives of the 130,000 people living with a stoma in the UK. Many patients treated for bowel cancer will live permanently with a stoma after their surgery. One study is aiming to reduce surgery and bring back quality of life for the 65,000 people with a parastomal hernia – a bulge around the stoma, which patients tell us is unsightly, uncomfortable and often debilitating. Another is looking at how to make it easier for people with a stoma to exercise, as there is strong evidence that physical activity improves the quality of life in patients with cancer or Irritable Bowel Disease.
Our research also aims to improve the detection and diagnosis of bowel cancer. People at high risk of developing the disease need regular colonoscopies – tests where a thin tube with a camera is passed through your bottom to spot growths that could turn into cancer, called polyps. This can be costly to the NHS and uncomfortable for patients. Our research, which is now being tested in a larger clinical, showed that a simple urine test alongside a faecal immunochemical testing (FIT), or poo sample, could halve the number of colonoscopies needed to detect polyps in high-risk patients.
Bowel Research UK has invested over £9 million directly into research projects tackling bowel cancer and bowel disease, and we’re proud to continue to fund research that not only provides hope for new treatments, but also helps improve lives of people living with the often long-term and serious effects of bowel surgery.
by Rachel Gonzaga
February 2024