The national bowel cancer screening programme has proven to be immensely effective in reducing cases, according to a groundbreaking study. Experts are calling these checks “life-saving” and are urging individuals to participate when invited by the NHS. These tests help identify abnormalities and assist doctors in finding pre-cancerous polyps, offering the opportunity for their removal before they become tumors.
After the introduction of the Bowel Cancer Screening Programme (BCSP) in 2006, there has been a significant 15% decrease in the incidence of bowel cancer in the lowermost portion of the large bowel. The study, published in the journal Colorectal Disease, reveals that the most substantial reductions were observed in men and patients living in areas with the greatest socioeconomic deprivation.
In England, more and more people have been coming forward for bowel cancer screening over the years. Official data shows that approximately 70% of the eligible population, just over 6 million people, returned a postal bowel cancer test in 2021-2022, setting a new record.
The screening initiative was expanded in 2010 to cover all adults aged 60 to 74 registered with a GP in England. By 2025, it will be expanded once again to include adults over the age of 50. Individuals in this age group will be automatically sent an NHS bowel cancer screening kit known as a faecal immunohistochemical test (FIT) every two years. This involves taking a small stool sample at home and mailing it back to a laboratory for analysis, checking for traces of blood that may indicate cancer.
Those with abnormal results will be invited for further checks, such as a colonoscopy, which can uncover pre-cancerous growths or cancer itself. The study, conducted by researchers from the University of Bristol and University Hospitals Bristol and Weston NHS Foundation Trust, analyzed data from the National Cancer Registration and Analysis Service database. They identified 541,515 adults diagnosed with bowel cancer between 2001 and 2017, who were within the screening age range of 60-74 years.
The results showed that 44% of patients had tumors in the uppermost portion of the large bowel, while 56% had tumors in the lowermost portion. The incidence rate of bowel cancer initially peaked following the introduction of the BCSP but subsequently decreased, with the most significant reduction observed in tumors of the lowermost portion of the large bowel. In 2001, patients in the most deprived areas had an 11% higher incidence of tumors in that area compared to those in the least deprived areas. By 2017, this difference had decreased to 4%.
Furthermore, men experienced a greater reduction than women during the study period for tumors in both the uppermost and lowermost portions of the large bowel. Adam Chambers, one of the lead authors of the study, stated, “Our results show that one of the benefits of screening for bowel cancer is a significant reduction in colorectal cancer rates. This reduction is primarily driven by the detection and removal of pre-cancerous polyps during colonoscopy.”
Bowel cancer can manifest symptoms such as blood in the stool, changes in bowel habits, bowel obstructions caused by a lump, and weight loss. George Alagiah, a BBC newsreader, recently passed away after battling stage 4 bowel cancer that had spread to his liver and lymph nodes for nine years. In April 2014, Mr. Alagiah presented a podcast for Bowel Cancer UK to raise awareness of the disease by interviewing sufferers and experts. He also tweeted in May, encouraging people to access free screening kits.
To further improve the screening programme, efforts should be directed towards reducing the incidence of tumors in the uppermost portion of the large bowel by increasing screening uptake through the use of the new faecal immunohistochemical test (FIT) and improving the quality of colonoscopy. The reduction in the screening age threshold is also welcomed, as research has shown a rapid increase in bowel cancer incidence in young adults.
In the UK, there are nearly 43,000 bowel cancer diagnoses and 16,800 deaths annually. While 94% of new cases are diagnosed in people over the age of 50, bowel cancer can affect individuals of any age. Dr. Lisa Wilde, director of research and external affairs at Bowel Cancer UK, emphasizes the importance of screening for bowel cancer, as it allows for early detection and prevention. She highlights the potential impact of future improvements to the screening programme in making it more effective.
Unfortunately, only one in ten patients are diagnosed with bowel cancer through the national bowel cancer screening programmes in England and Wales. Screening can detect bowel cancer or pre-cancerous conditions before symptoms appear, so individuals are urged to participate when invited. If a screening kit is lost or discarded, a new one can be requested on the NHS bowel cancer screening website.
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