NHS Bowel Screening Programme.
Organisation:
Coordinated
nationally by the NHS Cancer Screening Programmes, the NHS Bowel Cancer
Screening Programme is now being phased in across England. The first
wave of screening commenced in July 2006 and it is anticipated that all
screening centres will be established across the country by the end of 2009.
Five programme
hubs operate a national call and recall system to send out test kits, analyse
samples and despatch results. Each hub is responsible for coordinating
the NHS Bowel Cancer Screening Programme in a specific area.
The programme hub
will each work with up to 20 local screening centres located
within their region.
These centres provide endoscopy (a test that looks inside your body) services and specialist screening practitioner clinics for people who are offered further investigation, following an abnormal screening result.
The Screening Centres are also responsible for referring those patients requiring treatment to their local hospital.
The Test:
What is the purpose of bowel cancer screening?
Bowel cancer screening aims to detect bowel cancer at an early stage when treatment is more likely to be effective.
Faecal Occult Blood (FOB) test:
The test used to
screen for bowel cancer is called a Faecal Occult Blood test, which participants
use in the privacy of their own home. A kit is used to collect a small sample
of bowel motion on a special card.
The samples are then sent to the laboratory for analysis. The laboratory checks the sample for small traces of blood that may be invisible to the naked eye.
The test kit does not diagnose bowel cancer but gives an indicator as to whether further investigations are required.
An abnormal FOB test result can occur for reasons that are unrelated to bowel cancer, such as piles.
Who is eligible?
In areas where screening has started, all men and women aged over 60 are eligible for screening every two years. Those aged 60 to 69, and registered with a GP are automatically invited and will receive an FOB test.
The risk of bowel
cancer increases with age, with 80% of bowel cancers arising in people who are
60 or over. Those aged 70 and over are able to request a kit by calling a
helpline number.
The Screening Process:
Step One - The invitation:
Men and women eligible for screening initially receive an invitation letter explaining the programme. Everyone who receives an invitation letter also receives a leaflet entitled ‘Bowel Cancer Screening –The Facts’
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 is sent out along with step-by-step instructions for completing the test at home.
Step two: completion of kit:
Small samples from three separate bowel motions are collected and, using the card-board 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 of the
first sample being taken.
A specially designed prepaid envelope, which meets postal regulations, is provided in which to return the test kit.
Step three: analysis and results:
The test kit is processed at the programme hub laboratory, and results are issued within two weeks of the sample being received.
What happens next?
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 whilst within the eligible age range
Around 2 in 100 people will receive an abnormal result. They will be referred for further investigation and usually offered a colonoscopy (a procedure to look at the bowel).
Around 4 in 100 people may initially 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 piles.
Receiving an unclear test does not mean that cancer is present, but the FOB test will need to be repeated.
Most people then go on to receive a normal test overall.
Those offered further investigation will be referred to a specialist screening practitioner, 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.
Further full information is
available on
http://www.cancerscreening.nhs.uk