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About staging and grading bowel cancer

The stage of bowel (colon and rectal) cancer tells you how big it is and whether it has spread. The grade means how abnormal the cancer cells look under the microscope.

Doctors use different systems to stage bowel cancer. 

Stages

You have tests and scans to diagnose your cancer. These tests also give information about the size of your cancer and whether it has spread (the stage). But sometimes doctors can't be certain about the stage of your cancer until after surgery.  

Your treatment depends on what stage of cancer you have. 

There are different ways of staging bowel cancer. There is a number staging system, the TNM system and the Dukes' staging system.

Grades

The grade of a cancer tells you how much the cancer cells look like normal cells. This gives your doctor an idea of how your cancer might behave and what treatment you need.

The grades of bowel cancer cells are from 1 to 4:

  • grade 1 (low grade) look most like normal cells
  • grade 2 look a bit like normal cells
  • grade 3  look very abnormal and not like normal cells
  • grade 4 looks completely different from normal cells (high grade)

A low grade cancer is likely to be slower growing and less likely to spread than high grade cancers. 

Last reviewed: 
03 Jul 2018
  • Colorectal cancer: the diagnosis and management of colorectal cancer
    The National Institute for Health and Care Excellence (NICE), 2011 

  • Primary colon cancer: ESMO Clinical Practice Guidelines for diagnosis, adjuvant treatment and follow-up
    Labianca and others. Annals of Oncology, 2010. Vol 21 

  • Rectal cancer: ESMO clinical practical guidelines for diagnosis, treatment and follow up
    R Glynne-Jones and others
    Annals of Oncology, 2017. Volume 28, Pages 422-440

  • AJCC Cancer Staging Manual (8th edition)
    American Joint Committee on Cancer
    Springer, 2017

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