# Bowel cancer: symptoms, treatment and survival > Source: World Aid Network — https://worldaidnetwork.org/cancer/bowel-cancer > Last reviewed: 2026-06-19 ## In short Bowel cancer (also called colorectal cancer) affects the large bowel — the colon or the rectum. It is one of the most common cancers in the UK, but it is also one of the most treatable when found early. Most bowel cancers grow slowly from small growths called polyps over many years, which is why screening works so well. One of the most common cancers — and one of the most preventable through screening. World Aid Network funds treatment for patients who cannot pay. ## At a glance - ~42,000: UK cases each year - People over 60: Most common in - Over 90% (Stage 1): Survival when caught early - Home FIT test, age 50–74: Screening ## What is bowel cancer? Bowel cancer (also called colorectal cancer) affects the large bowel — the colon or the rectum. It is one of the most common cancers in the UK, but it is also one of the most treatable when found early. Most bowel cancers grow slowly from small growths called polyps over many years, which is why screening works so well. Bowel cancer — also called colorectal cancer — is the fourth most common cancer in the United Kingdom, with approximately 42,000 new cases diagnosed every year. It accounts for around 16,800 deaths annually, making it the second most common cause of cancer death after lung cancer. The good news is that bowel cancer is highly treatable when caught early. The NHS Bowel Cancer Screening Programme has been shown to reduce mortality significantly by detecting cancer and pre-cancerous polyps before symptoms develop. More than nine in ten people diagnosed at Stage I will survive for five or more years. This guide answers the twenty most searched UK questions about bowel cancer, drawing on NHS and World Health Organization sources, and examines the enormous inequality in bowel cancer care between the UK and low-income countries where treatment is largely inaccessible to poor patients. Bowel cancer is cancer that develops in the large bowel — the colon or the rectum. Cancer of the colon is called colon cancer; cancer of the rectum is rectal cancer. Together they are referred to as colorectal cancer. The vast majority of bowel cancers (more than 90%) develop from adenomatous polyps — benign growths on the bowel lining that, over many years, can become malignant. This slow progression is why screening to detect and remove polyps before they turn cancerous is so effective. Bowel cancer most commonly affects people over 60, though it can occur at any age. Around 95% of cases in the UK are in people aged 50 and over. A small proportion of cases — approximately 5% — are linked to inherited conditions such as Lynch syndrome or familial adenomatous polyposis (FAP). The NHS advises seeing your GP if you notice any of the following persisting for three weeks or more: a persistent change in bowel habit (looser stools, more frequent stools, or constipation); blood in your stools, which may make them appear dark red or black; unexplained weight loss; fatigue; or unexplained abdominal pain, bloating or discomfort. It is important to note that these symptoms can be caused by many other conditions, including irritable bowel syndrome (IBS), haemorrhoids or infection. However, the NHS strongly advises not to assume that symptoms are due to a less serious cause — see a GP promptly so that bowel cancer can be ruled out or detected early. The NHS invites everyone aged 50 to 74 in England, Wales and Northern Ireland (45 to 74 in Scotland) for a home bowel cancer screening test every two years. The current test is the FIT (faecal immunochemical test), which detects tiny amounts of blood in a stool sample. The test is sent by post and completed at home. A positive FIT result triggers a referral for colonoscopy. Colonoscopy allows a specialist to examine the entire bowel lining using a flexible camera, remove polyps, and take biopsy samples. People at high familial or genetic risk are offered colonoscopic surveillance outside the standard programme. If you are aged 74 or over, you can self-refer for screening by contacting your local NHS screening centre. In the UK, the five-year survival rate for bowel cancer is approximately 60%. In low- and middle-income countries, survival is significantly lower — primarily because bowel cancer is rarely diagnosed at an early stage, surgical expertise is limited, and chemotherapy and targeted therapies are unaffordable for most poor patients. The World Health Organization notes that bowel cancer incidence is rising rapidly in middle-income countries as diets shift towards processed food. Yet the treatment infrastructure — colonoscopy services, surgical units, oncology wards — has not kept pace with this epidemiological transition. A man or woman diagnosed with bowel cancer in a poor rural area may have no realistic access to surgery, let alone chemotherapy. World Aid Network funds cancer treatment for poor patients through locally-licensed doctors and registered hospitals. Every donation directly supports access to care for a patient who cannot afford it. ## When should you see a doctor about bowel cancer? Most of these symptoms have a less serious cause — but it is always worth getting them checked. See a GP if you notice a new or persistent change. If you feel very unwell, contact NHS 111 or seek urgent help. Take a note of how long the symptom has lasted and whether it is getting worse. You do not need every sign on a list to book an appointment. This guide is general information from World Aid Network, not a diagnosis and not UK NHS care. Only a clinician can assess you. - A change in your normal bowel habit lasting three weeks or more (looser stools, going more often, or constipation) - Blood in your poo or bleeding from your bottom - Tummy pain, bloating or discomfort that does not settle - Losing weight without trying - Feeling very tired for no obvious reason ## What treatment options are available? Treatment depends on the stage and location of the cancer. For localised bowel cancer, surgery to remove the section of bowel containing the tumour is the primary treatment. For many colon cancers, surgery alone is curative if the cancer is caught at an early stage. Rectal cancer is more complex to treat and often requires a combination of pre-operative radiotherapy or chemoradiotherapy, surgery, and adjuvant chemotherapy. Advanced bowel cancer is treated with chemotherapy regimens such as FOLFOX or FOLFIRI, often combined with targeted therapies such as bevacizumab (anti-VEGF) or cetuximab (anti-EGFR) for appropriate patients. Immunotherapy (particularly pembrolizumab) is effective for the small proportion of bowel cancers that are mismatch repair deficient (dMMR). ## What are the key takeaways? The most important points on bowel cancer for patients, families and donors. - Bowel cancer is the fourth most common cancer in the UK, with around 42,000 diagnoses and 16,800 deaths per year. - The five-year survival rate for Stage I bowel cancer exceeds 90%. For Stage IV, it is approximately 10% — underscoring the critical importance of early detection. - The NHS FIT (faecal immunochemical test) screens people aged 50–74 every two years at home. A positive result leads to colonoscopy. - Most bowel cancers develop slowly from benign polyps over many years — making screening and polyp removal one of the most effective cancer prevention strategies available. - In low-income countries, bowel cancer is increasingly common but largely untreated for poor patients — survival rates are far below UK levels. ## What will a donation for bowel cancer treatment provide? A gift to World Aid Network's Cancer Emergency Appeal helps pay for diagnosis and treatment that a poor patient has been recommended but cannot afford. Typical partner costs start at £10 for tests and £50 for a chemotherapy session. Trustees direct gifts to the most urgent cases. This is treatment access, not laboratory research and not UK NHS care. Clinicians in partner hospitals decide the medical plan. We fund the bill in Pakistan, Indonesia and Malaysia. The Cancer Emergency Appeal funds all types of cancer. Trustees direct gifts to the most urgent hospital bills in Pakistan, Indonesia and Malaysia. - £10 — Diagnostic tests that help a partner oncologist confirm the next step - £25 — Cancer medication towards a treatment cycle a family cannot afford - £50 — One chemotherapy session for a patient who would otherwise be turned away - £100 — Surgical support or a fuller block of treatment costs ## How can I donate to help people with bowel cancer? Donate by card on this page or at worldaidnetwork.org/donate and choose the Cancer Emergency Appeal. World Aid Network is a UK CIO with Charity Commission registration in progress; Gift Aid applies once registration is granted. If you need UK support as a patient or relative, see a GP, NHS 111, Macmillan or the specialist UK charity for this cancer. We fund treatment overseas; we are not a UK helpline. ## How do you do the NHS bowel cancer screening test? The NHS sends a FIT home test to people aged 50 to 74. It finds hidden blood in poo and can pick up bowel cancer before you feel unwell. - Do the kit when it arrives: The FIT test is a small poo sample posted back in the envelope provided. It takes a few minutes. - Do not ignore bowel changes: Blood in poo, a lasting change in bowel habit, or unexplained weight loss should be checked by a GP even if your last FIT was normal. - Follow up an abnormal result: A positive FIT usually leads to a colonoscopy. That is how polyps and early cancers are found and treated. - Keep doing the test every two years: Bowel cancers can grow from polyps over years. Repeat screening is how the programme works. ## Frequently asked questions ### What is bowel cancer? Bowel cancer — also called colorectal cancer — is cancer that develops in the colon (large intestine) or rectum. It is the fourth most common cancer in the UK, with around 42,000 new diagnoses each year. The vast majority of bowel cancers develop slowly from adenomatous polyps on the bowel lining over many years. ### What are the symptoms of bowel cancer? According to the NHS, symptoms to report to your GP include: a persistent change in bowel habit lasting three weeks or more (looser, more frequent stools or constipation); blood in the stools; unexplained weight loss; fatigue; abdominal pain, bloating or discomfort. These symptoms can have many causes — but bowel cancer should always be ruled out by a GP. ### How common is bowel cancer in the UK? Bowel cancer is the fourth most common cancer in the UK and the second most common cause of cancer death. Around 42,000 people are diagnosed each year, and approximately 16,800 people die from it annually. About 95% of cases occur in people aged 50 and over. ### What causes bowel cancer? Most bowel cancers develop from adenomatous polyps — benign growths on the bowel lining — that accumulate genetic mutations over many years and become malignant. Risk is increased by a diet high in red and processed meat, low physical activity, being overweight, smoking, alcohol and inflammatory bowel disease. A small proportion of cases are linked to inherited syndromes such as Lynch syndrome or FAP. ### What are the risk factors for bowel cancer? The main risk factors are: age over 50; a diet high in red and processed meat; low dietary fibre; being overweight or obese; physical inactivity; smoking; alcohol; a personal or family history of bowel cancer or polyps; inflammatory bowel disease (Crohn's or ulcerative colitis); and inherited conditions such as Lynch syndrome or familial adenomatous polyposis (FAP). ### How is bowel cancer diagnosed? Diagnosis involves a combination of investigations: a colonoscopy (the gold standard, allowing direct visualisation of the bowel lining, polyp removal and biopsy); CT colonography (a virtual colonoscopy using CT scanning); flexible sigmoidoscopy (examination of the lower bowel only); and biopsy of any suspicious tissue. Blood tests and CT scanning are used to assess spread (staging) once cancer is confirmed. ### What is the NHS bowel cancer screening test? The NHS Bowel Cancer Screening Programme invites people aged 50–74 (45–74 in Scotland) to complete a home FIT (faecal immunochemical test) every two years. The kit is sent by post. A small stool sample is collected and returned by post for analysis. A positive result — indicating blood in the stool — triggers a referral for colonoscopy. People aged 75 and over can self-refer. ### What is the FIT test? The FIT (faecal immunochemical test) is the NHS bowel cancer screening test. It uses antibodies to detect tiny amounts of human blood in a stool sample that may not be visible to the naked eye. The test is completed at home, is painless and takes a few minutes. A positive FIT result does not mean cancer — it means further investigation (typically colonoscopy) is needed. Most people with a positive FIT result do not have cancer. ### What is a colonoscopy? A colonoscopy is a procedure in which a doctor uses a long, flexible tube with a camera (colonoscope) to examine the entire lining of the large bowel. It allows polyps to be removed and tissue samples (biopsies) to be taken for laboratory analysis. Patients are usually given a sedative. A bowel preparation (laxative) is taken the day before to clear the bowel. Colonoscopy is the most accurate way to diagnose bowel cancer and detect pre-cancerous polyps. ### What are the stages of bowel cancer? Bowel cancer is staged from I to IV. Stage I means the cancer is confined to the inner bowel lining. Stage II means the cancer has grown through the bowel wall but has not spread to lymph nodes. Stage III means the cancer has spread to nearby lymph nodes. Stage IV means the cancer has spread to distant organs, most commonly the liver or lungs. Stage determines prognosis and treatment approach. ### What is the treatment for bowel cancer? Treatment depends on the stage and location of the cancer. Surgery to remove the section of bowel containing the tumour is the primary treatment for localised colon cancer. Rectal cancer often requires a combination of pre-operative chemoradiotherapy and surgery. Adjuvant chemotherapy (FOLFOX or CAPOX) is offered to higher-risk Stage II and Stage III patients after surgery. Advanced bowel cancer is treated with chemotherapy combined with targeted therapies (bevacizumab, cetuximab) or immunotherapy for eligible patients. ### What is the survival rate for bowel cancer? Five-year survival for bowel cancer depends heavily on stage at diagnosis. Stage I: over 90% five-year survival. Stage II: approximately 80%. Stage III: approximately 70% with lymph node involvement. Stage IV (metastatic): approximately 10% five-year survival, though survival has improved with modern chemotherapy and targeted therapies. Overall five-year survival for bowel cancer in England is approximately 60%. ### Can bowel cancer be prevented? Bowel cancer cannot be fully prevented, but risk can be significantly reduced. The NHS recommends: eating a high-fibre diet with plenty of wholegrains, fruit and vegetables; limiting red and processed meat; maintaining a healthy weight; exercising regularly; limiting alcohol; and not smoking. Participating in the NHS bowel screening programme allows polyps to be detected and removed before they become cancerous — which is one of the most effective cancer prevention strategies available. ### Is bowel cancer hereditary? Approximately 5% of bowel cancers are linked to inherited conditions. Lynch syndrome (hereditary non-polyposis colorectal cancer — HNPCC) is the most common inherited bowel cancer syndrome, caused by mutations in mismatch repair genes (MLH1, MSH2, MSH6, PMS2). Familial adenomatous polyposis (FAP) causes hundreds of polyps to form and carries near-certain risk of bowel cancer if untreated. People with a significant family history should discuss screening with their GP. ### What is the difference between colon cancer and rectal cancer? Colon cancer develops in the colon (the long section of the large intestine). Rectal cancer develops in the rectum (the final 15 cm of the large bowel, before the anus). Together they are called colorectal cancer. Rectal cancer is more complex to treat because of the rectum's proximity to the pelvic floor, bladder, prostate (in men) and uterus (in women). Rectal cancer typically requires pre-operative chemoradiotherapy before surgery, whereas most colon cancers are treated with surgery first. ### Does bowel cancer treatment always involve a stoma? Not always. Many people treated for bowel cancer do not require a permanent stoma. A stoma (a surgically created opening in the abdomen through which waste passes into a bag) may be temporary — used to allow a bowel join to heal — or permanent, where the surgeon is unable to reconnect the bowel. The need for a stoma depends on the location and stage of the cancer and the type of surgery performed. Rectal cancer surgery is more likely to require a stoma than colon cancer surgery. ### What is Lynch syndrome? Lynch syndrome is an inherited condition caused by mutations in mismatch repair genes (most commonly MLH1, MSH2, MSH6 or PMS2). It is the most common inherited cause of bowel cancer, accounting for around 3% of all cases. People with Lynch syndrome have a significantly elevated lifetime risk of bowel cancer (up to 80% depending on the gene affected), as well as raised risks of endometrial, ovarian, stomach and other cancers. Diagnosis is made through genetic testing, and regular colonoscopic surveillance is offered to those affected. ### How does diet affect bowel cancer risk? Diet is one of the strongest modifiable risk factors for bowel cancer. The NHS and WHO advise limiting red meat (beef, pork, lamb) and avoiding processed meat (bacon, sausages, salami), which the World Health Organization classifies as a Group 1 carcinogen for colorectal cancer. High dietary fibre — from wholegrains, vegetables, pulses and fruit — is associated with lower bowel cancer risk. Maintaining a healthy weight and limiting alcohol and smoking further reduce risk. ### What is secondary bowel cancer? Secondary bowel cancer (Stage IV colorectal cancer) occurs when cancer cells from the bowel spread to other organs via the bloodstream or lymphatic system. The most common site of spread is the liver, followed by the lungs. Secondary bowel cancer in the liver is sometimes operable and even curable if the spread is limited. Treatment typically involves chemotherapy combined with targeted therapies, and in some cases liver resection or ablation. ### How does bowel cancer affect people in developing countries? In low- and middle-income countries, bowel cancer incidence is rising sharply as diets shift and populations age, but survival rates remain far below UK levels. Colonoscopy services are scarce, surgical expertise is concentrated in major cities, and chemotherapy and targeted therapies are unaffordable for most poor patients. The World Health Organization reports that the majority of bowel cancer cases in low-income settings are diagnosed at an advanced stage. World Aid Network funds cancer treatment for poor patients through locally-licensed doctors, working to address this inequality. ## How you can help World Aid Network funds cancer treatment for poor patients in Pakistan, Indonesia and Malaysia through locally licensed oncologists. Donate at https://worldaidnetwork.org/cancer/bowel-cancer or https://worldaidnetwork.org/donate?cause=cancer-treatment&appeal=cancer-emergency ## Sources - NHS — Cancer: https://www.nhs.uk/conditions/cancer/ - Cancer Research UK --- This is general information, not medical advice, published by World Aid Network. Always consult a qualified clinician about your own health.