The number of bowel cancer patients who are admitted to hospital as an emergency is "stubbornly" high, an audit of the disease has found.
Around 22% of patients who suffer the disease are taken to hospital as an emergency case.
People who are admitted this way are likely to have a more advanced stage of cancer, which is often harder to treat.
The authors of the National Bowel Cancer Audit said that emergency admission rates are a "substantial challenge".
The audit, conducted by the Health and Social Care Information Centre, also found that patients who are operated on are almost twice as likely to live for two years beyond cancer diagnosis compared with those who are not.
The data from more than 50,000 bowel cancer patients found that four in five who underwent major surgery in England and Wales between April 2008 and March 2010 lived beyond two years of diagnosis.
But only two in every five who were too frail to have surgery or whose cancer was too advanced for them to be operated on survived for two years, researchers found.
Mark Flannagan, chief executive of the charity Beating Bowel Cancer, said: "A major concern is that there hasn't been any improvement on the number of people being diagnosed with bowel cancer as an emergency - when the disease tends to be more advanced and outcomes poorer.
"A mixture of embarrassment, worry and lack of awareness means that people delay seeking help until it's too late.
"More needs to be done to educate both the public and GPs about the symptoms of bowel cancer and how vital it is to catch it early."
Nigel Scott, audit clinical lead and consultant colorectal surgeon at the Royal Preston Hospital, said: "Blood, bowels and poo tend to get sat on, as embarrassment puts people off from seeing the doctor.
"Getting past the bathroom door and seeking the support of a health professional is the best means of finding a cancer as soon as possible."
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