Family history is vital to understanding your risk of bowel cancer.
Family history is vital to understanding your risk of bowel cancer.

Start screening early to battle bowel cancer

THE advice is to start screening earlier rather than later if your family has a history of bowel cancer.

That family history is a strong indicator of risk of being diagnosed with the disease, which is now detailed across three categories -

  • Category 1 - at near average risk. People with no first-degree relatives with colorectal cancer -- immunochemical FOBT (iFOBT) every 2 years from age 50 to 74 years; people with one first-degree relative with colorectal cancer diagnosed at 55 years or older - biennial iFOBT from age 45 years should be considered.
  • Category 2 - at moderately increased risk. People with one first-degree relative with colorectal cancer diagnosed with colorectal cancer at age 55 years or older - biennial iFOBT from age 40 to 49 years then colonoscopy every 5 years from age 50 to 74 years.
  • Category 3 - high risk. People with three first-degree relatives with colorectal cancer - biennial iFOBT from age 35 to 44 years, then colonoscopy every 5 years from age 45 to 74 years.

These changes to the national guidelines for the prevention, early detection and management of the disease have been summarised in report published in the Medical Journal of Australia.

The authors are recommending patients participate in iFOBT screening which is offered by the National Bowel Cancer Screening, if they are waiting for a colonoscopy to be arranged. This screening is done by home test kit which is distributed by mail. The test detects cancer early, saves lives and is simple, clean, safe and done at home.

The new guidelines recommend biennial screening for the majority of Australians from age 50 where there is modest or no family history.

"Depending on the strength of the family history, it is recommended to start iFOBT screening from age 35 or 45 years (ie, up to 15 years younger) before transitioning to colonoscopy after 10 years," the authors conclude.

Currently it is recommended that bowel cancer screening stop at age 74, but for people with a family history of this cancer, the optimal age to stop screening is still not known.


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