Bowel cancer is the name given to cancer that begins in the large bowel, although it can also be called colon, rectal or colorectal cancer, depending on where it starts.

Cancers of the colon and rectum are the second most common cause of death from cancer in the western world, with around 30,000 new cases diagnosed in England and Wales each year. Early presentation and diagnosis are critical to prevent the tumour from spreading and improve the overall prognosis.

Bowel cancer typically begins in the large bowel, although it also can occur in the small intestine in rare cases. It is estimated that one in every 20 people in the UK will develop this form of cancer at some point in their lifetime.

Early-stage bowel cancer does not present with obvious symptoms, but changes in bowel habits tend to be the most common sign. Anaemia may also develop through hidden bleeding. Incomplete opening of the bowel, or a feeling of wanting to continuously defecate, may be a sign of rectal cancer.

However, these symptoms can be common and may be caused by something other than bowel cancer. Most people who are diagnosed with the disease will suffer from a combination of symptoms, such as:

• Persistent bowel habit changes, involving looser stools, more frequent visits to the toilet and blood in or on the stools
• Persistent bowel habit changes not involving blood in the stools, but including abdominal pain
• Abdominal pain, bloating or discomfort after eating, which sometimes leads to a reduction in the amount of food consumed
• Blood in the stools, but with no haemorrhoid symptoms present, such as discomfort, itching, soreness or a lump hanging down outside the back passage 

Bowel cancer may be diagnosed in a number of different ways, depending on the location of the tumour. These include:

• Presenting to your GP with any of the symptoms above
• The discovery of a palpable mass during an abdominal or rectal examination, which would merit an urgent referral to a specialist

Where symptoms have persisted for more than six weeks but no mass can be detected, an urgent referral should still be made, because the specialist will need to carry out further investigations to make a prompt and correct diagnosis.

These investigations may include a colonoscopy or sigmoidoscopy, which involves a flexible tube being inserted into the bowel. Any abnormality can be seen through a small camera and biopsies can then be taken.

An enema containing dye may also be used to show up any abnormalities on an X-ray. Following diagnosis, urgent and correct management of the tumour is essential, as any delay in treatment can result in the cancer spreading to other organs, such as the liver or lungs.

If you feel that your bowel cancer should have been diagnosed sooner, or if your cancer was misdiagnosed, you should speak to a specialist solicitor about whether you may be entitled to compensation.

Surgery is the cornerstone of successful bowel cancer treatment. The tumour and affected part of the bowel will be removed, which reduces the risk of the tumour spreading if performed in a timely manner.

Following surgery, the pathology laboratory will stage the tumour and appropriate management of further treatment can be decided. This may include chemotherapy, radiotherapy or both.

Certain factors can mean you are predisposed to being at greater risk of suffering from bowel cancer at some point in your life. These include:

• Having a family history of the disease
• A prior history of carcinoma or adenoma
• A history of inflammatory bowel disease
• Being affected by polyposis (a group of several polyps)

As well as the above, the following lifestyle factors can increase your bowel cancer risk:

• Obesity
• Sedentary lifestyles
• Smoking
• Unhealthy diets that are high in calories, protein, animal fat and/or alcohol, and low in fibre

You are also at a greater risk of bowel cancer as you get older, with those aged 50 and over the most likely to develop the disease.