Rectal cancer

Causes

The exact cause of bowel canceris still unknown. However, research has shown several factors may make you more likely to develop it.

Cancer occurs when the cells in a certain area of your body divide and multiply too rapidly. This produces a lump of tissue known as a tumour.

Most cases of bowel cancer first develop insideclumps of cellscalled Polyps, bowel on the inner lining of the bowel.

However, it doesn't necessarily mean you'll get bowel cancerif you develop polyps.

Some polyps regress, andsome don't change. Only a few grow and eventually develop into bowel cancer over a period of several years.

The main riskfactors for bowel cancer are outlined below.

Age

Around1 in 20 people develop bowel cancer. Almost 18 out of 20 cases of bowel cancer in the UK are diagnosed in people over the age of 60.

Family history

Having a family history of bowel cancerin afirst-degreerelative a mother, father, brother or sisterunderthe age of 50 can increase your lifetime risk of developing the condition yourself.

If you're particularly concerned that your family's medical history may mean you're at an increased risk of developing bowel cancer, it may help to speak to your GP.

If necessary, your GP can refer you to a genetics specialist, who can offer more advice about your level of risk and recommend any necessary tests to periodically check for the condition.

Diet

A large body of evidence suggests a diet high in red and processed meat can increase your risk of developing bowel cancer.

For this reason, the Department of Health advises people who eat more than 90g (cooked weight) a day of red and processed meat cut down to 70g a day.

You can help reduce your risk of bowel and other cancers by being physically active every day.

For example, bowel cancer is more common in people who have hadextensive Crohn's disease or ulcerative colitis for more than 10 years.

If you have one of these conditions, you'll usually have regular check-ups to look for signs of bowel cancer from about 10 years after your symptoms first develop.

Check-ups involve examining your bowel with a colonoscopea long, narrow flexible tubethat containsa small camera. This is inserted into your bottom.

The frequency of the colonoscopy examinations will increase the longer you live with the condition. This also depends on factors such as how severe your ulcerative colitis is andwhether you have a family history of bowel cancer.

Genetic conditions

There are two rare inherited conditions that can lead to bowel cancer:

familial adenomatous polyposis (FAP) a condition that triggers the growth of non-cancerous polyps inside the bowel
hereditary non-polyposis colorectal cancer (HNPCC) , also known as Lynch syndrome an inherited gene fault (mutation) that increases your bowel cancer risk

Although the polyps caused by FAP are non-cancerous, there's a high risk that over time at least one will turn cancerous. Most people with FAP have bowel cancer by the time they're 50.

As people with FAP have such a high risk of getting bowel cancer, they're often advised by their doctor to have their large bowel removed before they reach the age of 25.

Families affected can find support and advice from FAP registries such as The Polyposis Registry provided by St Mark's Hospital, London.

Removing the bowel as a precautionary measure is also usually recommended in people with HNPCCas the risk of developing bowel cancer is so high.