Colorectal (Bowel) Cancer Screening

• National Bowel Cancer Screening Programme
• Why do we have screening?
• Why screen for bowel cancer?
• Why isn't there a national screening programme for bowel cancer?
• How much does colorectal screening cost?

National Bowel Cancer Screening Programme

The National Bowel Cancer Screening Programme will start in April 2006. Details are still being worked out and will be published as soon as they are available.

Why do we have screening?

Screening is when we look for evidence of a disease (in this case bowel cancer) in people who have no symptoms. The aim is to find diseases at an early stage when there is a better chance of a person being successfully treated.

Screening is not a diagnostic test. Finding an abnormal result in screening may show that a person is at risk of a disease. Further tests will be needed to make an accurate diagnosis.

Why screen for bowel cancer?

Bowel cancer is a major public health problem. It is the second most common cause of cancer deaths in the United Kingdom. Research has shown that screening for bowel cancer can help reduce death rates by finding and treating bowel cancer early. It is predicted that deaths from bowel cancer could drop by 15% as a result of screening. Nationally, screening for bowel cancer could save approximately 1,200¹ lives each year. Patients whose cancer is discovered early have more treatment options and a better long term outlook.

Why isn't there a national screening programme for bowel cancer?

The National Screening Committee (NSC) reviewed the evidence on bowel cancer screening and found that population screening of people over the age of 50 for non-visible (occult) blood in the faeces can reduce the mortality rate for bowel cancer². The NSC recommended to Ministers that a pilot screening project be organised to test the acceptability and feasibility of achieving the necessary levels of quality required to reduce mortality without significant adverse effects. For more background about the colorectal (bowel) cancer screening pilot try these National Screening Committee websites:

http://www.nsc.nhs.uk/pdfs/proposal_colorectal.pdf
http://www.nsc.nhs.uk/pdfs/summary_colorectal.pdf

Two pilot sites were set up in 1999 in Coventry and Warwickshire in England and Fife, Tayside and Grampian in Scotland. These areas are representative of the UK population including a mix of ethnic groups as well as rural and urban populations.

The pilot started inviting people to take part in the spring of 2000. For a two year period, men and women aged between 50 and 69 who were registered with a participating GP were offered a faecal occult blood test (FOBT) to screen for bowel cancer.

The UK pilot ended in 2002 and the evaluation report has been completed and submitted to the National Screening Committee (NSC) and the Departments of Health in England and Scotland. The NSC will work with the government to develop a national bowel cancer screening programme based on the report and other relevant research currently available.

The Department of Health in England has agreed to fund a second round of screening in the English site. The Scottish Department of Health has agreed to fund a second round of screening in the Scottish pilot site too. For more information about the second round of screening in Scotland go to http://www.show.scot.nhs.uk/nsd/

How much does colorectal screening cost?

A faecal occult blood (FOB) test for bowel cancer costs £5. Two per cent of all tests are positive and require a subsequent diagnostic colonoscopy at a cost of £127.

¹Atkin BMJ 1999;319:1212*3.

² Hardcastle JD, Chamberlain JO, Robinson MHE, et al. Randomised controlled trial of faecal-occult-blood screening for colorectal cancer. Lancet, 1996;348:1472-147

http://www.cancerscreening.nhs.uk/colorectal/screening.html
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