SCREENING

 

Statistically, Cancer Research UK suggests that approximately 41,000 people are diagnosed with bowel cancer in the UK and about 16,000 die of the disease, regardless of their sex, race or background. This makes it the Third most common cancer. They also suggest that if caught early (at stage 1 or 2) up to 97% of bowel cancer patients will have a chance of survival, and that younger bowel cancer patients have a better prognosis than older patients.

Cancerous cells can lurk in the bowel for a lengthy amount of time before exhibiting any symptoms. An early detection makes it easier to treat and provides a better chance of survival. Therefore, getting screened could be the difference between life and death.

The NHS Bowel Cancer Screening Programme has been running in England since July 2006. Men and women aged 60-75 registered with a GP will automatically be sent an invitation for screening through the post. This is a non-intrusive method which can be performed in the comfort of your home. The process is referred to as FOB (faecal occult blood). It involves collecting a sample of stool which is then sealed in a hygienic envelop which will eventually be sent off to a laboratory which will test for the presence of blood in the stool. Traces of blood in the stool could be indicative of bowel cancer. If no blood is found, a further screening will be scheduled for two years’ time. An inconclusive result will require an additional test for verification. However, if blood is found in the stool, an appointment will be scheduled for a colonoscopy. A colonoscopy involves an insertion of a thin and flexible tube with a tiny camera on the end which is passed into the anus through to the bowel.

Despite the effectiveness of the FOB, it is important to remember that;

  • The FOB test is not 100% reliable, though it saves many peoples lives per year.
  • An absence of blood in the faeces at the time of testing could decrease the chances of an early detection.
  • Development of bowel cancer could occur between screening tests. It is therefore important to be vigilant and to not ignore symptoms.

Screening tests for young adults

At the moment, bowel cancer screenings are aimed at the over 50s, but what about those who are of a much younger age and also have a higher than normal risk of developing colorectal cancer? As well as those with an increased risk, relatives of people with certain diseases, will also have more chance of developing colorectal cancer. Some people are offered regular screening tests, often from a young age. The groups of people offered screening tests include:

People with certain inherited conditions. This includes familial adenomatous polyposis (FAP), hereditary non-polyposis colorectal cancer (HNPCC), and some other syndromes including Peutz-Jeghers syndrome and juvenile polyposis syndrome. These conditions are very rare.

Close relatives of people with FAP or HNPCC.
People with a strong family history of first-degree relatives (mother, father, brother, sister, child) who have had colorectal cancer. In particular, if the cancer developed in a close relative under the age of 45 years.

People with ulcerative colitis or Crohn’s disease affecting the colon or rectum.

People with acromegaly.

People who have had one or more colonic polyps removed.

People who have had colorectal cancer in the past.

The age at which screening starts, the type of tests offered and the frequency of the tests depends on the level of increased risk. The different diseases and family associations mentioned above have varying levels of risk. The tests may include routine colonoscopy or some specialised scans. If you have a disease or family history that causes an increased risk of developing colorectal cancer, your doctor will advise on the type of tests recommended and their frequency.