Introduction Following the publication of the pilot study on flexible sigmoidoscopy for bowel cancer screening in 2010 by Professor Atkins, Guernsey was the first State in the British Isles to implement bowel cancer screening using this method. The screening programme was introduced following a successfully feasibility pilot study in 2011.
Method A total of 3,139 invitations were sent out in 2012, 2013 and 2014. The names of prospective paricipants are provied by local GPs. In 2012 and 2013 the programme screened participants aged 60years and in 2014, participants aged 60 and 65years old. Fleet enema is used for bowel preparation. The outcomes measured were: response rate, uptake, adenoma detection rate and participant satisfaction survey in 2014.
Results 1,909 eligible prospective participants accepted and 1,456 completed screening. The response rate for the individual years was 55%, 67%, and 65% for 2012, 2013 and 2014 respectively with an average of 62%. The uptake for the respective years was 36%, 56% and 56%, with an average of 49%. However, when the uptake was calculated using eligible accepted and the number of participants who completed screening for the three years, this was 66%, 84% and 86% respectively. Out of 1,456 participants who completed screening, 157 adenomas were detected, 51 (32%) of which were high risk. The adenoma detection rate (ADR) for the respective years was 12%, 8%, and 12% with an average ADR of 10.7%. Two cancers were identified in the 2012, none in 2013 and two cancers in the last four months of 2014 when 290 65 year old participants were screened. This older population also had more pathologically advanced adenomas. The 2014 participant satisfaction survey recorded that 91% were satisfied with the service and 91% would recommend the test to others.
Conclusion In conclusion, the uptake and ADR are comparable with the national average. The uptake of the eligible accepted needs to be audited to assess why these prospective participants did not attend. Participant satisfaction with the screening process is very high. Screening the older age group, although more arduous, the process catches advanced adenomas before they become cancerous and early curable cancers. The programme is preparing to screen two age groups, 60 and 65year olds.
Disclosure of interest None Declared.
Atkin WS, et al. Once-only flexible sigmoidoscopy screening in prevention of colorectal cancer: a multicentre randomised controlled trial. Lancet. 2010;375:1624–1633