Australian Doctor Australian Doctor 2 June 2017 | Page 17

How to Treat PULL-OUT SECTION www.australiandoctor.com.au C COMPLETE HOW TO TREAT QUIZZES ONLINE www.australiandoctor.com.au/cpd to earn CPD or PDP points. w INSIDE Diagnosis and investigations Inherited bowel cancer Colonoscopy Case studies THE AUTHORS ASSOCIATE PROFESSOR PAUL MCMURRICK head, Cabrini Monash University Department of Surgery, Cabrini Hospital Melbourne; chairman, Let’s Beat Bowel Cancer. ASSOCIATE PROFESSOR GARY RICHARDSON director, Cabrini Academic Haematology & Oncology Service, Melbourne; associate professor of medicine, Monash University, Melbourne; chairman, Foundation 49: Men’s Health. DR RAYMOND YAP colorectal fellow, Colorectal Surgical Society of Australia and New Zealand. Bowel cancer part 1: Diagnosis Background THIS is part one of a two-part series on cancer of the large bowel. Part one will cover the background of colorectal cancer, diagnosis and investigations. Inherited bowel can- cers are also discussed. The pre-symptomatic diagnosis of cancer of the large bowel (see fig- ures 1 and 2), management of estab- lished cases and primary prevention of this disease remain major chal- lenges in Australian society. Carcinoma of the colon and rec- tum is a common disease. There are around 17,000 new cases in Aus- tralia each year, affecting around one in 20 adults (one in 19 men and one in 28 women), accord- ing to the National Bowel Cancer Screening Program site. 1 While com- munity screening for many cancers remains of questionable value, there is unequivocal level-one evidence supporting population-based strati- fied screening for bowel cancer in Western society. At least three randomised trials www.australiandoctor.com.au have demonstrated a reduction in mortality of around one-third when FOBT is appropriately applied to the community. 2-4 The value of this has been recognised by successive Australian governments, which have instituted and continued to support the National Bowel Cancer Screen- cont’d next page Copyright © 2017 Australian Doctor All rights reserved. No part of this publication may be reproduced, distributed, or transmitted in any form or by any means without the prior written permission of the publisher. For permission requests, email: [email protected] 2 June 2017 | Australian Doctor | 17