Consultants: Advanced bowel cancers being seen in Emergency Departments

People who notice worrying changes in their body are being urged to seek help amid concerns by cancer doctors and the Irish Cancer Society about more advanced bowel cancers being detected.

Top bowel cancer experts have expressed their worry about a ‘catchup phenomenon’ where patients not picked up during the pandemic are now presenting at later stages.

April is Bowel Cancer Awareness Month and early detection is key to survival for bowel or colorectal cancers, with patients who present later in their illness facing a much more difficult treatment pathway with less chance of success.

St Vincent’s Hospital Consultant Gastroenterologist Prof Glen Doherty said: “We are now starting to recognise the knock-on effects of the pandemic for people with other diseases including cancer. We are concerned to see people presenting who have had symptoms for some time, even with very large and advanced primary tumours in some instances, and we have seen a number of cases of people presenting with advanced symptoms through Emergency Departments.

“We know there is a big backlog of patients awaiting routine colonoscopies. Even if it is only a small proportion of those people who turn out to have a more serious problem like colorectal cancer, it still means people are potentially getting lost in that large pool of patients and it’s something we all feel uncomfortable about and are anxious to address,” he added.

Gastroenterology Clinical Lead at Tallaght Hospital Prof Anthony O’Connor said: “Where diagnoses are delayed, this means that critical care is being delayed. Delays of longer than 3 to 6 months could be the difference in a stage of cancer. Fewer people may be surgical candidates, and those who are may require more invasive surgery or chemotherapy.

“We need a proper plan to restart cancer services. In the short term, gastroenterologists should be freed up from general medical duties to perform extra endoscopy lists to clear the backlog. In the long term there must be substantial investment in endoscopy infrastructure across the country.”

Mater Hospital Consultant Colorectal Surgeon Prof Ronan Cahill said: “We are now seeing colorectal cancer patients who have already moved through the stages from what would once have been a very curable diagnosis requiring a single surgery, to something that is going to have to extend over a year with chemotherapy, surgery and more treatment after with a much worsened prognosis: a diagnosis that is much more complex and that you’re much less likely to cure.

“It makes the diagnosis harder for patients to hear, and it’s very tough on these people who have genuinely been trying to look after their health in the middle of a pandemic. If you are on a waiting list and you have symptoms that are advancing or changing, the key message is: go back to your GP or doctor and ask for an earlier appointment. We want to prioritise people who are at higher risk at the moment.”

Irish Cancer Society Director of Advocacy Rachel Morrogh said: “We have serious concerns that waiting lists are putting people’s chances of surviving and having successful treatment at risk. Bowel cancer is a cancer that is diagnosed at a late stage (Stage 3 or 4) in 5 in 10 cases so it is critical that the health system has the capacity to fast-track all symptomatic patients and remove waiting lists that act as a barrier to timely care.”

The Irish Cancer Society Freephone Support Line is available on 1800 200 700 for anyone with a cancer-related query or concern, and people can find out more about bowel cancer symptoms and use the online Bowel Health Checker at


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