Why We Need to Stop Whispering About Our Guts
Bowel Cancer Awareness Month is a chance to break the taboo that is quietly costing lives
There's a peculiar kind of embarrassment that surrounds our digestive health in Britain. We'll happily discuss a sore throat at the dinner table, compare notes on a bad back, or post about a twisted ankle on Instagram. But blood in the toilet? A change in bowel habits that's been going on for weeks? We tend to keep that firmly behind closed doors - and often, to ourselves.
This April is Bowel Cancer Awareness Month, and this year the conversation has a particular urgency. Bowel cancer is the UK's second biggest cancer killer after lung cancer, claiming more than 16,800 lives every year according to Bowel Cancer UK. Yet it is also one of the most treatable cancers we know of - if caught early enough. The problem isn't treatment. It's that too many of us are arriving at the doctor far too late, in part because we didn't feel we could talk about what was happening in the loo.
The gap between symptoms and the GP's door
Here's a striking statistic. A YouGov survey carried out ahead of Bowel Cancer Awareness Month found that 35 percent of people in Great Britain couldn't name a single symptom of bowel cancer. Only 12 percent recognised bleeding from the bottom as a warning sign, and fewer than half knew that blood in their stool warranted a GP visit. This isn't ignorance, it's a symptom of the taboo itself. When we don't talk about something, we don't learn about it.
The silence has real consequences. Research published by Bupa found that one in five UK adults - roughly 6.6 million people - have delayed seeking medical advice about symptoms they consider embarrassing. For bowel cancer symptoms specifically, that delay stretched to an average of ten weeks. Ten weeks during which a cancer that is highly survivable at stage one can quietly progress toward a stage where it becomes far harder to treat.
Genevieve Edwards, chief executive of Bowel Cancer UK, put it plainly: "People do feel a bit embarrassed talking about poo and blood or bleeding from your bottom. But unless we do feel comfortable… cancer stays in the shadows, and that's when it's most deadly."
The survival figures make for sobering reading. When bowel cancer is diagnosed at the earliest stage, more than nine in ten people survive. By stage four, that figure drops to fewer than one in ten. The gap between those two outcomes is not primarily a matter of luck or biology. It is, in large part, a matter of when someone walks through their GP's door.
It's not just an older person's disease
The conventional image of bowel cancer is of someone older - and it's true that it remains most common in people over 60, with around nine in ten diagnoses falling in that age group. But a concerning shift has been underway for some time. Since the early 1990s, bowel cancer rates among 30 to 39-year-olds in the UK have been rising by roughly 1.8 percent each year, according to Cancer Research UK. Since 2010, new cases among people aged 20 to 39 have increased sharply by between 5 percent and 19 percent.
Researchers at The Royal Marsden and elsewhere are working to understand why. Possible factors include dietary changes, rising obesity rates, sedentary lifestyles, and changes in the gut microbiome. In September 2025, Cancer Research UK published research suggesting that childhood exposure to a toxin produced by certain strains of E. coli may partly explain the rise in bowel cancer in people under 50.
The practical implication is clear: if you are under 50, you should not dismiss gut symptoms because you feel too young to be at risk. That assumption is exactly the kind of thinking that leads to delayed diagnoses and poorer outcomes.
What to look out for
Bowel cancer symptoms can be subtle, and several overlap with far more common conditions like IBS or haemorrhoids - which is part of why people rationalise them away. (We've explored the difference between IBS and more serious conditions in our guide to gut health and our bowel habits explainer.)
The symptoms worth taking seriously include:
• A persistent change in your bowel habits - looser stools, going more frequently, or the opposite - lasting three weeks or more • Blood in your stool or bleeding from your bottom • Unexplained weight loss • Pain or discomfort in your abdomen that keeps coming back • A feeling that you haven't fully emptied your bowels • Unexplained tiredness or breathlessness (which can result from anaemia caused by bleeding).
None of these symptoms necessarily means cancer. Most of the time, they won't. But a GP cannot rule it out without seeing you and ruling it out is genuinely worth doing.
Your GP has heard it all before
One of the most persistent myths is that GPs find these conversations uncomfortable. They don't. Discussing bowel habits, rectal bleeding, and poo consistency is entirely routine in primary care. It happens dozens of times every day in every practice across the country. What GPs find far more difficult is diagnosing a cancer that could have been caught sooner, simply because a patient waited too long to come in.
If you're not sure where to start, you don't need to have the perfect words. You could simply say: "I've noticed a change in my stools that's been going on for a few weeks, and I wanted to get it checked." That's enough. Your GP can take it from there.
It's also worth knowing that if getting a face-to-face appointment feels like a barrier, a video or telephone consultation can be just as effective for an initial conversation about symptoms. Livi GPs can assess your symptoms, advise whether you need an in-person examination, and help facilitate onward referral if needed.
What about screening?
The NHS offers free bowel cancer screening to everyone aged 50 to 74 in England (the age was recently lowered from 60). You'll receive a home testing kit in the post - the Faecal Immunochemical Test (FIT) - which checks your stool for tiny traces of blood invisible to the naked eye. It takes about ten minutes and can detect cancer before symptoms even develop.
If you're invited, please do the test. Uptake remains imperfect, and every unopened kit is a missed opportunity for early detection.
This April, let's change the conversation
Bowel Cancer Awareness Month exists precisely because awareness saves lives - not as an abstract idea, but in the most literal sense. The more comfortable we become talking about our gut health, the sooner people seek help, the earlier cancers are caught, and the more lives are saved.
So, this April, mention it to a friend. Ask a family member over 50 whether they've done their screening kit. And if you've been quietly worrying about a symptom yourself, please - make the appointment. It won't be as awkward as you fear. And it could matter more than you know.
If you're concerned about any gut symptoms, you can speak to a Livi GP via video call. Our GPs can assess your symptoms, provide advice, and refer you for further tests if needed.
