You may have an increased genetic risk if you or close relatives have:

• Bowel cancer diagnosed before age 50
• A positive screening result for Lynch syndrome (abnormal IHC/MSI test)
• Multiple relatives with bowel cancer
• A family history of bowel and related cancers (such as womb or ovarian cancer)
• Multiple bowel polyps (benign growths that can sometimes develop into cancer)
• Cancer present across multiple generations

Several genes are associated with an increased risk of bowel cancer. At Check4Cancer, patients having cancer treatment who have insurance are usually tested for these. They include:

• APC, BMPR1A, EPCAM, MLH1, MSH2, MSH6, MUTYH, NTHL1, PMS2, POLD1, POLE, PTEN, SMAD4, STK11, TP53. 

A more comprehensive 31 gene panel is also available to self-pay patients. These include:

• APC, ATM, BAP1, BARD1, BMPR1A, BRCA1, BRCA2, BRIP1, CDH1, CDK4, CDKN2A, CHEK2, EPCAM, HOXB13, MLH1, MSH2, MSH6, MUTYH, NF1, NTHL1, PALB2, PMS2, POLD1, POLE, PTEN, RAD51C, RAD51D, SMAD4, STK11, TP53, VHL.

Genetic testing can:

• Identify if you have a higher risk of developing bowel cancer
• Help tailor cancer screening and prevention strategies
• Guide treatment decisions, such as surgery or chemotherapy

1. Pathogenic variant found – A gene variant that increases bowel cancer risk is detected. Extra screening and/or risk-reducing measures will be recommended.

2. Variant of uncertain significance (VUS) – A genetic change is found, but it’s unclear if it increases cancer risk. Screening recommendations will be based on family history.

3. No variant found – No known risk-increasing variant is detected, but this does not rule out a genetic predisposition. Cancer screening may still be beneficial.

If a pathogenic variant is found, your specific cancer risks depend on the gene involved. You may be offered:

• More frequent colonoscopies to detect and remove polyps early
• Screening for other cancers (if associated with your genetic risk)
• Risk-reducing options, such as medication or, in some cases, surgery
• Genetic testing for close relatives to determine if they also carry the mutation

Colonoscopies are the most effective screening tool. A flexible telescope is used to examine the bowel, and any polyps found can be removed before they become cancerous. The frequency of colonoscopies depends on the specific gene mutation.

Yes, research suggests aspirin may reduce bowel cancer risk, particularly for individuals with Lynch syndrome. If you have a genetic risk, your doctor may discuss whether aspirin is appropriate for you.

Surgery is an option in certain high-risk cases:

• Lynch syndrome: Women may consider a hysterectomy and oophorectomy (removal of the womb and ovaries) to lower their risk of womb and ovarian cancer.
• Familial Adenomatous Polyposis (FAP): In some cases, a colectomy (removal of the colon) is advised, though this is less common for other conditions.

The risk of bowel cancer increases with age, which is why routine screening for the general population starts at 50. However, additional risk factors include:

• A personal history of bowel polyps
• Type 2 diabetes
• Ulcerative colitis or Crohn’s disease
• Acromegaly (a rare hormonal condition)

If you have any of these risk factors, talk to your doctor about whether earlier screening is appropriate.

Check4Cancer’s Bowel Cancer Gene Test provides screening for people without symptoms aged 45+

It’s important to be aware of symptoms and seek medical advice if you notice:

• Bleeding from the anus or blood in the stool
• Changes in bowel habits (diarrhoea, constipation, or needing to go more often) lasting more than 3 weeks
• Unexplained weight loss
• Ongoing fatigue without a clear cause
• Abdominal pain or a lump in the tummy

Most people with these symptoms do not have cancer, but it's always best to check with a doctor.