What is bowel cancer screening?
Bowel cancer is the fourth most common cancer in the UK.
The estimated lifetime risk of being diagnosed with bowel cancer is 1 in 20 (5%) for females, and 1 in 17 (16%) for males born in 1961 in the UK (reference: Cancer Research UK – bowel cancer risk).
Regular bowel cancer screening has been shown to reduce the risk of dying from bowel cancer by 16%. 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. (reference: NICE – why screen?)
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.
The screening programme has recently reduced the age at which screening is now offered.
The NHS Bowel Cancer Screening Programme in Lincolnshire offers screening every two years to all men and women registered with a GP and aged 50 to 74. People over 74 can request a screening kit by calling the free phone helpline 0800 707 6060.
How the programme works
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 immunochemical testing (FIT) 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. For Lincolnshire the Hub is based at Queen’s Medical Centre (QMC) Nottingham. The test is then processed and the results sent within two weeks.
Polyps and bowel cancers sometimes bleed, and the FIT test works by detecting tiny amounts of blood which cannot normally be seen in bowel motions. The FIT test does not diagnose bowel cancer, but the results will indicate whether further investigation (usually a colonoscopy) is needed.
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 74 you can request a kit by calling the helpline 0800 707 6060.
Around two in 100 people will receive an abnormal result. They will be referred for further investigation and usually offered a colonoscopy.
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. These appointments may be face to face, over the telephone or via video. The letter that is sent will contain all the information about the initial appointment.
What is a colonoscopy?
A colonoscopy is an investigation that involves looking directly at the lining of the large bowel. A sedative may be 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.
In Lincolnshire the screening colonoscopies are undertaken in the endoscopy department at Lincoln County Hospital, Pilgrim Hospital, Boston and Grantham and District Hospital.
- About four in 10 people who have a colonoscopy will have a normal result.
- About five in 10 will be found to have one or more polyps, which if removed may prevent cancer developing.
- About one in 10 people will be found to have cancer when they have a colonoscopy. If a cancer is diagnosed then the screening team will ensure that all the appropriate referrals are made for ongoing care and management.
The screening programme is also undertaking the colonoscopic surveillance of patients with a confirmed diagnosis of Lynch Syndrome. This is a genetic condition which can make those affected more prone to developing a bowel cancer.
More information can be found about this on the Macmillan website.
For further information about all aspects of the programme the following websites may be useful visit:
- ULHT Endoscopy
- The GOV.UK Population Screening Programmes website
- Bowel cancer screening – NHS
- The bowel cancer screening helpline can be contacted on 0800 707 6060.
- The screening centre can be contacted directly on 01522 597548.