Bowel cancer screening
Approximately one in twenty 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. It effects men and women equally.
Regular bowel cancer screening has been shown to reduce the risk of dying from bowel cancer by 16%.
National Bowel Cancer Screening programme
From June 2008 a national bowel screening programme will be introduced across Nottinghamshire County. This aims to detect bowel cancer at an early stage when treatment is more likely to be effective.
Support from Cancer Research UK:
“The bowel screening programme is a vitally important step towards preventing and detecting cancer … put simply bowel screening is a lifesaver.” – Professor Alex Markham, Chief Executive of Cancer Research UK.
Who should be screened?
If you are aged 60-69 years old and registered with a Nottinghamshire County GP practice, you will automatically receive a free self-screening kit on a 2-yearly basis.
How will screening be carried out?
Patients will be sent a simple test kit to complete in the privacy of their home. This will involve collecting a small sample from three separate bowel motions and, using a specially designed prepaid envelope, returning the kit to the laboratory for analysis.
Further information on the NHS Bowel Cancer Screening Programme is available from www.cancerscreening.nhs.uk
or patient free-phone helpline 0800 707 60 60
How does bowel cancer develop?
Bowel cancer is also known as colon, rectal or colorectal cancer. The lining of the bowel is made up of cells that are constantly being renewed. Sometimes these cells grow too quickly, forming a clump of cells, known as bowel polyp. Polyps are not bowel cancers but they can develop into cancer over a number of years. Bowel cancer can develop in any part of the large bowel, including the colon and rectum.
Who is at risk from bowel cancer?
Bowel cancer is the second most common cause of cancer deaths in the UK. The biggest single risk factor for bowel cancer is age, and eight out of ten people who get bowel cancer are over the age of 60.
Diet, lifestyle and family history can also affect a person’s chances of developing bowel cancer.
Men: The lifetime risk of developing bowel cancer for men is around one in 18.
Women: The lifetime risk of developing bowel cancer for women is around one in 20.
Anyone concerned about their health, or their risk of developing bowel cancer, should contact their GP.
Bowel cancer symptoms
The most common symptoms to look out for are:
- A persistent change in bowel habit, especially going more often or looser stools for several weeks.
- Bleeding from the bottom without any obvious reason
- Abdominal pain, especially if severe
- A lump in the tummy
It should be remembered that most of these symptoms will not be cancer. If someone has experienced one or more of these symptoms for more than four to six weeks, they should visit their GP.
The NHS Bowel Cancer Screening Programme is the first national cancer-screening programme in England to target both men and women.
The screening programme will be introduced through a three-year phased implementation, which will be complete by 2009.
Bowel cancer is the second most common cause of cancer deaths in the UK.
Around 80% of bowel cancers arise in people who are over 60.
There are approximately 35,000 cases of bowel cancer identified every year in the UK.
There are approximately 16,000 deaths a year from bowel cancer.
Although bowel cancer affects more than one in twenty people in their lifetime, 90% survive if it is caught early.
NHS Bowel Cancer Screening Programme
Research has shown that screening men and women for bowel cancer can reduce the mortality rate from bowel cancer by 16% in those invited for screening.
Bowel cancer screening will be delivered nationally via five regional programme hubs. Each programme hub will oversee about 20 local screening centres. The local screening centres will provide specialist screening nurse clinics for people who are offered further investigation (usually colonoscopy) following an abnormal screening result. Colonoscopy (endoscopy) services will also be provided at the screening centre.
The screening process
Step one: the invitation
Men and women eligible for screening will initially receive an invitation letter explaining the programme. Everyone who receives an invitation letter will also receive a leaflet entitled ‘Bowel Cancer Screening – The Facts’, developed by Cancer Research UK.
This leaflet explains bowel cancer screening and the benefits and limitations of the test and supports men and women in making an informed decision about whether or not to take up the opportunity of screening.
About a week after the invitation letter, a test kit will be sent out along with step-by-step instructions for completing the test at home.
Step two: completion of the kit
Small samples from three separate bowel motions are collected and, using the cardboard sticks provided in the kit, spread onto sections of a special card. The test kit needs to be returned to the laboratory for analysis within two weeks (14 days) of the first sample being taken.
A specially designed prepaid envelope will be provided in which to return the test kit. A free phone telephone helpline provides additional support to those taking up the offer of bowel cancer screening.
Anyone who does not wish to participate in the programme can decline the offer of screening by contacting the programme hub following receipt of their invitation.
If a person who has not declined screening does not return their test kit, a reminder will be sent to them around four weeks from when their kit was despatched.
Step three: analysis and results
The test kit is processed at the programme hub laboratory, and the results are issued by post within two weeks (14 days) of the sample being received.
What happens next
Around 98% of 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.
Around 2% of people will receive an abnormal result. They will be referred for further investigation and usually offered a colonoscopy.
Around 4% of people may receive an unclear result. This means that there was a slight suggestion of blood in the test sample. This could be caused by conditions such as haemorrhoids (piles). Receiving an unclear result does not mean that cancer is present, but the FOB test will need to be repeated. Most people who receive an unclear result will then go on to receive a normal result overall.
Those offered further investigation will be referred to a specialist-screening nurse, based at the local screening centre, who will explain the procedure and discuss if colonoscopy is appropriate. A leaflet entitled ‘Bowel Cancer Screening – The Colonoscopy Investigation’ has been developed in conjunction with Cancer Research Uk to support men and women referred for colonoscopy at their local screening centre.