1 April 2026

From awareness to action: The future of bowel cancer care

Bowel Cancer Awareness Month takes place every April to increase public understanding of the disease and encourage earlier recognition of symptoms. Bowel cancer, also referred to as colorectal cancer, is the fourth most common cancer and the second leading cause of cancer mortality in the UK [1, 2]. Evidence highlights increasing incidence of early-onset (before the age of 50 years) colorectal cancer globally, a trend reflected by rising rates in 27 of the 50 countries and territories examined in one study [3]. However, early recognition and early intervention can drastically improve outcomes, with 9 in 10 people surviving their cancer for at least 5 years when diagnosed at Stage 1, as opposed to only 1 in 10 people when diagnosed at Stage 4 [2, 4].

What is bowel cancer?

Bowel cancer affects both the colon and the rectum and typically arises from abnormal tissue growth (polyps) inside the bowel that become malignant as a result of uncontrollable and disorganised cell growth within the bowel lining. Although most polyps remain benign, approximately 10% will become cancerous [5].

In 2021, 49,385 people in the UK were diagnosed with bowel cancer. This disease most commonly affects individuals aged 60 or older, with this age group representing 9 in 10 patients; however, diagnoses in those aged <50 years are increasing in many nations worldwide, including Australia, the USA and New Zealand [3, 6]. England experienced the fourth fastest growth in early-onset colorectal cancer, with the incidence rising by roughly 3.6% annually, over a recent 10-year span [3].

Risk factors for bowel cancer

Although the exact causes of bowel cancer are not clear, several risk factors have been identified. Certain risk factors are unavoidable, such as >50 years of age, family history of bowel cancer and long-term inflammatory bowel disease (e.g. Crohn’s disease or ulcerative colitis) [6]. Additional risk factors are linked to lifestyle.

Ways to reduce your risk:

In contrast, other risk factors are avoidable and should be avoided by maintaining a healthy lifestyle [5]. For example [7]:

  • Low fibre intake
    • Causes ~28% of bowel cancers in the UK
  • Excessive consumption of red or processed meat
    • Estimated to be linked to ~13% of bowel cancers in the UK
  • Obesity
    • Estimated to be linked to ~11% of bowel cancers in the UK
  • Smoking
    • ~7% of bowel cancers in the UK are linked to smoking
  • Excessive alcohol intake
    • Estimated to be linked to ~6% of bowel cancers in the UK

Recognising the key symptoms

Early recognition of symptoms is essential to increase the chance of survival and for effective bowel cancer treatment. Approximately 9 in 10 people survive their cancer for 5 years or more when diagnosed at Stage 1, compared with only 1 in 10 people when diagnosed at Stage 4 [2, 4].

Despite the importance of early detection, many people struggle to recognise bowel cancer symptoms or feel embarrassed discussing them. Key symptoms include changes in bowel habits, blood in the stool, abdominal discomfort, unexplained weight loss and persistent fatigue [6].

Figure 1: Overview of bowel cancer pathogenesis and key symptoms

Stigma, misunderstanding, and the taboo around poo remain significant barriers and contribute to delayed diagnosis both in the UK and globally. A recent UK survey highlighted that approximately one-third of adults said they are embarrassed or uncomfortable talking about changes in their bowel habits with a healthcare professional (HCP) [8]. Charities across the UK are aiming to tackle these barriers, such as the Bowelbabe Fund for Cancer Research UK, which aims to “help smash poo taboos” through a range of activities. One such initiative, launched last year for Bowel Cancer Awareness Month, was ‘Toilet Talk’, in which famous faces discussed the stigma and encouraged people to talk about their poo [8].

Screening: A transformative moment

2026 marks a major shift in the UK’s bowel cancer screening landscape. NHS England has announced that the sensitivity of the faecal immunochemical test (FIT) home test, widely offered to all people >50 years of age, will be increased by lowering the threshold for detecting trace blood in stool samples. This update means the NHS will be able to offer a resultant 35% more follow-up screening colonoscopies from positive home test kits each year to aid diagnosis. Moreover, this enhancement in the FIT home test sensitivity is expected to detect around 600 additional cases of bowel cancer each year (an 11% increase on current detection rates) and identify 2,000 more high-risk polyps that can be removed before they can develop into cancer [9].

Progress in diagnostics and treatment

A recent update on emerging diagnostics provides hope for the future; the UK government detailed their funding of a cutting-edge, AI-driven blood test, known as miONCO-Dx, to diagnose bowel cancer earlier. miONCO-Dx was developed in collaboration with the University of Southampton and the Bowelbabe Fund for Cancer Research UK. The test works by measuring the levels of microRNA in a blood sample and using AI analysis to identify whether cancer is present and, if so, where in the body it is located. MicroRNA are small, non‑coding RNA molecules that regulate gene expression and can act as cancer‑specific biomarkers, as their expression patterns are often altered in tumour development and progression [10]. Early evaluations indicate strong potential, with miONCO-Dx detecting 12 of the most significant and prevalent cancers, including bowel cancer, at early stages and achieving accuracy rates above 99% [11].

Treatment of bowel cancer is also evolving; the National Institute for Health and Care Excellence (NICE) recently approved bevacizumab in combination with chemotherapy for people with advanced-stage bowel cancer. This development is expected to provide 7,000 patients across England and Wales with access to life-extending treatment. Clinical trials reveal that when bevacizumab is given alongside chemotherapy, it extends the time before cancer worsens to an average of 9.4 months, versus 8 months with chemotherapy alone. Additionally, this combination therapy increases overall survival from 19.9 months to 21.3 months [12].

Hope on the horizon

Looking ahead, there is genuine optimism for improving how bowel cancer is detected and diagnosed. Continued investment in high-quality research is central to this progress.

Recently, half a million pounds has been committed to new studies aimed at enhancing early diagnosis, including projects focusing on improving diagnosis for specific groups of patients, such as patients with early-onset bowel cancer and those with certain conditions that increase their risk of bowel cancer, e.g. inflammatory bowel disease [13].

Among these initiatives, one grant specifically focuses on improving diagnostic pathways for younger adults. The research, led by Dr Christina Dobson, focuses on recognising the rising incidence of early-onset bowel cancer and the urgent need to understand how delays occur within this age group. The research results will be used to formulate a ‘map’ of diagnostic pathways for early-onset bowel cancer, set to be used in workshops with patients, HCPs and organisations such as Bowel Cancer UK [14]. This will help to pinpoint where delays most commonly occur, enabling targeted strategies to improve early intervention.

This targeted investment, alongside the others, reflects a growing commitment to ensuring that more people are diagnosed at the earliest and most treatable stages. With innovative research, expanding diagnostic technologies and greater public awareness, the future holds meaningful promise for transforming outcomes and moving closer to a time when fewer lives are lost to bowel cancer.

The information in this article is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. All content is for general information purposes only. Always seek the guidance of your doctor or other qualified healthcare professional with any questions you may have regarding your health or medical condition.

#BowelCancer #BowelCancerAwarenessMonth #Oncology

References

  1. Awareness Days. Bowel Cancer Awareness Month 2026. Available at: https://www.awarenessdays.com/awareness-days-calendar/bowel-cancer-awareness-month/. Accessed March 2026.
  2. Cancer Research UK – Cancer News. Bowel cancer awareness month: Common questions answered. Available at: https://news.cancerresearchuk.org/shorthand_story/bowel-cancer-awareness-month-common-questions-answered/. Accessed March 2026.
  3. Sung H, Siegel RL, Laversanne M et al. Colorectal cancer incidence trends in younger versus older adults: An analysis of population-based cancer registry data. Lancet Oncol 2024; 26 (1): 51–63
  4. Cancer Research UK – Cancer News. Let’s talk about poo. Available at: https://news.cancerresearchuk.org/shorthand_story/lets-talk-about-poo/. Accessed March 2026.
  5. Guts UK Charity. Bowel Cancer Awareness Month. Available at: https://gutscharity.org.uk/awareness/awareness-dates/bowel-cancer-awareness-month/. Accessed March 2026.
  6. Guts UK Charity. Bowel cancer: Advice and information. Available at: https://gutscharity.org.uk/advice-and-information/conditions/bowel-cancer/. Accessed March 2026.
  7. Cancer Research UK. Risks and causes of bowel cancer. Available at: https://www.cancerresearchuk.org/about-cancer/bowel-cancer/risks-causes. Accessed March 2026.
  8. Bowelbabe Fund. ‘Poo Taboo’ campaign. Available at: https://www.bowelbabe.org/pootaboos. Accessed March 2026.
  9. NHS England. NHS to detect and prevent thousands more bowel cancers with more sensitive screening. Available at: https://www.england.nhs.uk/2026/01/nhs-detect-prevent-thousands-more-bowel-cancers-more-sensitive-screening/. Accessed March 2026.
  10. Calin GA and Croce CM. MicroRNA signatures in human cancers. Nat Rev Cancer 2006; 6 (11): 857–866.
  11. UK. Breakthrough in bowel cancer research will speed up diagnosis. Available at: https://www.gov.uk/government/news/breakthrough-in-bowel-cancer-research-will-speed-up-diagnosis. Accessed March 2026.
  12. Bowel Cancer UK. NICE approves new drug for advanced bowel cancer patients in England and Wales. Available at: https://www.bowelcanceruk.org.uk/news-and-blogs/news/nice-approves-drug-bevacizumab-for-advanced-bowel-cancer-patients-in-england-and-wales/. Accessed March 2026.
  13. Bowel Cancer UK. Half a million pounds for new research into bowel cancer diagnosis. Available at: https://www.bowelcanceruk.org.uk/news-and-blogs/news/half-a-million-pounds-for-new-research-into-bowel-cancer-diagnosis/. Accessed March 2026.
  14. Bowel Cancer UK. Examining diagnostic pathways for bowel cancer in younger people. Available at: https://www.bowelcanceruk.org.uk/research/our-research/current-research-projects/examining-diagnostic-pathways-for-bowel-cancer-in-younger-people/. Accessed March 2026.

Author: Anna Bolsher Ι Porterhouse Pathfinders Intern