Primary care series to address perceived age bias in bowel cancer

Medical: Studies reveal that younger individuals with bowel cancer often endure a prolonged period of 3 months to 5 years consulting multiple doctors before receiving a diagnosis, sometimes requiring 10 or more visits to GPs.

Bowel Cancer Australia today launched the Never2Young CPD series, a range of GP educational activities to help overcome perceived age bias by people under age 50 diagnosed with bowel cancer.

The series was developed in response to requests from early-onset bowel cancer advocates and recent Australian research which cited the mounting imperative for GPs to receive more information and clinical guidance on early-onset bowel cancer specific diagnosis.

Patients perceived their GPs’ low suspicion of cancer given their age as an age bias that shaped the nature of clinical assessments, influenced the investigations conducted and referrals given, and created tensions between patients and doctors which obstructed shared decision-making.

Bowel Cancer Australia CEO Julien Wiggins said “Limited clinical awareness of early-onset bowel cancer presents a challenge for young people seeking diagnosis.”

“Younger patients are often overlooked for bowel cancer which was the motivation for developing this important educational resource,” he added.

“My advice to other young people is to please not ignore symptoms, no matter how embarrassing, and even more important, please don’t allow your doctor/s to be complacent about your symptoms,” advised one participant in a recent patient perspective study.

Another participant emphasised, “It is crucial if you have any symptoms at all that you are concerned with, request to have a further investigation and DO NOT let anyone tell you, you are too young to get bowel cancer!”

The Never2Young CPD series is an approved activity of The Royal Australian College of General Practitioners (RACGP) and The Australian College of Rural and Remove Medicine (ACRRM). The educational activities total 2.5 CPD hours.

From late July, Measuring Outcome (MO) hours can also be earned with two audit activities focused on early-onset bowel cancer in general practice.

Early-onset bowel cancer patients differ from late-onset bowel cancer patients in their diagnostic trajectories; time to diagnosis can be 60% longer with a greater number of missed diagnostic opportunities, and younger people are more likely to be diagnosed in later stages of the disease.

Late-stage diagnosis increases the likelihood of aggressive treatment with physical, psychosocial, and quality of life outcomes that are uniquely challenging for this under-50 patient population, especially with regards to fertility and ostomy management.

International analysis of nearly 25 million patients younger than 50 published in JAMA Network Open, found nearly half of individuals (45%) presented with blood in the stool, 40% presented with abdominal pain, and more than one-quarter (27%) presented with altered bowel habits.

Blood in the stool and abdominal pain were associated with a 5 to 54-fold and 1.3 to 6-fold increased likelihood of early-onset bowel cancer, respectively.

1,716 Australians are diagnosed with bowel cancer under age 50 each year and it is the deadliest cancer for Australians aged 25-44.

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