THE recent tragic death of much-loved television presenter George Alagiah has once again pushed an uncomfortable topic, that of our bowels, into the spotlight.

Mr. Alagiah, who died at the age of 67, was diagnosed when his cancer was at an advanced stage. He himself admitted that he had ignored some symptoms that in hindsight were red flags of serious disease.

Yet what he argued might have saved him would have been if screening commenced at an earlier age.

At the time of his diagnosis, aged 58, home screening in England was only offered to those aged between 60-74, while in Scotland it had already been extended to those over 50.

He argued that he could have been screened at least two if not three times, and that any early changes, such as a polyp, would have been identified and removed, and that would have been the end of the matter.

While it is true that 90 per cent of bowel cancers occur in those over 50, that still leaves you a one in ten chance of getting the disease under this age.

Research from America in 2021 showed that those born in 1990 had double the chance of getting bowel cancer compared to those who were born 40 years previously.

The NHS website advises that from April 2021 screening has been extended to those from the age of 50-59, every two years. This is an excellent move. As one of the most treatable cancers, if caught an early stage, survival at five years can be as high as 90 per cent.

Yet as the disease advances, this window of opportunity is lost.

The FIT test, a home screening kit, checks for microscopic amounts of blood in your poo. When compared to other screening tests it could be argued that it is the least invasive and most time effective screening tool currently offered. It is sent to those in the selected age bracket as an envelope in the mail that you complete in the comfort of your own home and then post back.

You do not need to attend your GP practice as you would do for a cervical smear. It is not painful in the way that many women report mammography to be. You are not exposed to harmful radiation in the same manner that those sent for screening chest x-rays or CT scans are when looking for lung cancer.

Despite this, uptake is still only 70 per cent, having recovered from a low of 50 per cent during the pandemic. Some will argue this as a good figure, but it leaves almost one in three of those eligible not completing a simple test that just might save your life.

To be clear, you cannot see the amounts of blood in your poo that the FIT test will detect. They are is microscopic. So, observing your stool with the naked eye and not finding any obvious blood is merely false reassurance.

As one of the most talked about cancers of late, the majority will be aware of the red flags for bowel cancer, these being rectal bleeding, a change in bowel habit and abdominal pain.

However, by the time you are reporting weight loss and being aware of a mass in the abdomen, it is highly likely that the tumour will have spread.

You need to be seeking advice at the earliest stage. A new red flag symptom to be aware of is fatigue. This may be a symptom of multiple conditions, including but not exclusive to cancer. It could just be a sign of you burning the candle at both ends. Yet if it is persistent, it is important to not ignore it.

We may experience the “George Alagiah Effect” with a rapid increase in the uptake of bowel screening, in the same way that there was a huge rise in cervical screening following the death of television reality star Jade Goody. Sadly, 10 years after Miss Goody’s death, cervical screening was at an all time low, showing despite the tragedy these things only occupy the mind for a certain time, after which they are forgotten about.

For those fearful of getting the results of a FIT test it may be helpful to realise that not every positive FIT test equals cancer. Indeed, the majority will not be. Yet it is perhaps the most reliable way to pick up anything serious at the earliest stage, when the most can be done to address anything of concern.

* Useful websites:

www.bowelcanceruk.org.uk

www.bowelresearchuk.org

www.gutsfbc.co.uk

Dr. Zak Uddin, General Practitioner