Bowel cancer in Nigeria: the early signs, and why screening changes everything

Bowel cancer used to be described as a Western disease. That is no longer true, and it has not been true in Nigeria for some time. Cases are rising, patients are presenting younger, and far too many arrive at a stage where treatment is difficult.

Here is what matters: colorectal cancer is one of the most preventable cancers there is. Not just treatable. Preventable.

Why cases are rising here

The pattern follows urban life. Diets in Lagos and other cities have shifted toward processed foods, red meat and less fibre. People sit more and move less. Rates of obesity, smoking and heavy alcohol use have climbed. All of these push bowel cancer risk up.

The second factor is detection. There is almost no organised screening in Nigeria, so most cases are found because someone developed symptoms, and symptoms tend to appear once the disease is established.

The early signs

The difficult truth is that early bowel cancer often causes no symptoms at all. When symptoms do appear, watch for:

• A lasting change in bowel habit, looser or more frequent stools, or new constipation, continuing beyond two weeks
• Blood in the stool, particularly dark blood or blood mixed through it
• Unexplained weight loss
• Persistent abdominal pain, cramping or bloating
• A feeling that the bowel has not emptied after going
• Unexplained tiredness or a low blood count, which can be the only sign

Any of these lasting more than two weeks deserves a conversation with a doctor, especially after 45.

Who is at higher risk

Risk is higher if you have a close relative who had bowel cancer, a personal history of polyps, inflammatory bowel disease such as Crohn's or ulcerative colitis, type 2 diabetes, or a family history of certain inherited syndromes. Diet, weight, smoking and alcohol all contribute too.

That said, plenty of people who develop bowel cancer have none of these. Age alone is a risk factor.

The screening age

For people at average risk, screening should begin at 45. If a close relative has had bowel cancer, start earlier, usually around 40, or ten years before the age at which they were diagnosed, whichever comes first.

How often you repeat it depends on what we find. A completely clear colonoscopy in an average-risk person usually means a long interval before the next one. If polyps are found and removed, we will advise a shorter interval.

How screening actually prevents cancer

This is the part worth understanding properly, because it changes how you think about the test.

Most bowel cancers do not appear from nowhere. They begin as a polyp, a small growth on the bowel wall, which sits there for years, often a decade or more, slowly changing. During a colonoscopy we find those polyps and remove them there and then, where appropriate. Sedation is not routine at Zendale; optional anaesthesia can be requested.

Remove the polyp and the cancer it might have become never happens. That is prevention in real time, and no scan or blood test does it. A CT scan or a stool test may find a problem; a colonoscopy finds it and deals with it in the same sitting.

What screening involves

It is exactly the same procedure as a diagnostic colonoscopy: bowel preparation, the examination and individual aftercare. Sedation is not routine at Zendale; optional anaesthesia can be requested. The difference is only the reason you are there.

What to do with this

If you are 45 or older and have never been screened, book it. If bowel cancer runs in your family, do not wait for 45. If you have had symptoms for more than two weeks, come in now rather than waiting for a birthday.

We see both kinds of patient in this unit. The ones who came early leave with reassurance, or with a polyp removed and a problem prevented. The ones who waited have a much harder road. The difference between them is usually nothing more than one appointment.

Call 070 7056 6272 to arrange screening at Ayinke House, LASUTH.