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Service development II
PTU-246 NHS bowel cancer screening programme
  1. L Coleman1,
  2. J Patnick1,
  3. C Nickerson1,
  4. H Griffiths2,
  5. I Fretwell3
  1. 1Bowel Cancer Screening, NHS Cancer Screening Programmes, Sheffield, UK
  2. 2Endoscopy Unit, Hereford Hospital NHS Trust, Hereford, UK
  3. 3Endoscopy Unit, Chesterfield Royal Hospital NHS Trust, Chesterfield, UK

Abstract

Introduction Background: The NHS Bowel Cancer Screening Programme (BCSP) in England was established following successful pilot screening programmes in England and Scotland.1 The BCSPcommenced in 2006 with a 3-year phased implementation offering screening to men and women aged 60–69. The programme also enabled people aged 70 and over to self-refer into the screening programme.

Objectives:

  • –reduce mortality from bowel cancer by up to 16%.2

  • –offer men and women aged 60–69 a guaiac-based FOBt every 2 years.

  • –enable those over 70 to be screened on request.

  • –offer those with an abnormal screening result a colonoscopy as the investigation of choice.

  • –refer for treatment if cancer is found at screening colonoscopy.

  • –transfer to colonoscopic surveillance within BCSP where intermediate/high risk polyps are found.

Methods The programme comprises five regional programme hubs responsible for call and recall, laboratory processing of test kits and booking clinic appointments for participants with abnormal FOBt results. Participants with an abnormal FOBt result are referred to a local screening centre to discuss colonoscopy with a specialist screening practitioner (SSP) within 2 weeks and offered a screening colonoscopy within a further 2 weeks. General practitioners are not directly involved in the screening process, but do receive information to support their patients to make an informed choice.

Results All 58 screening centres have completed their prevalent round of screening, and the entire eligible population has received at least one invitation. The screening invitation age range is being extended to 75th birthday from 2010 in response to the government's Cancer Reform Strategy.

Conclusion Over twelve million invitations have been despatched. Data shows that uptake has increased from 47.73% in prevalent round to 87.41% in incident round and positivity has decreased from 2.19% in prevalent to 1.99% in incident round. Of these patients, prevalent round data showed 9.90% had a confirmed cancer diagnosis and in incident round this has reduced to 6.05%. Over 143 000 diagnostic tests have been carried out, of which 130 402 were screening colonoscopies. Episode outcomes also show a reduction in incident rounds of high risk polyps (10.21% to 7.65%) and intermediate risk polyps (17.95% to 14.33%). There has been an increase in low risk polyps (15.81% to 21.13%) and abnormal findings, not polyps (19.73% to 26.38%).

Competing interests None declared.

References 1. Alexander F, Weller D. Evaluation of the UK Colorectal Cancer Screening Pilot. Final Report, February 2003, revised May 2003. Report to The UK CRC Screening Pilot Evaluation Team.

2. Cancer Research UK. UK Bowel Cancer Statistics. http://info.cancerresearchuk.org/cancerstats

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