Bowel cancer is the second-deadliest cancer in Australia. One in 16 Australians will be diagnosed with it in their lifetime, and more than 5200 die from the disease each year.
Despite its prevalence, it’s still largely misunderstood. Many people assume bowel cancer only affects those above 50 and people with a family history. And while bowel cancer risk does increase with age and hereditary factors, there’s more to the story.
Bowel cancer is the deadliest cancer for Australians aged 25 to 54 – roughly 12 per cent of those diagnosed each year are under the age of 50.
Married at First Sight relationship expert Mel Schilling was in her early 50s when she was diagnosed with colon cancer (another term for bowel cancer, both are cancers of the large intestine) in 2023. The tumour was successfully removed, but she later developed brain cancer, which led to her death on Tuesday.
Schilling’s death has left many wondering about the signs of bowel cancer and if symptoms present differently in women and men.
What are the symptoms of bowel cancer?
Associate Professor Graham Newstead, medical director at Bowel Cancer Australia, says there are several symptoms to look out for. These include blood in your stool, severe or ongoing cramping, unexplained weight loss, extreme unexplained tiredness and swelling of the abdomen.
“It could also be any change in your bowel habit,” Newstead says. “That could be diarrhoea, constipation, feeling of incomplete evacuation from your lower rectum. If you have any of these symptoms, and they last for more than a week, go straight to your doctor.”
Younger populations are particularly at risk due to lack of awareness. “In the last 20 years, bowel cancers in people under 50 have been increasing. But people in their 30s and 40s don’t think about bowel cancer. GPs, until recently, have not been taught that bowel cancer occurs in young people unless there’s a genetic history,” he explains.
On average, more men over the age of 50 are diagnosed, but it’s certainly not just men getting bowel cancer. In fact, Newstead says slightly more women develop bowel cancer in younger demographics.
Do symptoms differ between men and women?
Generally, symptoms don’t differ between genders. However, Newstead notes that some women, particularly those who are perimenopausal or those who have more irregular menstrual cycles, may mistake any signs of blood or severe cramping as a result of their period, potentially delaying checks.
The same goes for pregnant women, especially those having children later in life.
“Let’s say [theoretically] someone is eight months pregnant, and they think, ‘Oh, dear. I’ve seen a bit of blood’. They go to their GP, who says, ‘You’re 38 years of age and eight months pregnant, you have haemorrhoids’. Then, a month later, she has her baby, and six months later, she dies from secondary cancer in the liver. Don’t assume any bleeding is haemorrhoids,” Newstead says.
Kate Broun, Cancer Council Victoria’s head of screening, early detection and immunisation, says it’s important for women to take note of anything that appears abnormal, and not assume symptoms like abdominal pain or bleeding are simply because of their menstrual cycles.
“For women, it’s important that they present anything that’s unusual for them, or anything that’s changed and has persisted for a couple of weeks, to their doctor as soon as possible,” she says. “Women are often so busy, and it can be easily dismissed as potential perimenopause.”
If in doubt, Broun suggests calling the Cancer Council helpline on 13 11 20.
What is the treatment for bowel cancer?
As alarming as the statistics initially appear, Bowel Cancer Australia data shows that almost 99 per cent of bowel cancer cases can be successfully treated with early detection.
“The earlier it’s found, the easier it is to treat,” Broun says. “The main treatment for early bowel cancer is surgery and, hopefully, if it’s found in those early stages, that’s all that’s needed.”
Later stages of bowel cancer, meanwhile, require further possible treatments like radiation or chemotherapy, and will often vary between individuals.
How can you check for bowel cancer?
In Australia, people aged 50 to 74 receive a free bowel cancer screening test in the mail from the government every two years. As of July 2024, people aged 45 to 49 could also opt in to have the tests mailed to them, which Broun strongly suggests you do if you fall in that age bracket.
However, Newstead says it’s imperative that anyone below the age of 50 still monitor for symptoms and see a doctor if any arise.
“You can go to a chemist any time you like, at any age, and buy the tests over the counter,” he says. “You’re a crazy person if you don’t do your screening. They may not be perfect, but they’re sure better than doing nothing.”
These screening tests are vital, Broun says, not only because they help people discover bowel cancer early, but they can also help prevent bowel cancer by picking up on early warning signs, including very subtle bleeding.
“And of course, bowel cancer can develop without symptoms as well,” she notes.
If a screening test comes back positive, or you present symptoms to your GP, the next step will likely be a colonoscopy – a common procedure that examines the entire inner lining of the large intestine for abnormalities, including polyps, inflammation and cancer.
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Nell Geraets is a Culture and Lifestyle reporter at The Age and The Sydney Morning Herald.Connect via X or email.
