How to ask a loved one to screen for bowel cancer

This year, do you think it would be more likely for a loved one of yours to die in a car accident or from bowel cancer?

If you answered ‘car accident’ then you’ll be shocked to know that in Australia there are about five times more deaths from bowel cancer than road fatalities every year[1]!

Among cancers, bowel is one of the less talked-about types, despite being the third most commonly diagnosed cancer and second most common cause of cancer death in Australia. In fact, every day about 15 Australians die from bowel cancer.

A silent killer, often bowel cancer symptoms become apparent only when it’s too late, and the cancer is too advanced to be treated. Even when presented early, bowel cancer symptoms are not unique, and are common to many other medical conditions. Additionally, over 90% of bowel cancers are treatable if caught early. With this in mind, it’s evident how essential screening is, as the only way to reliably catch the disease in its early stages.

The National Bowel Cancer Screening Program (NBCSP) invites eligible people between 50-74 years of age to screen themselves for bowel cancer using a free, simple test at home. The faecal occult blood test (FOBT) looks for microscopic traces of blood in your poo, which may be a sign of polyps, cancer or another bowel condition.

So far, we have a 41% participation rate across Australia and need you to help us raise this number[2]. If we were to only pull this figure up to 60%, we could save 83,000 lives over the next 20 years[3].

Delivery of sensitive information like this, from a trusted friend or family member, can have a far greater personal impact. However, having this conversation with a loved one can be tough, especially when they feel healthy and not at risk.

So here are some tips and trick for starting this conversation with a loved one between 50-74 years old who has yet to complete an FOBT:

Understand the context

Firstly, it’s important to look at why people might avoid taking part in the screening program. This could be any of the following:

• Fear of diagnosis
• Anxiety around aging
• Lack of belief in the system/process
• Perceived time cost
• Grossed out by the screening test
• Unaware that it exists
• Confidence in health
• Cultural restrictions

When trying to convince your loved one to take part, it’s important to understand their position and why they might resist taking part. This way you can come equipped with the correct knowledge to put them at ease or inform them of facts they need to know.

Gently introduce the concept

Try not to lead with an accusatory, aggressive or judgemental tone. Instead, introduce the thought within the context of your own discovery. Statements like, “I saw this on Facebook…” make it less about your loved one, and more about your own shock at the severity of bowel cancer.

Think carefully about the timing

A private time in an environment free of distractions (mobile phones) is usually best for this type of conversation. Given the faecal matter involved, it’s probably best to avoid occasions centred around food, like dinner or a meal out. Also avoid mentioning it when visitors or children are around, as this can hinder your loved one’s ability to take it seriously.

Use language that you know will connect with your loved one

Methods for effective communication vary hugely from person to person. Try to think of what kind of statements are likely to break through. Your mother may be more receptive to emotional conversations, but your dad might be more comfortable if you use humour to ease him into the topic. View the issue from their perspective and tailor your message to suit them.

It’s a difficult but necessary conversation that we all need to be having. That brief moment of awkwardness is well worth the number of lives that could be saved by just a small increase in the screening program participation. As Australians, we are incredibly lucky to be offered a program like this, now all we need to do is take advantage of it.

[1] https://bitre.gov.au/statistics/safety/

[2] Australian Institute of Health and Welfare. National Bowel Cancer Screening Program: monitoring report 2018. Cat. no. CAN 112. Canberra: AIHW.

[3] Lew, J.B., et al., Long-term evaluation of benefits, harms, and cost-effectiveness of the National Bowel Cancer Screening Program in Australia: a modelling study. Lancet Public Health, 2017. 2: p. e331-e340