Author: Alex Ure, Junior Product Manager FIT, Alpha Laboratories Ltd
The Backbone Behind Bowel Cancer Support
Bowel cancer is one of the most common cancers worldwide, yet early detection and timely intervention can significantly improve survival rates (Cancer Research UK, 2023)1. Healthcare professionals play a crucial role in raising awareness, promoting screening, and supporting patients throughout their journey. From general practitioners (GPs) and nurses to pharmacists and specialists, a multidisciplinary approach is essential in detecting bowel cancer early and ensuring effective treatment. This paper explores the contributions of healthcare professionals in bowel cancer awareness, diagnosis, and patient care.
The Role of General Practitioners (GPs) in Early Detection and Care
GPs are often the first point of contact for patients experiencing symptoms such as persistent changes in bowel habits, rectal bleeding, or unexplained weight loss (NICE, 2023)2. Their ability to recognise red flag symptoms and refer patients for further testing, such as a Faecal Immunochemical Tests (FIT) or a colonoscopy, is vital in early diagnosis. Additionally, GPs play a crucial role in:
- Encouraging eligible patients to participate in national screening programmes.
- Providing reassurance and clear explanations about diagnostic procedures.
- Offering ongoing support for patients diagnosed with bowel cancer, such as discussing treatment options and managing side effects.
Studies3,4 have shown that early GP referrals for suspected bowel cancer led to higher survival rates and cost saving for the NHS, highlighting the importance of primary care in cancer detection. N. Calanzani et al.3 found that 91.7% of patients survived when colorectal cancer was diagnosed at stage 1, 84.1% of patients survived when diagnosed at stage 2, whereas only 64.9% of patients survived when diagnosed at stage 3.
Nurses, Endoscopists, Pharmacists and Other Healthcare Professionals
Beyond GPs, other healthcare professionals are essential in educating and supporting patients throughout their journey.
Nurses: Educators and Patient Advocates
Nurses provide essential guidance and emotional support for patients undergoing tests, treatment, and recovery. Colorectal Clinical Nurse Specialists work alongside surgeons, endoscopists and other specialists to ensure the patient feels the upmost support. 
Their roles can include:
- Providing clear explanations of screening procedures and test results, along with supporting disabled patients in completing a FIT test.
- Offering post-diagnosis counselling, helping patients understand their cancer journey whilst also providing assistance through explaining the treatment options available.
- Assisting with pain and symptom management and improving quality of life for patients undergoing chemotherapy or surgery (Macmillan Cancer Support, 2022)7.
Endoscopists: Carry out colonoscopies to screen for disease
A colonoscopy is a procedure carried out by Endoscopists which allows them to depict the large intestine, therefore enabling the identification of polyps and early signs of cancer, which can often be asymptomatic. Although they are highly beneficial when diagnosing cancers, they can be uncomfortable for patients and costly to the NHS.
C.C. Kearsey et al4 conducted a study evaluating the cost-effectiveness of using FIT testing as an initial diagnostic tool for patients with lower gastrointestinal symptoms. With patient referrals increasing each year, the demand for colonoscopies continues to rise. In 2014, endoscopic procedures cost the NHS £178.4 million, yet 40% of these tests yielded normal results. The study highlighted the crucial role of FIT testing, demonstrating how an initial FIT test can help the NHS identify patients who truly require further investigation. NHS England has also emphasised the value of FIT testing in reducing unnecessary procedures and supporting cost-saving initiatives5.
Some responsibilities of endoscopists can include:
- Removal of polyps to prevent further spread of cancers.
- Take tissue samples known as biopsies for pathological analysis.
- Review malignant lesions in surgery to evaluate the extent of the cancer (Bowel Cancer UK, 2024)6.
Pharmacists: Enhancing awareness and treatment adherence
Community pharmacists play a role in bowel cancer awareness through:
- Advising patients on the importance of screening and directing them to the appropriate services.
- Providing information on the treatment of side effects, such as nausea or constipation.
- Supporting patients with medication adherence, particularly during chemotherapy.
- Educating customers on the vital role FIT testing plays in early diagnosis.
Other Allied Healthcare Professionals
- Dietitians help patients maintain a sound nutrition during and after treatment, whilst managing symptoms such as constipation, diarrhoea and nausea.
- Radiologists take accurate imaging of the cancer to determine the extent of the cancer.
- Pathologists perform a detailed biopsy examination to verify the cancer diagnosis as soon as possible.
- Psychologists and Counsellors provide mental health support, helping patients adapt to the nature of the disease and cope with any anxiety and emotional distress.
Resources for Healthcare Professionals to Promote Awareness
Several tools and initiatives support healthcare professionals in raising awareness and promoting early detection:
- Public Health Campaigns: Organisations like Bowel Cancer UK and the NHS provide awareness materials and patient guides.
- Screening Programmes: National bowel screening initiatives help detect cancer at an early stage, reducing mortality rates (NHS, 2023)7.
- Training and Guidelines: Professional bodies such as the National Institute for Health and Care Excellence (NICE)2 offer guidelines on symptom recognition, referral pathways, and treatment options.
Healthcare professionals form the backbone of bowel cancer support and patient care. GPs, nurses, endoscopists, pharmacists, and allied healthcare workers contribute to early diagnosis, effective treatment, and ongoing patient support. This paper provides exposure to healthcare roles that are often overlooked by the public. By promoting awareness, facilitating screening, and guiding patients through their journey, these professionals play a pivotal role in improving bowel cancer outcomes. Integrated collaboration among GPs, hospital staff, and allied professionals results in a positive patient pathway every time.
References:
1Cancer Research UK. (2023). ‘’Bowel Cancer Statistics’’. Available: https://www.cancerresearchuk.org/about-cancer/bowel-cancer/survival
2NICE. (2021). ‘’Gastrointestinal tract (lower) cancers – recognition and referral’’. Available: https://cks.nice.org.uk/topics/gastrointestinal-tract-lower-cancers-recognition-referral/
3Natalia Calanzani et al ‘’Recognising Colorectal Cancer in Primary Care’’. Available: https://pmc.ncbi.nlm.nih.gov/articles/PMC8052540/#:~:text=Increased%20use%20of%20the%20urgent,cancers%20%5B69%2C%2070%5D.
4CC Kearsey et al ‘’Cost effectiveness of using Faecal Immunochemical Testing (FIT) as an initial diagnostic investigation for patients with lower gastrointestinal symptoms suggestive of malignancy’’. 2021. Available: https://bmcprimcare.biomedcentral.com/articles/10.1186/s12875-021-01435-7
5NHS England ‘’Home-testing kits that detect bowel cancer could almost halve invasive examinations by 2020’’. Available: https://www.england.nhs.uk/2017/09/home-testing-kits-that-detect-bowel-cancer-could-almost-halve-invasive-examinations-by-2020/
6Bowel Caner UK. (2024). ‘’Hospital Tests’’. Available: https://www.bowelcanceruk.org.uk/about-bowel-cancer/diagnosis/hospital-tests/#:~:text=What%20is%20a%20colonoscopy?,be%20removed%20during%20a%20colonoscopy.
7Macmillan Cancer Support. (2022). ‘’Bowel Cancer’’. Available: https://www.macmillan.org.uk/cancer-information-and-support/bowel-cancer
8NHS. (2023). ‘’Bowel Cancer Screening Programme’’. Available: https://www.nhs.uk/conditions/bowel-cancer-screening/
