The risks of failing to diagnose bowel cancer

Posted: 14/02/2024

Bowel cancer, or colorectal cancer, is the fourth most common cancer in the UK, with about 43,000 people diagnosed every year according to Bowel Cancer UK.

The bowel is part of the digestive system, made up of the small bowel and large bowel. Your colon and rectum make up the large bowel. Bowel cancer typically affects the large bowel, and can mean cancer is present in the colon or rectum.

What are the symptoms of bowel cancer?

The NHS website has considerable information about the various symptoms of bowel cancer and you can read more about this here.

In summary, some common symptoms might include:

• changes in your poo;
• needing to poo more or less often than usual;
• blood in your poo, which may look red or black;
• bleeding from your bottom;
• often feeling like you need to poo, even if you have just been to the toilet;
• tummy pain;
• a lump in your tummy;
• bloating;
• losing weight without trying;
• feeling very tired for no reason.

Often the above symptoms are not signs of bowel cancer and are experienced by many of us. However, it is important to know what ‘normal’ looks like for you so that any changes in your poo, or other abnormal trends can be spotted.

The risk of developing bowel cancer depends on many factors, including your age and genetics. However, lifestyle can also play a role and over half of cases are thought to be preventable. Cancer Research UK has suggested that 28% of bowel cancer cases in the UK are caused by eating too little fibre, and 13% by eating processed meat. There is also strong evidence that keeping physically active lowers your risk of developing bowel cancer. 

If you have concerns you should speak to your GP, who can check your symptoms and refer you for any further testing or treatment that might be necessary.

Diagnosing bowel cancer and the risk of delay

In the context of a current decline in mortality rates for other forms of cancer, there is a worrying trend in the opposite direction for bowel cancer. Sadly, the journal Annals of Oncology has predicted that death rates for women with bowel cancer in the UK are predicted to rise for all age groups in 2024. In particular, there is a predicted rise of 39% for those women aged 24-49, compared to 2015-2019 statistics. For men, the death rate is also predicted to increase by 26% in the same age group.

However, despite these alarming statistics, bowel cancer is preventable in many cases. As with other types of cancer, early detection can make a substantial difference to a patient’s chances of survival. The proportion of people surviving bowel cancer drops from more than 9 in 10 when diagnosed at the earliest stage, to 1 in 10 when diagnosed at the latest stage.

Whilst there have been recent improvements to bowel cancer screening across the UK, unfortunately, there are still significant delays in diagnosis and treatment. Bowel Cancer UK suggests that around half of hospitals are in breach of waiting time targets for urgent diagnostic tests, as a result of a serious lack of capacity to meet the demand. Dr Lisa Wilde, director of research and external affairs at the charity, says:

“It’s unacceptable that nearly a third of bowel cancer patients face avoidable delays to their diagnosis. This data is from 2014, and there have been a number of key initiatives within the last five years aimed at reducing this, such as new pathway referrals for GPs who suspect patients may have cancer.

“However, we know that NHS services for bowel cancer still face significant and growing staff shortages, leading to thousands of patients waiting for crucial tests that can diagnose the disease.

“The next Government must urgently tackle this capacity crisis by increasing the supply and overall numbers of endoscopy and pathology staff working to diagnose cancer. This will ensure that patients are not left waiting for lifesaving tests.”

The effect of a delay in diagnosing and treating bowel cancer can be significant not only in terms of mortality rates, but also prognosis and treatment. A 52-year-old woman received a total of £150,000 in damages after she was left with a permanent ileostomy (an opening of the small bowel onto the surface of the abdomen) following a negligent delay in diagnosing bowel cancer for over 12 months.

In this case, it was accepted that had the bowel cancer been diagnosed earlier, she would have undergone a completion colectomy with an ileorectal anastomosis (a surgical procedure involving the removal of your colon and joining the ileum to your rectum to restore bowel motions), which would have avoided the need for ileostomy.

With the above in mind, it is important to be aware of the signs and symptoms of bowel cancer, as well as to consider taking steps to decrease your chance of developing it in the first place.

This article was co-written with Ellen Banks, trainee solicitor in the clinical negligence team.

Return to news headlines