Around the world, three new cases of bowel cancer are diagnosed every minute, and this varies among different countries. The rate of bowel cancer is particularly high in Australia, United States, certain South American countries, Europe, New Zealand, and more recently in Japan. Studies have shown that socioeconomic status is an important risk factor for bowel cancers. A difference in exposure to risk factors (especially food) could explain this difference.

In addition, low incomes, a low level of education, and insufficient health cover would limit access to appropriate preventive, diagnostic, and treatments for patients. However, the stage of the tumour at the time of diagnosis is the main factor in survival.

With early screening and management, bowel cancer is cured in 90% of cases.

In Australia

Bowel cancer is the third most common type of newly diagnosed cancer in Australia. 15,610 Australians are diagnosed with bowel cancer each year, including 1,680 people under the age of 50. Bowel cancer claims the lives of 5,354 Australians every year, including 290 people under the age of 50.

A changing tumour

Bowel cancer develops from a cell in the inner lining of the colon (large intestine) or rectum, often by progressive transformation of a benign tumour, also known as a polyp. The risk of transformation of a polyp into cancer varies, depending on the size and type of cells in the benign tumour. At first, bowel cancer grows locally. Then, cancer cells can spread to other parts of the body (metastases) most often to the liver and lungs.

A silent cancer

The absence of symptoms is common. Bowel cancer can therefore develop silently and can remain undiagnosed for a while. Hence the need for screening. Nevertheless, certain signs may point to the need for seeing your GP.

Screening

The National Bowel Cancer Screening Program aims to reduce deaths from bowel cancer by detecting the early signs of the disease. Every 2 years, eligible Australians from 50 to 74 years of age are sent a free, simple test that is done at home.

The program started in 2006 and has grown to testing approximately 2.1 million Australians per year, which represents 42% of this age group.

Treatments

Different types of treatments can be used to treat bowel cancer, depending on the stage of the disease: surgery, radiotherapy, chemotherapy, and targeted treatments. These treatments can have different objectives depending on the stage of the disease: to cure the cancer – that is, by destroying all the cancer cells, to prevent the cancer from spreading, or to improve the quality of life of the patient by reducing the symptoms. Depending on each patient and their circumstances, one treatment or a combination of treatments may be recommended (for example, surgery plus chemotherapy).

At Servier

Oncology is one of our main priorities. Today, we spend more than a third of our research investment on the fight against cancer. What is Servier’s vision? We aim to improve the management of patients with cancer, including bowel cancer, by proposing innovative solutions like:

• developing models to better understand the mechanisms involved in the development of the disease and resistance to treatment
• developing tools to improve the choice of the most appropriate treatment for each patient
• evaluating different combinations of treatments to optimise patient care
• creating less invasive methods of analysis and follow-up for patients; taking into account patient perspectives and quality of life when developing new products

References:

• World Health Organization 2018, National Cancer Institute Colorectal Cancer Screening 2017, https://www.aihw.gov.au,
• World Cancer Research Fund Colorectal cancer statistics 2018, BMJ Best Practice Colorectal Cancer 2018
• https://www.bowelcanceraustralia.org/facts