Our final Pathology Spotlight blog of the year looks at bowel cancer. Bowel cancer is the fourth most common cancer in the UK today, affecting around 1 in 19 women and 1 in 14 men. According to Cancer Research UK, there are now more than 41,900 new cases of bowel cancer being diagnosed every year [source].
This specimen shows a rectal adenocarcinoma. Adenocarcinomas develop from glandular tissue, and are the most common type of colorectal cancer. We can see about 20cm of the rectum has been opened up to show a large tumour with rolled edges and a partially ulcerated centre. Haemorrhoids can be seen around the anus at the bottom of the specimen where the gut surface changes to skin. Because the surgeon here removed the lowest part of the bowel, the patient would have had a permanent colostomy. Today, surgeons cut out the tumour and sometimes also recommend radiotherapy or chemotherapy. The cure rate continues to rise, with more than nine out of ten people surviving a diagnosis of stage 1 bowel cancer five years after diagnosis, and the chance of recurrence after five years is small. Increasingly in rectal cancers the surgeon can save the anal sphincter and avoid a permanent colostomy.
Bowel cancer is the UK’s fourth most common cancer. It is more common in people over the age of 50, and incidence is slightly higher in men than in women. A family history of bowel cancer increases the chances of developing the condition; other risk factors include a diet that is high in red meat and low in fibre, an inactive lifestyle, and obesity.
Screening is offered to people between the ages of 50 and 74 in Scotland (60 and 74 in the rest of the UK) every two years. Early diagnosis increases the chances of successful treatment. Any rectal bleeding should be referred to a doctor for assessment; most cases will have a less serious cause such as piles.