I thought I had a tummy bug, but it was bowel cancer

When Marie McGrath returned from holiday with an upset stomach she thought she was one of many tourists who pick up a bug when travelling; the last thing on her mind was bowel cancer.

At 52, she had a healthy, active lifestyle and thought the illness was something that happened to older people. Now she says the screening age should be lowered to catch cases like hers.

Bowel cancer screening is currently offered in Northern Ireland between the ages 60-74, but the Department of Health (DoH) has said work to expand the programme is ongoing.

In England, Scotland and Wales screening begins at 50.

Northern Ireland is also the only UK region yet to lower the level at which traces of blood in a home screening test trigger further investigation to detect more bowel cancers early.

"Bowel cancer was not on my radar," Marie said. "Bowel cancer, for me if there were tick boxes, I wouldn't be ticking any boxes.

"It was only in my view because of the professional awareness of my GP, and unfortunately, his own personal experience that I feel I was picked up and picked up well and picked up in time."

Despite displaying no typical symptoms, a colonoscopy uncovered "something of a significant size and of a significant concern".

When she heard the news, she said she "went a bit blank".

"She can't really be saying these words to me," she thought. "This is a tummy bug."

"To have a screening age set at 60, I'm wondering would I have made it to 60 if I hadn't got the GP and the circumstances at the time?"

"If much younger people are being affected, why is the threshold so high for us to be diagnosed and diagnosed at an early stage? It just is unfathomable to me."

Marie's GP, Dr Jonny Dillon is familiar with the early stages of cancer but he displayed no typical symptoms before being diagnosed with bowel cancer at 49.

He had surgery just two days after his 50th birthday.

Dillon said he was "very angry" that Northern Ireland's "excellent" screening programme lags behind the rest of the UK.

He wants to see changes to both the age that screenings are offered at and the level at which patients get further investigations to be reduced.

"That will pick up cancers or pre-cancers at a much earlier stage," he said.

"It will cost money upfront, but that will save money because people will be picked up and it will ultimately save many lives."

The Banbridge GP said his diagnosis was a "huge shock".

As the cancer had not spread, the father of three did not need chemotherapy or radiotherapy and was back working within six months.

According to the NI cancer registry, the average age of patients diagnosed with colorectal (bowel) cancer during 2018-2022 was 71 years.

Some 11.1% of patients diagnosed were under 55.

Bowel cancer is one of the most common cancers in the UK.

Screening involves a faecal immunochemical test (FIT) to look for blood in a stool sample.

It can help detect cancer at an early stage when there are no symptoms and when treatment is more effective.

It can also check for polyps which can develop into cancer.

Polyps can be easily removed, which reduces the risk.

Those eligible for screening who are registered with a GP get a home FIT kit through the post every two years.

Dillon said people in Northern Ireland between 50 and 59 were missing five potential screening opportunities.

In England, Scotland and Wales, the level at which traces of blood in FITs trigger further investigation is 80 micrograms of blood per gram of poo.

In Northern Ireland, it is 120.

A lower level would mean more people being referred for colonoscopies to help diagnose or rule out bowel cancer.

"This isn't screening for a head cold. This is screening for cancer. This is screening for a condition that could result in major surgery or even take your life," Dillon added.

Genevieve Edwards, chief executive of Bowel Cancer UK, said Northern Ireland was "falling dangerously behind" on screening and urged the executive to lower the screening age.

She said "more than nine in 10 people" can survive bowel cancer if it is diagnosed early and that "one in four people are currently diagnosed in A&E" when the cancer is at an advanced stage.

The DoH said the Northern Ireland Cancer Strategy (2022-32) has committed to reducing the sensitivity levels used in FITs and to lowering the age range in the Bowel Cancer Screening Programme, in line with the UK National Screening Committee recommendation.

It said work to expand the screening programme "is ongoing but must be viewed within the context of wider financial and capacity challenges within the supporting services".