April is bowel cancer awareness month. It's an opportunity to highlight the potential we have to save lives through prevention and early detection, as well as through swift access to the best possible treatment.
I'd like to focus on the first two aspects of prevention and detection, because I think many of us don't appreciate just how much we can do, as individuals, to reduce the risk of bowel cancer - and because these are the areas where Public Health England (PHE) has the most to contribute.
Bowel cancer is the third most common cancer in England and it's also the third most common cause of cancer death (for men and for women).
We're seeing increasing numbers of new cases of bowel cancer, with 42,747 cases diagnosed in 2011. The increase in new cases (per 100,000 people) is partly due to an ageing population and partly due to more new cases found through national screening, which was introduced in 2006.
But while the incidence of bowel cancer is rising, the death rate from bowel cancer has been steadily falling. This is probably due to several reasons, including earlier detection and better treatment. There's an opportunity, though, for improving this trend further, especially among the most deprived in our country, where mortality rates are greatest.
So what does our prevention agenda look like? The starting point is the risk factors for bowel cancer. Some of these, of course, we have no control over, such as age: in 2010 over 70% of newly diagnosed cases were among those aged 65 and over.
But there are some risks we can modify and thanks to major international studies, we now have a better understanding of the role of risk factors such as a poor diet, obesity, smoking, alcohol and physical inactivity. For example, diets high in fibre are likely to reduce the risk of bowel cancer whereas diets high in red and processed meats are likely to increase the risk. Scientists estimate that about half of all bowel cancer cases in the UK could be prevented through healthy lifestyles, such as maintaining a healthy weight, eating healthily and being physically active, among other things.
But knowing something is rarely enough of a motivation: we all need help and encouragement to make the right choices, and there are many things that can influence this. Our behaviours are shaped by our friends and families, by where we live and whether we work, the quality of the food we can buy, and the opportunities we have, at every age, to become and stay active. Part of PHE's role is to champion those things that help us to live as well as we can.
But we can go further in preventing diseases like bowel cancer. New screening techniques can also help. Bowel scope screening is a new test for men and women at the age of 55 that can help to prevent bowel cancer by finding small growths, polyps, which may develop into cancer if left untreated. PHE recently announced that it's ahead of target in rolling out the new test, with nearly 37% of screening centres in England now up and running.
Another core plank of our fight against bowel cancer is to improve the outlook for people who already have the disease through better detection - which is the purpose of our existing national screening programme for people over 60. There are several aspects to this.
First, there's the importance of early detection. In recent years, about one in four people with bowel cancer were diagnosed as emergency cases, with a higher proportion in later stage cancers (and for older people). We know that catching the disease early can be key: over 90% of patients diagnosed with the earliest stage of disease survived five years from diagnosis. That's why the current screening programme - a test that checks for hidden blood in the stool - is offered every two years.
Second, there's the importance of doing all we can to improve the accuracy of the test as well as making it as easy as possible for patients to use it. That's why, from April, the NHS Bowel Cancer Screening Programme is piloting a new test (Faecal Immunochemical Test), which may have advantages over the current test.
At the beginning of this decade, the Government outlined its strategy for cancer, setting out an ambition to save an additional 5,000 lives per year by 2014/15. Preventing more bowel cancers from developing and catching them as early as possible are an essential part of delivering on this ambition.