English Colorectal Cancer Screening Pilot Information Pack

Information Pack in Microsoft Word Document (8.8Mb)

Page 1: What is the pilot?
Page 2: Colorectal Cancer
Page 3: Screening Progress
Page 4: Further Investigations
Page 5: Appendix I The Screening Pathway
Page 6: Appendix II Contact List
Page 7: Appendix III Reference List

The Screening Process: What is screening?

Screening involves looking for evidence of abnormalities that may indicate disease (in this case colorectal cancer) before people notice signs of the disease. The aim of cancer screening is to find the cancer at an early stage or a pre-cancerous stage. Finding the cancers early improves a person's chance of successful treatment.

Screening cannot diagnose disease. Finding an abnormal result in screening tests only means that there is a higher chance of that person having the disease being screened for. Further tests are needed to make a confirmed diagnosis.

By taking part in screening, people can reduce their risk of dying from colorectal cancer by having it detected at an early stage. No screening test is 100% effective so a normal result does not mean that an individual does not have or will never develop bowel cancer. An FOBT does not guarantee that colorectal cancer will be detected if it is present, or that it can be treated successfully if it is identified. However an FOBT is currently the best means of detecting traces of blood long before the individual is symptomatic.

Screening for colorectal cancer helps to find the disease early but it is not fail-safe. The test can be positive even when cancer is not present (false positive) and can be negative when a cancer is present (false negative). Colorectal cancers can bleed intermittently, which can lead to a false negative result.

Screening for colorectal cancer has four stages:

FOBT
Results from FOBT
Discharge or retest or Colonoscopy
Results of colonoscopy and possible referral for barium enema if the colonoscopy was incomplete

Please refer to Appendix 1 for a diagram of the patient pathway.

How will people be screened?

Individuals living within the pilot areas may be made aware of the programme through the local media. All men and women living within the pilot area and aged between 50-69 will be invited to participate in the pilot scheme. They will automatically be sent a test kit through the post. Anyone over the age of 69, living in the pilot area who is also registered with a participating GP, can request a kit directly from the screening unit (they will not be sent a kit automatically).

Details of individuals who will be invited to participate will be gathered from the local Health Authority databases. You will be given the opportunity to see and amend the lists for your practice before invitations are sent out, although this is not mandatory. The individual carries out the test in his or her own home. The FOBT is a simple test that looks for occult (invisible) traces of blood in faeces. The pack comes with full instructions about how to use the test. The pilot has considered the possibility that some individuals will complete the test incorrectly. There is the facility within the programme to send out second test kits to all who require them. Copies of all the letters and leaflets that may be sent to your patients are included in this pack.

Possible Results and what they mean.

Normal Results

A normal result means that no blood was found in the samples provided on the FOBT. No screening test is 100% effective so a normal result does not mean that the patient does not have or will never develop bowel cancer.

Individuals with a normal result will be notified of their result in writing and discharged from the screening programme. They will not hear from the screening unit again unless a third round of screening takes place. No plans for a third round are currently in place.

Abnormal results

An abnormal result is not a diagnosis of cancer. It is only suggestive of blood in the bowel motion. All individuals with abnormal results will be offered a colonoscopy to examine the whole of the large bowel.

Technical fails/spoilt kits and Repeat FOB Testing

If the findings from an FOBT is unclear (i.e. a weak positive) or the kit was spoilt or unreadable (technical fail or spoilt) for whatever reason, then individuals will be asked to repeat the test. They will be sent a second FOBT by the screening unit with full instructions of how to complete the test.