Introduction UK population colorectal cancer (CRC) screening has been successfully implemented with Bowel Cancer Screening Programme (BCSP) faecal occult blood testing biannually from age 60–75.
A large UK study of once-only flexible sigmoidoscopy (FSIG) demonstrated a reductions in CRC incidence of 33% and death rates of 43% (1). This, with the screening centre infrastructure developed for the FOB programme, allowed provision of a new arm of BCSP, offering FSIG to 55 year olds in England, known as BowelScope screening.
BowelScope screening began May 2013, with 6 pilot sites performing FSIGs in the first 7 months.
Methods We aim to describe procedural data from the early months of BowelScope screening.
Data were obtained from The Bowel Cancer Screening System (BCSS) database for all participants invited and participating in BowelScope FSIGs May-Dec 2013. Procedural data were recorded, including insertion depth, FSIG length, adenoma detection rates (ADR), cancer detection, discomfort levels, entonox usage and colonoscopy conversion rates.
Results 13927 people were invited or opted in to BowelScope screening at 6 centres. Overall uptake is 43.5% (range 37.0–51.9%). 4 cancers were detected. Polyps were detected in 16.4–23.8% of FSIGs (mean 20.7%). Mean ADR 8.4%. One centre has a significantly higher ADR than the other five sites (p < 0.05) (see Table 1).
Most (53%) procedures took 6–10 min.
79% of procedures were reported as causing no or minimal pain only, with only 34 procedures (1%) reporting severe pain.
Conclusion Uptake has varied between centres, but is lower than for the FOB arm of BCSP. Average ADR is 8.4% (range 6.1–12.1%), lower than in the UK flexible sigmoidoscopy screening trial (12.1%1) although the age range studied in the trial differs from the cohort described here.
Further work will be required to investigate the variation in uptake rates and to improve these rates. ADR variations may also need to be addressed; further analysis of patient groups may explain these differences.
Reference 1 Atkin et al. Lancet 2010:375:1624–1633
Disclosure of Interest None Declared.
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