There's a test that could save your life sitting quietly in your letterbox — and most Australians either haven't used it or don't realise how important it is. Bowel cancer is the second most common cause of cancer death in Australia, claiming the lives of around 5,000 people every year. That's a confronting number. But here's the part that offers real hope: when bowel cancer is detected early, the survival rate is over 90 per cent. Early detection isn't just helpful — it's genuinely life-changing. This June, during Bowel Cancer Awareness Month, we want to take a moment to talk plainly about the risks, the screening options available to you, and what you can do right now.
What is bowel cancer and who is at risk?
Bowel cancer (also called colorectal cancer) develops in the large bowel, which includes the colon and the rectum. It usually begins as small, non-cancerous growths called polyps on the inner lining of the bowel. Over time — often years — some of these polyps can become cancerous. The good news is that if those polyps are found and removed before they turn cancerous, the disease can be prevented altogether.
Bowel cancer doesn't discriminate as much as we'd like to think. While your risk does increase with age — particularly over 45 — it affects both men and women, and people of all backgrounds. In fact, Australia has one of the highest rates of bowel cancer in the world, which makes awareness and screening all the more important for our community.
Certain factors can increase your risk beyond the general population. These include a personal or family history of bowel cancer or bowel polyps, a long-standing inflammatory bowel condition such as Crohn's disease or ulcerative colitis, being overweight, low levels of physical activity, a diet high in processed or red meat, smoking, and heavy alcohol use. Having one or more of these risk factors doesn't mean you will develop bowel cancer — but it does mean that staying on top of screening is especially worthwhile.
Recognising the signs (and understanding why early cancer often has none)
One of the most challenging aspects of bowel cancer is that in its early stages, it often causes no symptoms at all. This is precisely why screening — rather than waiting until something feels wrong — is so important. By the time symptoms appear, the cancer may already be at a more advanced stage, which is why we encourage people not to wait for a sign before acting.
That said, there are symptoms worth knowing about. If you notice any of the following, please don't put off speaking to a GP:
- Blood in the stool or rectal bleeding
- A change in bowel habits lasting more than a few weeks (such as persistent diarrhoea, constipation, or a change in the consistency of your stools)
- Unexplained weight loss
- Persistent abdominal pain, cramping, or bloating
- A feeling that your bowel hasn't emptied completely after going to the toilet
- Unexplained tiredness or anaemia (low iron)
Important: these symptoms can be caused by many conditions other than cancer, but they should always be checked by a GP. Never assume it's nothing. Getting checked early is always the right decision.
The home test kit: simple, private, and potentially life-saving
The National Bowel Cancer Screening Program (NBCSP) is a free Australian Government initiative that sends an immunochemical faecal occult blood test — commonly known as an iFOBT or FOBT — to eligible Australians aged 45 to 74 by mail. The test itself is done entirely at home, and it's much simpler than many people expect. You collect small samples from two separate bowel motions and return them in the prepaid envelope provided. There are no dietary restrictions beforehand, and the whole process takes just a few minutes.
The test works by detecting tiny traces of blood in the stool that can't be seen with the naked eye. Blood in the stool can be an early indicator of polyps or cancer. A positive result doesn't automatically mean cancer — there are other reasons blood might be present — but it does mean a follow-up colonoscopy is recommended to investigate further. A negative result is reassuring, though it's still important to continue screening every two years as recommended.
If you're between 45 and 74 and you've received a kit in the mail, we genuinely encourage you to use it. Many Australians put it aside and forget about it, or feel squeamish and let it sit on the shelf. It's understandable — but it's worth taking five minutes to complete. If you haven't received a kit, or you've lost yours, you can request a replacement through the National Cancer Screening Register by calling 1800 627 701.
What if you have a higher risk — or you're under 45?
The national program covers people aged 45 to 74, but if you have a family history of bowel cancer or polyps, or other risk factors, your GP may recommend starting surveillance earlier or more frequently. For people with a first-degree relative (parent, sibling, or child) who has had bowel cancer, current guidelines may suggest beginning colonoscopy screening at a younger age — often around 40, or ten years before the age at which your relative was diagnosed, whichever comes first.
It's also worth noting that people under 45 aren't immune to bowel cancer. If you're experiencing any of the symptoms mentioned above — regardless of your age — please speak with your GP. Age alone shouldn't stop you from raising concerns.
Small steps that support bowel health every day
While no lifestyle choice can guarantee protection against bowel cancer, there are evidence-based habits that are associated with a lower risk. Incorporating these into daily life is worthwhile for your overall health too:
- Eat a diet rich in vegetables, fruit, legumes, and wholegrains, and limit red and processed meats
- Stay physically active — aim for at least 30 minutes of moderate activity most days
- Maintain a healthy weight
- Limit alcohol intake
- Quit smoking, or seek support to do so
- Drink plenty of water and eat enough fibre to support regular, healthy bowel movements
- Complete your bowel screening test every two years if you're in the eligible age group
For more information about bowel cancer and Australia's awareness efforts, Bowel Cancer Australia is an excellent resource. You can visit them at bowelcanceraustralia.org/get-involved/campaigns/bowel-cancer-awareness-month to learn more and find out how to get involved.
Have you completed your free home screening test? If you're between 45 and 74 and your kit is still sitting unopened, now is the time. It takes just a few minutes and could make all the difference.
At Cronulla Medical Practice, our GPs are here to support you with all aspects of your health, including cancer screening and prevention. Whether you have questions about your bowel cancer risk, want to discuss your family history, have noticed a symptom that's worrying you, or simply want to make sure your screening is up to date — we'd love to hear from you. Booking a conversation with your GP is a straightforward, positive step you can take today. We're here, and we're on your side.