Bowel cancer screening

Public Health England is calling on all men and women, aged over 60, to get screened for bowel cancer after the latest figures show over 40% are not getting tested. Embarrassment over providing a stool sample is one of the reasons, among men in particular, behind thousands being unnecessarily at risk of dying.

Bowel cancer screening is offered to all men and women aged 60 to 74, who are sent a home test kit to provide stool samples.  There were over 3,000 bowel cancers diagnosed as a result of screening in 2016 to 2017. In over 90% of these cases, cancers were found at an early stage, where treatment is more likely to be successful.

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Image source: http://www.gov.uk

Bowel cancer is the fourth most common cancer in England, but the second leading cause of cancer deaths, with around 13,000 people dying from it every year.

If detected early, bowel cancer is very treatable which is why screening is vital and it has been shown to reduce the risk of dying from bowel cancer by 16%.

The latest NHS Screening Programmes in England annual report details the progress and activities of the NHS population screening programmes.

PHE press release: Men and women asked not to miss out on bowel screening

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NHS England action to save lives by catching more cancers early

NHS England announces the scaling up of an innovative scheme that catches lung cancer early by scanning patients, along with new details of a more sensitive bowel cancer test that could save thousands of lives.

NHS England is now funding scanners in other areas as part of a national programme to diagnose cancer earlier, improve the care for those living with cancer and ensure each cancer patient gets the right care for them. This follows the success of the Manchester scanner scheme, where mobile scanners are detecting four out of five cases of lung cancer in the early stages when it is easier to treat. The mobile scanning trucks have picked up one cancer for every 33 patients scanned over the course of a year.

Plans for ‘FIT’, a more sensitive bowel cancer test that could see as many as 1,500 more cancer caught earlier every year have also been confirmed.

‘FIT’ is an easy to use home testing kit which predicts bowel cancer, following the introduction of the test almost a third of a million more people are expected to complete screening. The sensitivity level determines the number of people who should go on for further cancer testing.

 

Eating plenty of wholegrains cuts your risk of bowel cancer, according to a new report.

Wholegrains and bowel cancer – what you need to know | CRUK

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Eating plenty of wholegrains cuts your risk of bowel cancer, according to a new report. And it seems we can reap the benefits without making wild changes to our diets .

The news comes from a report produced by the World Cancer Research Fund (WCRF) and the American Institute for Cancer Research (AICR), outlining the latest evidence on how we can reduce our risk of bowel cancer.

It focusses on the effects of diet, weight, physical activity and alcohol on bowel cancer risk. And with bowel cancer being the fourth most common cancer in the UK, finding ways to reduce our risk of the disease are important.

The WCRF studies all the evidence on a potential cause of cancer and decides whether that evidence is strong enough to support recommendations on ways we can reduce our risk.

Bowel cancer deaths drop by a third in 20 years

The rate of people dying from bowel cancer in the UK has plummeted by more than 30 per cent in the last 20 years | Cancer Research UK 

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Image source: CRUK 

Bowel cancer was responsible for 38 deaths per 100,000 people in 1995, falling to 26 deaths per 100,000 people by 2015. The drop in rates, taking into account changing population figures, equates to a decrease in bowel cancer deaths from 17,600 in 1995 to 15,800 in 2015.

Experts believe better treatment lies behind the dramatic drop in deaths. Improved public awareness among both patients and doctors, the bowel screening programme, may also be playing a part.

Read the full blog post here

Reducing the socioeconomic gradient in uptake of the NHS bowel cancer screening Programme

The aim of this study was to determine whether a supplementary leaflet providing the ‘gist’ of guaiac-based Faecal Occult Blood test (gFOBt) screening for colorectal cancer could reduce the socioeconomic status (SES) gradient in uptake in the English NHS BCSP | BMC Cancer

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The trial was integrated within routine BCSP operations in November 2012. Using a cluster randomised controlled design all adults aged 59–74 years who were being routinely invited to complete the gFOBt were randomised based on day of invitation. The Index of Multiple Deprivation was used to create SES quintiles. The control group received the standard information booklet (‘SI’). The intervention group received the SI booklet and the Gist leaflet (‘SI + Gist’) which had been designed to help people with lower literacy engage with the invitation. Blinding of hubs was not possible and invited subjects were not made aware of a comparator condition. The primary outcome was the gradient in uptake across IMD quintiles.

In November 2012, 163,525 individuals were allocated to either the ‘SI’ intervention (n = 79,104) or the ‘SI + Gist’ group (n = 84,421). Overall uptake was similar between the intervention and control groups (SI: 57.3% and SI + Gist: 57.6%; OR = 1.02, 95% CI: 0.92–1.13, p = 0.77). Uptake was 42.0% (SI) vs. 43.0% (SI + Gist) in the most deprived quintile and 65.6% vs. 65.8% in the least deprived quintile (interaction p = 0.48). The SES gradient in uptake was similar between the study groups within age, gender, hub and screening round sub-groups.

Providing supplementary simplified information in addition to the standard information booklet did not reduce the SES gradient in uptake in the NHS BCSP. The effectiveness of the Gist leaflet when used alone should be explored in future research.

Full reference: Smith, S.G. et al. (2017) Reducing the socioeconomic gradient in uptake of the NHS bowel cancer screening Programme using a simplified supplementary information leaflet: a cluster-randomised trial. BMC Cancer. 17:543

Discovery in fight against bowel cancer

New research has discovered how a genomic approach to understanding bowel (colorectal) cancer could improve the prognosis and quality of life for patients.

Bowel cancer is the fourth most common cancer in the UK, with 41,200 people newly diagnosed each year. A number of treatment options are available but mortality rates remain high, with bowel cancer the second most common cause of cancer death in the UK.

Researchers at Queen’s University Belfast, in collaboration with the University of Oxford and the University of Leeds have made a significant advance in the treatment of bowel cancer. The study, which has been published in the journal Nature Communications, has shown how defining precise gene signatures within bowel cancer cells can allow us to develop novel prognostic and predictive markers for bowel cancer and help to drive personalised medicine approaches.

Full story via ScienceDaily

Link to the research:  Dunne, P.D. et al. Cancer-cell intrinsic gene expression signatures overcome intratumoural heterogeneity bias in colorectal cancer patient classification. Nature Communications, 2017

Bowel cancer screening: benefits and risks

This leaflet explains the benefits and risks of bowel cancer screening in English, large print, 20 other languages and mp3 audio format | PHE

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Image source: PHE

Bowel cancer screening, the facts (Bengali)

Bowel cancer screening, the facts (Chinese)