Bowel Screening

The NHS Bowel Cancer Screening Programme is now fully rolled out.

This means that most people in their sixties will have already received an invitation from the programme.

It is important to note, however, that exactly when the invitation is sent out depends upon a person’s date of birth. For example, some areas began sending invitations to people with ‘even’ birthdays (60, 62, 64 etc). Others started with those with ‘odd’ birthdays (eg 61, 63, 65…). It can take up to two years for every eligible person in an area to be invited.

Most areas will have sent out invitations to all those eligible by the end of 2012.

Screening is for people without symptoms.

If you are concerned about any symptoms, please contact your GP or visit NHS Direct Online.

 

Why screen for bowel cancer?

About one in 20 people in the UK will develop bowel cancer during their lifetime. It is the third most common cancer in the UK, and the second leading cause of cancer deaths, with over 16,000 people dying from it each year.1Regular bowel cancer screening has been shown to reduce the risk of dying from bowel cancer by 16 per cent2.

 

What is the purpose of bowel cancer screening?

 

Bowel cancer screening aims to detect bowel cancer at an early stage (in people with no symptoms), when treatment is more likely to be effective.

Bowel cancer screening can also detect polyps. These are not cancers, but may develop into cancers over time. They can easily be removed, reducing the risk of bowel cancer developing.

 

How is the NHS Bowel Cancer Screening Programme organised?

The NHS Bowel Cancer Screening Programme started being rolled out in July 2006 and achieved nation wide coverage by 2010.Programme hubs operate a national call and recall system to send out faecal occult blood (FOB) test kits, analyse samples and despatch results. Each hub is responsible for coordinating the programme in their area and works with up to 20 local screening centres.

The screening centres provide endoscopy services and specialist screening nurse clinics for people receiving an abnormal result. Screening centres are also responsible for referring those requiring treatment to their local hospital multidisciplinary team (MDT).

Who is eligible for bowel cancer screening?

The NHS Bowel Cancer Screening Programme offers screening every two years to all men and women aged 60 to 69. People over 70 can request a screening kit by calling the freephone helpline 0800 707 6060

Age extension to bowel cancer screening

In December 2007 the Cancer Reform Strategy stated that the NHS Bowel Cancer Screening Programme would be extending the age range for screening from April 2010 to invite men and women up to their 75th birthday.This was reaffirmed by the Coalition Government in Improving Outcomes: A Strategy for Cancer .

Five screening centres started implementing the age extension in 2008. As screening centres complete their first two – year screening round they are rolling out the extension, (subject to meeting criteria and subsequent approval by the national office).

By May 2012, 35 of the 58 local screening centres had started inviting the extended population.

How are GPs involved in bowel cancer screening?

GPs are not directly involved in the delivery of the NHS Bowel Cancer Screening Programme but they are notified when invitations for bowel cancer screening are being sent out in their area. They also receive a copy of the results letters sent to their patients.

How much does bowel screening cost?

The over all cost of the NHS Bowel Cancer Screening programme for the 60 – 69 age group is £77.3 million.

How does the screening process work?

Men and women eligible for screening receive an invitation letter explaining the programme, and an information leaflet entitled Bowel Cancer Screening – The Facts.About a week later, a faecal occult blood (FOB) test kit is sent out along with step-by-step instructions for completing the test at home and sending the samples to the hub laboratory.

The test is then processed and the results sent within two weeks.

What does my bowel cancer screening result mean?

Around 98 in 100 people will receive a normal result and will be returned to routine screening. They will be invited for bowel cancer screening every two years if still within the eligible age range for routine screening. Remember, if you are over 70 you can request a kit by calling the helpline 0800 707 6060.Around 2 in 100 people will receive an abnormal result. They will be referred for further investigation and usually offered a colonoscopy.

Around 4 in 100 people may initially receive an unclear result which means that there was a slight suggestion of blood in the test sample. This could be caused by conditions other than cancer such as haemorrhoids (piles). An unclear result does not mean that cancer is present, but that the FOB test will need to be repeated. Most people who repeat the test will then go on to receive a normal result.

How does the FOB test work?

Polyps and bowel cancers sometimes bleed, and the faecal occult blood (FOB) test works by detecting tiny amounts of blood which cannot normally be seen in bowel motions. ‘Occult’ means hidden. The FOB test does not diagnose bowel cancer, but the results will indicate whether further investigation (usually a colonoscopy) is needed.

People who receive an abnormal result will be offered an appointment with a specialist nurse. The nurse will explain what a colonoscopy involves, assess the patient’s fitness for the procedure, and answer any questions.

What is a colonoscopy?

A colonoscopy is an investigation that involves looking directly at the lining of the large bowel. A sedative is given and then a thin, flexible tube with a tiny camera attached (a colonoscope) is passed into the back passage and guided around the bowel. If polyps are found, most can be removed painlessly, using a wire loop passed down the colonoscope tube. These tissue samples are then checked for any abnormal cells that might be cancerous.

  • About five in 10 people who have a colonoscopy will have a normal result.
  • About four in 10 will be found to have a polyp, which if removed may prevent cancer developing.
  • About one in 10 people will be found to have cancer when they have a colonoscopy.

What are the risks of colonoscopy?

A colonoscopy is the most effective way to diagnose bowel cancer and for most people it is a straightforward procedure. However, as with most medical procedures, there is the possibility of complications. These can include heavy bleeding (about a one in 150 chance) which will need further investigation or medical advice. There is approximately a one in 1,500 chance that the colonoscope could cause a hole (perforation) in the wall of the bowel. In extremely rare cases , colonoscopy may result in death. Current evidence suggests that this may only happen in around one in 10,000 cases.

Breast Screening

This is offered to women aged 50 to 70, with women over 70 able to self-refer. Breast screening saves one life for every 2,000 women screened, or up to 1,300 lives per year.

Cervical Screening

Thisisoffered to women aged 25 to 64 (every three years to women aged 25 to 49 and every five years from the ages of 50 to 64). Cervical screening saves around 5,000 lives per year. The incidence of cervical cancer is expected to fall further as the effects of HPV vaccination start to emerge.

Bowel Cancer Screening

This isoffered to men and women aged 60 to 74, with another one-off screening test offered to men and women at the age of 55 in some parts of England. Bowel cancer screening saves around 2,400 lives per year.

Prostate Cancer Screening

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