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  • Staging and prognosis of bowel cancer

    Last reviewed by January 2013

    Diagnostic tests help to determine whether you have bowel cancer. Some tests also show if the cancer has spread to other parts of the body. This is called staging. It helps your doctors work out the best treatment for you.

    There are different staging systems used to stage bowel cancer. In Australia the most common staging system used is called the Australian Clinico-Pathological Staging (ACPS) system.

    Stage A cancer is found only in the bowel wall
    Stage B cancer has spread to the outer surface of the bowel wall
    Stage C cancer has spread to the lymph nodes near the bowel
    Stage D     cancer has spread beyond the lymph nodes to other areas of the body such as the liver or lungs

    Another staging system being used more often is called the TNM system. It shows how far the tumour (T) has spread into the bowel wall, if lymph nodes are affected (N) and if the cancer has spread (metastasised) to other parts of the body (M). In the TNM system, each letter is assigned a number that indicates how advanced the cancer is.

    You may also hear about the Dukes system, which is an older staging system similar to the ACPS.


    Often people want to know what their chances of getting better are. This is called a prognosis which means the expected outcome of a disease.

    You will need to discuss your prognosis and treatment options with your doctor but it is not possible for any doctor to predict the exact course of your disease. Test results, the type of cancer you have, the rate and depth of tumour growth, how well you respond to treatment, and other factors such as age, fitness and medical history are all important factors in assessing your prognosis.

    In most cases the earlier bowel cancer is diagnosed and treated, the better the prognosis.

    Information reviewed by:  Karen Barclay, Colorectal Surgeon, The Northern Hospital, Lecturer in Surgery, University of Melbourne, VIC; Carole Arbuckle, Cancer Nurse, Cancer Council VIC; Karen Bowers, Eat it to Beat it Strategy Project Officer, Cancer Council NSW; Darrell Bowyer, Consumer; Rebecca Foot-Connolly, Stomal Therapy Nurse, The Alfred Hospital, VIC; Bernadette Hadfield, Stomal Therapy Nurse, The Alfred Hospital, VIC; Melissa Heagney, Media and Communications Advisor, Cancer Prevention Unit, Cancer Council VIC; Dorothy King, Consumer; and Loreto Pinnuck, Stomal Therapist, Wound Consultant, Paediatric Continence Specialist, Monash Medical Centre, VIC.

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