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Bowel Cancer Screening

The bowel screening programme, the test and what happens with a positive result

What is meant by screening?

Screening is a non-compulsory public health service which aims to try and identify and treat a disease, cancer or pre-cancerous condition at an early stage. By starting early treatment, it is often possible to cure the disease or prevent a cancer developing. Screening is usually only offered to those most likely to benefit from screening e.g. breast screening is offered only to women of a certain age.


Why is screening important?

Screening can find serious conditions early, before any symptoms have developed. The earlier the condition is found, the better chance of dealing with it. If a condition is found early, it is less likely to become severe and often, the treatment is less invasive compared to the treatment that may be necessary when the condition is more advanced e.g. many pre-cancerous bowel polyps can be removed by a relatively simple procedure called a polypectomy. This can be carried out as soon as they are identified during a colonoscopy. However, if left alone, some polyps can turn cancerous and surgery (with removal of part of the bowel) may be necessary to get rid of a bowel cancer.  Regular screening can reduce the number of deaths from particular conditions.


What is bowel screening and how do I do the test?

Although bowel cancer is common, it is also highly treatable if detected early. If bowel cancer if found in it’s early stages, there’s more than a 90% chance of successful treatment. The sooner it’s caught, the easier it is to treat.


The NHS Bowel Screening Programme invites all men and women aged 50–74 to participate. Bowel screening involves taking a simple FOB (faecal occult blood) test at home every two years. The FOB test detects microscopic traces of blood hidden in small samples of faeces (poo). You complete the test over the course of a few days, in the privacy of your own home. Once complete, you simply return it in the post to a central laboratory for testing.  A useful video on how to take the bowel cancer screening test can be viewed here.  Once you have decided to start thPositive (blue colour) FOB test as part of the bowel screening programmee test, it must be completed with samples from three separate bowel motions taken a couple of days apart.  You must complete all of the samples within 10 days of taking the first sample and return them to the Bowel Screening Centre, using the pre-paid envelope supplied in your kit.


An FOB test does not diagnose bowel cancer, but will identify blood in the faeces (poo). A positive test will trigger an invitation to have an investigation to find out what is causing the bleeding.


Bowel screening was gradually introduced across England, Wales and Scotland from 2006 in a rolling programme which now covers the whole of mainland UK. It aims to detect polyps and other changes in the bowel that might develop into bowel cancer in the future. It can detect bowel cancer at a much earlier stage, before people are experiencing any obvious symptoms. This is very important, because bowel cancer is usually a very slow growing disease, and can be cured with a straightforward operation if it is detected before it has started to spread. Benign (harmless) polyps can also be removed quickly and easily in a simple procedure called a polypectomy that will significantly reduce the risk of bowel cancer developing later.


What is the Bowel Scope test?

The Department of Health in England launched a pilot programme for a new, additional, one-off bowel screening test in March 2013, the bowel scope (flexible sigmoidoscopy). In Scotland, the Bowel Scope Test was introduced in June 2014. The new test which has been labelled the “Bowel Scope Test” will initially be offered in Scotland to around 20,000 patients in Tayside, Fife, Grampian and Greater Glasgow and Clyde NHS board areas. If it is successful in these areas is will be rolled out across the country.


The Bowel Scope Test  is in reality, a one-off flexible sigmoidoscopy (similar to a colonoscopy). The new programme will run alongside and complement the current home based Scottish Bowel Screening Programme which tests for microscopic traces of blood in the stool. It is estimated that the current Bowel Screening Programme saves approximately 150 lives each year in Scotland. The new Bowel Scope Test could halve the number of deaths from bowel cancer over 10 years.


Why should I take part in the Bowel Screening Programme?

Around one in 25 people in the UK will develop bowel cancer - men and women of all ages, cultures and backgrounds. It is the third most common cancer and the second biggest cause of cancer deaths. Bowel cancer screening has been shown to reduce the risk of dying from bowel cancer by 16 per cent.


Bowel screening can detect bowel cancer in people that have no symptoms. When diagnosis is made early, before it has had a chance to spread, bowel cancer can be cured in over 90% of cases. The later a diagnosis is made, the more difficult bowel cancer is to treat. Points to bear in mind


When will I be asked to take part in the Bowel Screening Programme?

If you are in the target age group, an invitation letter will be sent to you, followed 2 weeks later by a screening test kit. Your screening programme will start within a few weeks of your 50th birthday if you live in Scotland and your 60th birthday if you live in the rest of the UK. A repeat invitation and test will occur automatically every two years until your 75th birthday. The pack comes with full instructions on how to complete the test in the privacy of your own home.


Over a period of several days, you will need to collect very small samples of your faeces (poo) on a special test card, after you use the toilet. This card is then posted back to a laboratory, where a chemical is added to the samples on the card to check for blood.


Around 98 in 100 people will receive a 'normal' result and will be asked to undertake a further test in 2 years if they are still within the eligible age range. In around 4 in 100 people - the test may initially be 'unclear' which means you will be asked to repeat the test up to two more times. Most people who repeat the test receive a 'normal' result.


Around 2 in 100 people will have an 'abnormal result' and will be offered an appointment with a specialist screening practitioner at a local bowel screening centre to discuss having a colonoscopy. Alternatively, you may be offered a telephone consultation to discuss colonoscopy, which is a a more detailed examination of your bowel.


Can I use my private health insurance to undergo a screening colonoscopy?

Although most insurance companies do not support “screening tests”, in general, if a ‘positive FOB’ result is obtained, they will support investigations such as colonoscopy.


Can I have a Private Health colonoscopy at the Glasgow Colorectal Centre?

The Glasgow Colorectal Centre surgeons Richard Molloy & Graham MacKay are expert in colonoscopy, screening colonoscopy and therapeutic colonoscopy and perform screening colonoscopy examinations within the NHS as part of the National Scottish Bowel Screening Programme. They also perform Private Health colonoscopy at the Glasgow Colorectal centre, based at BMI Ross Hall hospital in patients who have had an initial positive FOB test as part of the Bowel Screening programme. BMI Ross Hall hospital has recently opened a dedicated state-of-the-art Endoscopy Suite at Ross Hall hospital which has the latest generation high definition Pentax colonoscopes to facilitate detection of even the smallest polyps.  


Richard Molloy and Graham MacKay also specialise in minimally invasive surgery (MIS) including trans-anal minimally invasive surgery (TAMIS) and laparoscopic colorectal surgery for bowel cancer and to treat large colon and rectal polyps that cannot be removed with colonoscopy. The unit is based at BMI Ross Hall hospital, Glasgow, Scotland


Are there differences in the Bowel Screening Programmes throughout the UK?

England, Wales, Scotland and Ireland each have a slightly different strategy for bowel cancer screening:

Scottish Bowel Screening Programme

Scottish Bowel Screening LogoThe Scottish Bowel Screening Programme is offered every two years to everyone (registered with a GP) in Scotland between the ages of 50 to 74.  The programme should start within a few days of your 50th birthday and continue automatically, provided you are registered with a GP practice and they have an accurate record of your home address. If you are within the screening age range and have not yet received your first test kit, please contact the national helpline to request one.

More information on the Scottish Bowel Screening programme is available from www.bowelscreening.scot.nhs.uk

Phone number: 0800 0121 833.


England

The NHS Bowel Cancer Screening Programme is offered every two years to everyone (registered with a GP) in England aged 60 to 74. People over 75 can request a screening kit by calling the freephone helpline below. The organisation for sending out of testing kits works in exactly the same way as the programme for Scotland.

More information on the English Bowel Screening programme is available from www.cancerscreening.nhs.uk

Phone number: 0800 707 60 60.


Wales

The Bowel Screening Wales programme is offered every two years to everyone (registered with a GP) in Wales aged 60 to 74. The organisation of sending out testing kits works in exactly the same way as the programme for England.

More information is available from www.wales.nhs.uk/bsw

Phone number: 0800 294 3370.


Northern Ireland

The Northern Ireland Bowel Cancer Screening Programme offers screening every two years to all men and women aged 60 to 71. After your first screening test you will be sent another invitation and screening kit every two years for as long as you remain within the screening age group.

Full information on the programme is available at www.cancerscreening.hscni.net

Phone number: 0800 015 2514.

BowelScreen Ireland logo

Republic of Ireland

The BowelScreen programme has now started in Ireland, on a phased basis starting with men and women aged 60-69. Over time the programme will be extended on a phased basis until the full 55-74 age group is reached.

More information is available from www.cancerscreening.ie

Phone number: 1800 45 45 55.


If I'm not eligible for the NHS Bowel Screening Programme, can I have the test done privately?

Screening ages are set to reflect the fact that bowel cancer occurs most commonly in people over the age of 60, and it is usually a slow growing disease. If you are concerned about bowel cancer but not experiencing symptoms and don't qualify for the screening programme, you could order a screening kit online from several, reputable private laboratories for example POCL (www.pocl.co.uk) at an average cost of £25.00. You will be supplied with an FOBt kit, a return mailer envelope and full instructions. Samples are analysed in a dedicated laboratory and the results are returned to you within 10 days.


If the private test gave a positive or unclear result, you would then have to consult your GP. At the Glasgow Colorectal Centre, we are happy to perform a colonoscopy if a positive test has been received from a private laboratory. We do not recommend other bowel screening kits where you test the sample yourself, as the results could be inaccurate even if you follow the instructions carefully.


Please remember that no screening test is 100% reliable. If you have symptoms of bowel cancer at any age, you should not wait for a screening invitation, but make an appointment with your GP.

Download the NHS Scotland Bowel Screening Leaflet here

Read BBC report on how Bowel Screening Programme is saving lives

NHS Scotland Bowel Screening Kit which is sent 2-yearly those aged 50-75 years Scottish Bowel Cancer Screening kit including the FOB test and information leaflets Bowel Cancer Screening FOB test Glasgow Colorectal Centre logo showing silhouette of Glasgow skyline including the SECC, the Finnieston crane & reflections in the river Clyde

Bowel cancer screening is a public health service offered to try and identify bowel polyps and bowel cancer early, before any symptoms have developed. Early identification and removal of bowel polyps reduces the risk of developing cancer. If  a bowel cancer is identified, the earlier it is treated, the better the chance of curing it. Although bowel cancer is common, it is also highly treatable if detected early. If bowel cancer is found early enough, there’s more than a 90% chance of successful treatment.

The Scottish Bowel Screening Programme invites all men and women aged 50–74 to participate by taking a simple bowel screening test at home every two years. The test aims to identify if there are traces of microscopic blood in the  bowel motions. If traces of blood are found, individuals are invited to attend for a colonoscopy to get a more detailed assessment of the entire colon and rectum.

Advert for English Bowel Cancer Screening Programme advising that you can take the test at homeEarly signs of bowel cancer are often hidden

Download NHS information sheet on the new

BOWEL SCOPE TEST

Bowel_Scope_Screening_Test.pdf

Download information sheet on

BOWEL/COLONIC POLYPS

Information sheet on Colonoscopy