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The Scottish government has just announced a new screening test for bowel cancer. The new test which has been labelled the “Bowel Scope Test” will initially be offered 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.

Everyone who is offered the new Bowel Scope Test will also continue to be offered the home bowel screening kit as well. The Bowel Scope Test will be offered to patients around the age of 60. The current Scottish bowel screening programme is offered every two years to all men and women registered with a GP in Scotland and who are aged between 50 and 74 years.  This programme was recently extended so that patients over the age of 74 can also self-refer every two years by requesting the screening kit through the Scottish bowel screening helpline.

The Bowel Scope Test  is a flexible sigmoidoscopy test which is like a limited colonoscopy. Whereas a colonoscopy examination aims to assess the entire colon and rectum, a flexible sigmoidoscopy only examines the lower one third of the bowel. The test is performed in hospital, following a self-administered enema to clean out the lower bowel. It is normally performed without any sedation but it is likely that most centres will be able to offer sedation if a patient wishes.  A thin flexible tube with a tiny camera at the end is used to look at the inside lining of the lower part of the bowel. If any polyps are identified, these will either be biopsied or removed and sent for microscopic assessment. The whole procedure takes around 15 to 20 minutes.

It is hoped that the short examination can save lives by either detecting bowel cancers at an earlier and more curable stage. However, more importantly, it is expected that the Bowel Scope Test  will also detect small polyps. These polyps can be removed easily during the bowel scope test. We know that many of these small polyps can progress in time to develop into cancers. The aim of the Bowel Scope Test  is therefore to identify and remove these small polyps before the get a chance to turn cancerous.

The Bowel Scope Test  is been introduced following the publication of a seminal study which looked at the benefit of a once only flexible sigmoidoscopy screening test in the prevention of colorectal cancer. The final results of the study were published in May 2010 in the Lancet. The lead author was Prof Wendy Atkin. The study involved 170,000 patients, 57,000 of whom underwent a one-off flexible sigmoidoscopy. Median follow-up was for more than 11 years.

The results from this study showed that the Bowel Scope Test reduced the overall risk of bowel cancer by around one third and also reduced all bowel cancer related deaths by 43%. It reduced the incidence of cancer in the lower bowel (the bit that was examined) by 50%.

The numbers needed to be screened to prevent one colorectal cancer diagnosis was 191 and the number needed to be screened to prevent one colorectal cancer related death was 489.

Further Information on the Bowel Scope Test

Link to original research article that justifies the Bowel Scope Test

Scottish Government announcement regarding the introduction of the new test

Screening Scotland website providing information on the new test

New “Bowel Scope Test” to be offered in Scotland

(June 2014)

Click here to download an information sheet on Bowel Screening Programme

Click here to download an information sheet on Bowel Scope Test


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