Six ways to reduce your risk of bowel cancer

Bowel cancer is a general term for cancer that begins in the large bowel. Depending on where the cancer starts, bowel cancer is sometimes called colon or rectal cancer.

The main symptoms of bowel cancer are:

• Bleeding from your bottom and/or blood in your poo.

• A persistent and unexplained change in bowel habit.

• Unexplained weight loss.

• Extreme tiredness for no obvious reason.

• A pain or lump in your stomach.

Ways to help prevent bowel cancer

More than half of all bowel cancer cases are preventable¹, and are generally due to lifestyle. Preventable causes are thought to be the main reason why there has been a 48% increase in the number of 25 - 49 year olds with bowel cancer². Living a healthy lifestyle is more important than ever.

Cancer Research UK says the main causes of bowel cancer and the percentage of people affected are:

• 28% - eating too little fibre.

• 13% - eating processed meat.

• 11% - being overweight or obese.

• 6% - alcohol drinking.

• 7% - smoking.

• 5% - too little physical activity.

• 2% - ionising radiation.

Simple changes to your diet and lifestyle can make a big difference to your chance of getting bowel cancer. And making those changes as early as possible could be key to reducing your risk. Here are six steps you can try to make a real difference.

Reduce how much red and processed meat you eat

The amount of red and processed meat we eat has increased over the past 50 years. Coinciding with this, is research that shows the long-term consumption of red and particularly processed meat - such as hams, salami, and sausages - may increase your risk of bowel cancer³.

You don't need to stop eating red meat completely - it's a good source of protein and iron and can help form a balanced diet - but do so in moderation. Guidelines suggest we should eat no more than 70g a day of red or processed meat - this is around three slices of ham, two rashers of bacon, or one small beefburger. However, there has been much research which links the nitrates put into many processed meats to increasing risks of bowel cancer⁴.

Try swapping red meat for chicken or fish, have a few meat free days each week and have as little processed meat as possible.

Eat more dietary fibre

Dietary fibre - also called plant-based carbohydrates - provides a variety of health benefits, including helping your digestive system stay healthy. It may also help prevent you getting bowel cancer.

To get more fibre in your diet, try:

• Swapping to brown rice, pasta, or bread.

• Swapping crisps for low calorie plain popcorn.

• Choosing wholegrain breakfast cereals.

• Eating more fruit and vegetables high in fibre, such as peas and raspberries.

• Adding beans and pulses to your diet.

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Exercise

Alongside changes in your diet, exercise can help reduce the risk of bowel cancer. More than half of all people in the UK are overweight or obese. Weight issues are a leading risk factor for many preventable cancers. According to Cancer Research UK, 1,900 more people get bowel cancer from being overweight than from smoking.

Just 11 minutes (75 minutes a week) of moderate-intensity physical activity - such as a brisk walk - can lower your risk of many cancers and also provide many other health benefits⁵.

You can use our BMI calculator to see if you are a healthy weight or not.

Drink less alcohol

Drinking too much alcohol can cause many digestive cancers and accounts for 6% of people with bowel cancer.

Reducing your alcohol intake is one of the most important steps you can take to invest in your long-term health. To reduce the health risks associated with alcohol, both men and women should drink no more than 14 units of alcohol a week.

Consume vitamin D and calcium

Whilst traditionally known for their beneficial effects on bone health, calcium and vitamin D may reduce the chance of bowel cancer. In one study, people who had vitamin D levels below the current guidelines had a 31% increased risk of bowel cancer⁶. In comparison, those with a vitamin D intake above the recommended levels had a 22% reduced risk.

The most effective way to increase your intake of vitamin D and calcium is to integrate them into your diet through foods such as fatty fish and a variety of dairy products. In winter, it's also a good idea to take vitamin D supplements, as we're exposed to less vitamin D from sunlight.

Stop smoking

A common factor behind many cancers, cigarette smoking is also a long-established risk factor for bowel cancer. The risk of former smokers getting bowel cancer is up to 25% more than that of those who have never smoked.

With bowel cancer rates in young adults increasing, the risk is also higher in people who start smoking younger, contributing to this upward trend.

Bowel cancer screening

Although changes in your lifestyle are important measures to prevent bowel cancer, one of the most effective steps you can take is to have a bowel cancer screening.

Caught early, bowel cancer is a very treatable disease, leading to a 90 - 95% survival rate. If pre-malignant lesions are detected, cancer can even be prevented. The NHS in England and Northern Ireland offers a home testing kit for people over 60, which is a simple and effective testing method to detect possible indications of bowel cancer. The programme is being expanded to everyone over 50 by 2025. In Wales everyone over 55 is eligible for a free testing kit and in Scotland it's for everyone over 50.

Dr Monique van Leerdam is a member of the European Gastroenterology (UEG) Public Affairs Committee.

Further reading

1. Cancer Research UK: Bowel Cancer.

2. BJS: Demographic trends in the incidence of young-onset colorectal cancer: a population-based study.

3. The relationship between processed meat, red meat, and risk of types of cancer: A Mendelian randomization study.

4. NLM: Nitrites in Cured Meats, Health Risk Issues, Alternatives to Nitrites: A Review.

5. BMJ: Non-occupational physical activity and risk of cardiovascular disease, cancer and mortality outcomes: a dose–response meta-analysis of large prospective studies.

6. David Feldman et al: The role of vitamin D in reducing cancer risk and progression.