Introduction The aim of the NHS Bowel Cancer Screening Programme (BCSP) is to diagnose colorectal cancer. Small studies have demonstrated a yield of diagnoses other than cancer or adenomas (non-neoplastic diagnoses (NND)) ranging from 11% to 25%. NND may account for false positive FOB test (FOBt) results and may generate a significant workload outside the BCSP. The aim of this study was to evaluate the burden of NND generated by the BCSP.
Methods Data were obtained from the BCSP national database for all patients with a positive FOBt who subsequently underwent investigation from August 2006 to November 2011. These data included patient demographic data, smoking status, clinical outcome and NND made. Data were analysed using SPSS.
Results 121 728 patient episodes in the BCSP were included in the analysis. 60.2% of patients were male and the mean age was 65.7 years. In this period 10 836 cancers were detected (8.9%). One or more NND were made in 26 251 patients (21.6%). Patients with a diagnosis of neoplasia (cancer or adenomas) were less likely to have a NND than those without neoplasia (19.8% vs 24.4%, p<0.001). Older age and male gender were, but smoking status was not, associated with a greater likelihood of an NND being made (NND in males 21.8% vs 21.2% in females, p=0.01; NND in those <65 years 20.6% vs 22.3% in those ≥65 years, p<0.001; NND in smokers 21.4% vs 21.7% in non-smokers, p=0.34). After adjustment for confounding using multivariable analysis, older age and male gender were still associated with a small but statistically significant increased risk of a NND.
Conclusion The BCSP generates a significant volume of Non-Neoplastic Diagnoses. Inflammatory bowel disease is an important and common diagnosis and may have important implications for the management of the patient. Large numbers of patients had diverticulosis and haemorrhoids diagnosed however reporting of these findings may vary. Patients undergoing bowel cancer screening should be aware that a diagnosis other than cancer or polyps may be made. The burden of NND generated by the BCSP nationally has not been investigated and the impact of this on primary and secondary care is not known.
Competing interests None declared.
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