Emma has been a Registered Dietitian for over 17 years and has experience in adult and paediatric dietetics. She has been the Editor of NHD for seven years, steering the editorial content and supporting the production process. Emma currently works in industry.

Emma Coates, RD

Bowel cancer awareness: that gut feeling!

Each year in the UK, nearly 43,000 people are diagnosed with bowel cancer.(1,2) It’s the fourth most common cancer in the UK, with more than 9 out of 10 cases being diagnosed in people over the age of 50.(1) However, it can affect people at any age. It’s slightly more common in women than men, where 1 in 18 women will be diagnosed versus
1 in 15 men.(1)

April is bowel cancer awareness month. Since 1987, this annual event has been held to highlight this condition, encourage discussion about symptoms, fund research and ultimately promote early diagnosis.(3) Since the 1990s, bowel cancer rates in the UK have been relatively stable and over the past decade, rates have declined by around 6%, with a projection to fall further in the coming years.(2) This may be due to improvements in early diagnosis and treatment options and the introduction of the national bowel screening programme.(1,4) Nevertheless, the awareness work needs to continue in order to support this, particularly in some population groups.

When compared with people of White ethnicity, bowel cancer incidence is lowest in people of mixed ethnicity, and Asian and black ethnic groups.(2) In England, there is also a link between deprivation and bowel cancer in males.(2)


Bowel cancer can affect any part of the bowel, with colon and rectal cancer being the most common types.(5) Bowel cancer develops from polyps within the bowel, which can remain benign. However, in approximately 1 in 10 cases, it will develop into cancer.(6). As it stands, nearly 17,000 people in the UK die from bowel cancer each year, making it the second biggest cancer killer.(1) If diagnosed early, bowel cancer is treatable and curable (1,6) and most people survive if it is diagnosed at the earliest stages,(1) with more than a 90% chance of a cure.(6)

Let’s talk about symptoms...

Not everyone feels comfortable talking about their bowel habits. However, there comes a time when this is REALLY important!
Breaking the stigma attached to talking about what goes on in our guts and when we hit the toilet is all part of the vital awareness work to ensure that no one suffers in silence.

The main symptoms: (7)

  • Changes in your poo, such as having softer poo, diarrhoea or constipation that is not usual for you
  • Needing to poo more or less often than usual for you
  • Blood in your poo, which may look red or black
  • Bleeding from your bottom
  • Often feeling like you need to poo, even if you've just been to the toilet
  • Tummy pain
  • A lump in your tummy
  • Bloating
  • Losing weight without trying
  • Feeling very tired for no reason

Whilst it’s important to know and recognise the symptoms, it’s equally important to seek medical advice a soon as possible.

Preventing bowel cancer

The cause of bowel cancer is not always clear, however, age, lifestyle choices, environmental factors and genetic changes can all play a part in increasing the risk of developing this condition.(2,8)

According to Cancer Research UK, 54% of bowel cancer cases in the UK are preventable by having a healthier lifestyle, with 28% of UK cases being caused by poor dietary fibre intake alone.(2) Being overweight or obese, limited physical activity, drinking alcohol, smoking and eating processed meat have all been identified as avoidable risks.(2)

Other risk factors are not avoidable, such as genetic influences. For example, if a close relative has had bowel cancer, this can increase the risk. Also, the presence of inflammatory bowel diseases such as ulcerative colitis, Crohn’s disease, or bowel polyps can increase risk.(2)


Whilst there’s a wealth of information and research to discuss dietary recommendations for this topic, here are some key messages which link in with the risk factors above:

1 Increase fibre intake (9)

  • Fibre is vital in keeping our bowels healthy. Eating a range of high-fibre foods is highly recommended.
  • Fruits and vegetables provide a variety of antioxidants, which can prevent or delay cell damage.
  • For those looking to achieve or maintain a healthy weight they can promote satiety.
  • Including wholegrains, beans, pulses, nuts and seeds into our diet are all encouraged as part of the daily fibre intake.

2 Drink well (9,10)

  • Paired with an increased fibre intake, a good fluid intake supports a healthy gut.
  • Non-sugary/non-alcoholic drinks are encouraged - limiting fruit juice to one small glass per day.
  • Alcohol is not completely off limits but it is a well-known cause of cancer.
  • Aiming for no more than 14 units of alcohol per week with several alcohol-free days each week is recommended.

3 Eat less red and processed meat (10)

  • Red and processed meat is linked with an increased risk of bowel cancer. This includes – beef, pork, lamb, bacon, sausages salami and ham.
  • Choosing white meat, fish, beans, pulses and meat alternatives provide healthier options instead as they tend to be lower in fat and higher in fibre.

Keeping active, achieving and maintaining a healthy weight; and smoking cessation all help to reduce risk too.

Stuff to remember!

  1. Bowel cancer is the fourth most common type of cancer in the UK.
  2. If you think you have symptoms or someone shares their symptoms with you, seek medical advice as soon as possible. Early diagnosis and treatment really does save lives!
  3. Lower the risk of bowel cancer by eating a healthy diet.
  4. Eat less red and processed meat.
  5. Eat more fibre.
  6. Aim for at least five portions of fruit and vegetables per day.
  7. Drink less alcohol.
  8. Aim to achieve and maintain a healthy weight.
  9. Keep active and exercise regularly.
  10. Quit smoking.


      1. Bowel Cancer UK (2023). Bowel cancer. What is bowel cancer? | Bowel Cancer UK | Bowel Cancer UK
      2. Cancer Research UK (2024). Bowel cancer statistics. Bowel cancer statistics | Cancer Research UK
      3. Sky History (2024). The history of bowel cancer awareness month. The history of Bowel Cancer Awareness Month | Sky HISTORY TV Channel
      4. UK Government (2021). Guidance: Bowel cancer screening: programme overview. Bowel cancer screening: programme overview - GOV.UK (www.gov.uk)
      5. Macmillan Cancer Support (2024). Bowel cancer awareness month. Bowel Cancer Awareness Month | Macmillan Cancer Support
      6. Guts UK (2024). Bowel cancer awareness month. Bowel Cancer Awareness Month - Guts UK (gutscharity.org.uk)
      7. NHS (2023). Symptoms of bowel cancer. Symptoms of bowel cancer - NHS (www.nhs.uk)
      8. NHS (2023). Causes of bowel cancer. Causes of bowel cancer - NHS (www.nhs.uk)
      9. Bowel Cancer UK (2024). Diet | Reduce your risk | About bowel cancer | Bowel Cancer UK
      10. British Nutrition Foundation (2023). Cancer risk and nutrition. Cancer and Nutrition | British Nutritional Foundation