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Bowel cancer symptoms and signs


9 April 2021

Evelyn Wallace

Written by Evelyn Wallace

Evelyn, a Registered General Nurse, is Operations Manager of AXA Health’s Cancer Care team, where she is responsible for ensuring excellent customer service and continuing development of the team.

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What is bowel cancer?

Bowel cancer (also known as colorectal cancer) is an umbrella term given to a cancer that starts in the lining of the colon and rectum (or large bowel).

Most cancers of the bowel start with small, benign growths that develop in the lining of the gut. These can turn malignant over time if they aren’t treated. The cancer can then spread through the wall of the bowel. If it spreads further, commonly to the liver or lungs, it is very difficult to cure. If it is caught early when it is just in the bowel wall, the chances of cure are very good.

What are the symptoms of bowel cancer?

The main symptoms of bowel cancer are:

  • Bleeding from your bottom and/or blood in your poo (please do look)
  • A change in bowel habit lasting for 3 weeks or more, especially to looser or runny poo
  • Unexplained weight loss or loss of appetite
  • Extreme tiredness for no obvious reason or shortness of breath
  • A pain in your tummy
  • A lump in your tummy.

Tiredness and breathlessness may seem surprising but these can be symptoms of anaemia. Anaemia can occur due to loss of blood from a bowel tumour, so in that way it can be an initial symptom of bowel cancer.

You may get one, some or all of the above. None of these symptoms mean you have bowel cancer, but you should see your doctor to get them checked out.

The most important thing is to know what is normal for you, and if you notice any changes, see your doctor.

Who does bowel cancer most commonly affect?

Bowel cancer is one of the most common cancers in the UK.

Bowel cancer is more likely to develop in older people. The most common age group affected is 70-80. The NHS bowel cancer screening programme checks people aged 60-74, to  help detect bowel cancer at an early stage, when it's easier to treat. It can also be used to help check for and remove small growths in the bowel called polyps, which can turn into cancer over time.

Bowel cancer rarely occurs before the age of 50, but specialists always have it in the back of their minds, particularly if it runs in the family. If several members of your family have suffered from it then your risk of getting it is often higher.

The majority of bowel cancers do not have a genetic (or familial) cause. However a small number – perhaps 1 in 20 – do. In these cases, there are usually several close members (such as a parent, sister or brother) of the same family with bowel cancer. Also, the younger a person is when they get bowel cancer, the more likely it is to have a genetic cause. It can skip a generation, but this is unusual.

The key is to look out for any symptoms – see below for more details.

People with bowel conditions such as Crohn's disease and ulcerative colitis are more likely than the general population to develop bowel cancer because the bowel lining is inflamed. The risk of developing bowel cancer increases with the length of time the patient has had the disease.

This is why it is so important for individuals with these conditions to be seen regularly by a specialist so they can be monitored for early changes in the bowel lining which may lead to cancer.

How can you prevent bowel cancer?

There’s some evidence that a diet containing a lot of red and processed meats (such as smoked meat, ham, bacon, sausages, pâté and tinned meat) can increase the risk of developing cancer of the bowel. The greatest increase in risk seems to be for people who eat two or more portions of a day. Conversely, people who eat less than two portions a week seem to have the lowest risk.

Eating fried or grilled meat might also increase the risk. No link has been found between eating poultry (such as turkey and chicken) and an increased risk of bowel cancer.

A well balanced diet, high in fibre, is a good idea as evidence suggests that increasing fibre intake decreases the risk of colorectal cancer. Lots of fresh fruit, vegetables and unrefined grains, for example porridge, are good. Choosing brown rather than white bread is another good source of fibre.

Occasionally, you may be asked to follow a low fibre or low residue diet to rest your bowel, or as part of your preparation for surgery. These are specialised diets followed under the supervision of a dietitian.

You can also consider taking a child strength aspirin every day from age 50 as a preventative measure, but always take medical advice before starting this.

Bowel health pathway

In 2020 we launched a bowel health pathway pilot, managed by OneWelbeck Digestive Health, a dedicated facility founded by leading specialists in gastroenterology. The pathway is designed to get people to diagnosis and treatment fast. It’s available to those aged 35 or over without a GP referral (or under 35 with a GP referral). It’s currently open to clients on our Advance corporate healthcare scheme - if you’re interested in joining, please speak to your intermediary or account manager. 

Read more about out bowel health pathway pilot

Further reading

Coping with a cancer diagnosis – AXA Health

Tried and tested, these practical tips can really help you manage the day-to-day challenges

How do I tell people I have cancer? – AXA Health

This can be a daunting part of the process, but it’s the perfect opportunity to reach out for the help and support you need.

5 cancer myths busted – AXA Health

Evelyn Wallace, who heads our Cancer Care team, helps to sort the fact from the fiction

Some useful tips to empower you as you navigate the new (to you) cancer journey.

Useful resources for help and support

NHS – Bowel / Anal cancer factsheet

Cancer Research UK

Bowel Cancer UK

Macmillan Cancer Support

Office for National Statistics – cancer survival bulletins