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

Further Investigations

Colonoscopy

If the first FOBt provides a strong positive result and/or the repeat FOBt shows blood again the individual will be invited to an appointment with a nurse to discuss the possibility of having a colonoscopy.

A completed colonoscopy is the most reliable test for colorectal cancer as it can detect about 95% of tumours. The procedure may be a little uncomfortable for the individual, who will be sedated and may be given a pain killer.

Before colonoscopy the bowel is cleaned using bowel preparation. During the procedure a long flexible tube called a colonoscope, which has a tiny camera on the end, is passed into the large bowel through the anus. Once inside, the camera allows the doctor to see any tumours or polyps, which can then either have a sample taken or be removed completely as part of the colonoscopy procedure. Any samples of tissue removed during the colonoscopy will be examined to find out whether they are malignant or not.

On average, only one in ten individuals with a positive FOBt will be found to have cancer following this procedure. About three out of the ten will have a polyp, which if removed may prevent the development of a cancer.

In some cases it is not possible to carry out a complete colonoscopy. In these cases the individual will be invited to have a barium enema.

Double Contrast Barium Enema (DCBE)

The DCBE detects between 85-95% of colorectal cancer. Bowel cleansing is required as in colonoscopy. The bowel is partially filled with a liquid barium suspension and then distended with a little air. A series of films are then taken to show the thin mucosal coating of barium within the air distended bowel. This allows any tumour to be visualised in detail. No sedation is required.

How safe are these tests?

There is some risk involved in colonoscopy. Serious complications are rare when the procedure is carried out by an experienced and skilled operator. Perforation or severe haemorrhage can occur in approximately 1 in every 1,000. If either of these happen, the individual may need emergency abdominal surgery. Very occasionally death can result from this kind of complication, in about 2 out of every 10,000 examinations.

Complications from DCBE are very rare, approximately 1 in 9000 procedures. The mortality rate for DCBE is approximately 1 in every 56,700.