Bowel cancer is common in NSW, with around 1 in 10 men and 1 in 14 women being diagnosed by age 85. It is the second leading cause of cancer death after lung cancer. Screening can detect bowel cancer early when treatment is more effective, and increase early stage detection rates. However, only 33% of eligible people in NSW participate in screening. Increased screening to 60% could save up to 90,000 lives over 40 years. NSW delivers better bowel cancer outcomes than other countries due to high rates of radiotherapy and surgery treatment.

1. Together we can end bowel cancer as we know it
Bowel cancer in NSW: The facts
Be informed • Take action • Save lives

2. Together we can end bowel cancer as we know it
Bowel cancer is common
Many people don’t realise the full extent of its impact
One in
people in NSW
will be diagnosed
by the age of 85
1 in 10 men, and
1 in 14 women will be diagnosed
Note: Risk of being diagnosed with bowel cancer by the age of 85, based on NSW incidence 2010.
*Ferlay J, Soerjomataram I, Ervik M et al. GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11 [Internet]. 2013 [cited 2015 May 06].
Note: Incidence has been age-standardised to the Australian 2001 standard population.
Sources: NSW Cancer Registry and NSW Secure Analytics for Population Health Research and Intelligence.
Australia and New Zealand have the highest incidence of
bowel cancer in the world*
Bowel cancer incidence in NSW
has remained high for the last 2 to 3 decades

3. Together we can end bowel cancer as we know it
of all cancer deaths
in NSW
In 2010,
bowel cancer
accounted for
13%
Many people die of bowel cancer
Bowel cancer is the second biggest cancer killer in Australia and NSW after lung cancer.
Bowel cancer kills more people in NSW
than prostate cancer, breast cancer or melanoma
Source: NSW Cancer Registry

4. Together we can end bowel cancer as we know it
The outlook for bowel cancer is best
when it is diagnosed at an early stage
The good news is that 5-year survival is 89% in
localised disease
Compared with 16% in distant disease.
89%
localised
16%
distant
VS
Note: Survival by extent of disease is based on 5-year net survival of NSW cases diagnosed 2005-2009 and followed up to 2013.
Sources: NSW Cancer Registry and National Death Index Australia.

5. Together we can end bowel cancer as we know it
Screening leads to lower bowel cancer mortality
through early detection
Bowel cancer, distribution of stage at diagnosis in
unscreened vs. screened scenario
Notes: Unknown stage is not shown.
Source: Ananda SS, McLaughlin SJ, Chen F et al. Initial impact of Australia’s National Bowel Cancer Screening Program. Med J Aust 2009; 191:378-81.
Stage I Stage II Stage III
Diagnosed through
screening (screened)
Not diagnosed through
screening (unscreened)
Stage at diagnosis
Percentageofcases
14%
40%
31%
25%
24%
25%
15%
3%
• Bowel cancer screening by faecal
occult blood testing can detect
more cancers at an earlier stage,
when treatment is more effective
and less invasive, and mortality is
lower.
• Screening can even prevent bowel
cancer by detecting pre-cancerous
lesions.
Stage IV

6. Together we can end bowel cancer as we know it
Screening participation rates for bowel cancer
need to increase for more people to benefit
Currently only 33% of eligible people in NSW
take part in bowel cancer screening
If bowel screening participation rates
increased to 60% in NSW
and across Australia, up to
lives could be saved from
bowel cancer over the next 40 years.*
90,000
Cancer screening, screening participation rates,
by screening type, NSW, 2012-2014
* Cenin DR, St John J, Slevin T et al. Optimising the expansion of the National Bowel Cancer Screening Program. Med J Aust 2014;201:456-61.Notes:
• Bowel screening participation rate is based on the proportion of the eligible population invited to the National Bowel Cancer Screening
Program from July 2013 to June 2014, who returned a completed faecal occult blood test (FOBT).
• Breast screening participation rate is based on the number of women aged 50-69 who live in NSW and are screened in NSW from July 2012
to June 2014.
• Cervical screening participation rate is based on NSW women aged 20-69 who are screened from July 2012 to July 2014.
Sources: National Bowel Cancer Screening Program; BreastScreen NSW; NSW Pap Test Register; Epidemiology and Surveillance Branch, NSW Ministry of Health.

7. Together we can end bowel cancer as we know it
Prevention
Reduce the risk of bowel cancer
Obesity is linked to
increased risk of
bowel cancer.
Staying physically
active and lean can
lower your risk.
Physical activity
Smoking increases the
risk of bowel cancer.
The following services
are available for more
information and support
on how to quit.
Quit smoking
Several dietary factors
are linked to bowel
cancer risk.
Increased risk
Red meat
Processed meat
Excessive alcohol
Decreased risk
Dietary fibre
Healthy diet

8. Together we can end bowel cancer as we know it
NSW delivers world’s best outcomes for bowel cancer
It is important to seek treatment once diagnosed...
with radiotherapy
and surgery
While surgery is the mainstay of curative treatment
for bowel cancer, adjuvant therapy can further
improve outcomes for suitable patients
Survival from bowel cancer in NSW is better
than comparative countries
with radiotherapy
and surgery
with only
surgery
vs 5%
Cancer returns within 10 years of treatment
11% of rectal
cancer
cases
of rectal
cancer
cases
Bowel cancer, 5-year relative survival, in selected countries,
diagnosed 2005-2007
Note: Relative survival was estimated using the period method for cases diagnosed 2005-2007 and followed up to 2007, and has been
age-standardised to the International Cancer Survival Standard Weights.
Source: Coleman MP, Forman D, Bryant H et al. Cancer survival in Australia, Canada, Denmark, Norway, Sweden, and the UK, 1995–2007
(the International Cancer Benchmarking Partnership): an analysis of population-based cancer registry data. Lancet 2011; 377:127-38.
Note: Based on a sample of international patients.
Source: van Gijn W, Marijnen CA, Nagtegaal ID et al. Preoperative radiotherapy combined with total mesorectal excision for resectable rectal
cancer: 12-year follow-up of the multicentre, randomised controlled TME trial. Lancet Oncol 2011;12:575-82.