Cancer screening can identify early signs of disease before symptoms become apparent and when treatment is more likely to be successful. Screening may also pick up pre-cancerous changes. The UK has an established national screening programmes for breast, cervical and bowel cancer. Screening tests for other cancers such as prostate cancer and ovarian cancer are being investigated but, to date, systematic population screening programmes for prostate cancer or for ovarian cancer are not recommended by the UK National Screening Committee.

The NHS Bowel Cancer Screening Programme (BCSP) in England is commissioned by NHS England (biennial faecal occult blood testing (FOBt) 60-74 years) and Public Health England (once-only flexible sigmoidoscopy (Bowelscope) at 55 years) and co-ordinated through five regional Hubs. Across England, in the last five years in excess of 21 million men and women have been invited to be screened or screened again, sending over 400,000 invites each month.

FOBt

• Nationally the uptake of the programme is currently approximately 58%, which has increased year-on-year since the start of the screening programme in 2006.
• A small percentage of the returned kits will be abnormal (show the presence of hidden blood), these people will be offered an assessment appointment at a local screening centre (one of 64 – geographically based), and, where appropriate, booked for a diagnostic test – such as a colonoscopy.
• Since 2006 the programme has identified over 32,000 cancers and 200,000 people with adenomas.
• In 2018/19 the qualitative guaiac FOBt (gFOBt) will be replaced by the faecal immunochemical test (FIT), which has a number of advantages including higher sensitivity specificity for human haemoglobin than gFOBt.

Bowelscope

• In 2013, the BCSP bowel scope programme was started offering 55-year-old men and women a once-only examination of the lower bowel using a flexible sigmoidoscope.
• Nationally this programme has invited almost 1 million people to participate. Uptake is just under 45%.
• For those people who attend a bowel scope procedure, nearly half have a non-normal outcome, such as findings of polyps, adenomas or cancers, as well as haemorrhoids or diverticular diseases.

 

NHS Bowel Cancer Screening Southern Programme

Director:  Sally C Benton

BSPS, our pathology network are just setting up a new website. A link will be shared to this once live.

Bowel cancer screening research 

• http://www.cancerscreening.nhs.uk/bowel/index.html
• https://www.nicefitstudy.com/

Recent publications

Peer-reviewed publications:

1.  GP participation in increasing uptake in a national bowel cancer screening programme: the PEARL project.Benton SC, Butler P, Allen K, Chesters M, Rickard S, Stanley S, et al. British Journal of Cancer. 2017; 116(12):1551-7.
2. Does the mass of sample loaded affect faecal haemoglobin concentration using the faecal immunochemical test?Piggott C, John C, Bruce H, Benton S. Annals of Clinical Biochemistry (23^rd May 2018 published online) https://doi.org/10.1177/0004563218778701).
3.  An assessment of the effect of haemoglobin variants on detection by faecal immunochemical tests.Carroll M, John C, Mantio D, Djedovic N, Benton S. Annals of Clinical Biochemistry (23^rd May 2018 published online) doi: 10.1177/0004563218778716.
4.  Detection capability of quantitative faecal immunochemical tests for haemoglobin (FIT) and reporting of low faecal haemoglobin concentrations. Fraser CG, Benton SC. Clin Chem Lab Med. 2018 Jul 11. pii: /j/cclm.ahead-of-print/cclm-2018-0464/cclm-2018-0464.xml. doi: 10.1515/cclm-2018-0464. [Epub ahead of print] PMID: 29995629
5.  Does the mass of sample loaded affect faecal haemoglobin concentration using the faecal immunochemical test?Piggott c, John C, Bruce H, Benton S. Annals of Clinical Biochemistry, 2018 Jan 1:4563218778701. doi: 10.1177/0004563218778701. [Epub ahead of print]
6.  An assessment of the effect of haemoglobin variants on detection by faecal immunochemical tests.Carroll M, John C, Mantio D, Djedovic N, Benton S. Accepted for Annals of Clinical Biochemistry,2018 Jan 1:4563218778716. doi: 10.1177/0004563218778716. [Epub ahead of print]
7.  Detection capability of quantitative faecal immunochemical tests for haemoglobin (FIT) and reporting of low faecal haemoglobin concentrations.Callum G. Fraser and Sally C. Benton. Clin Chem Lab Med 2018 Jul 11. pii: /j/cclm.ahead-of-print/cclm-2018-0464/cclm-2018-0464.xml. doi: 10.1515/cclm-2018-0464. [Epub ahead of print]
8. Setting up a service for a faecal immunochemical test for haemoglobin (FIT): a review of considerations, challenges and constraints.Godber I, Benton S, Fraser C. J Clin Path (accepted Sept 2018 for publication).

Conference abstracts:

1.  FIT sample stability for haemoglobin-positive faeces using two analytical systems over seven days.  Part 1: Piggott C, McDonald P, John C, Bruce H. British Society of Gastroenterology, Liverpool 2016. Part 2: Piggott C, John C, Bruce H. United European Gastroenterology Week Vienna 2016 /Cancer Data and Outcomes Conference, Manchester 2016 (poster).
2. GP Participation in increasing uptake in a national cancer screening programme: the PEARL Project.  Butler P, Duffy S, Reed K, Chesters M, Stanley S, Rickard S, et al. United European Gastroenterology Week, Vienna 2016 /Cancer Data and Outcomes conference, Manchester 2016 (poster).
3. Haemoglobin concentration in faeces from one to 48 hours after sampling using three FIT analytical systems.  John C, Piggott C, Bruce H. British Society of Gastroenterology, Liverpool 2016 /Cancer Data and Outcomes Conference, Manchester 2016 (poster).
4. Participation, positivity and outcomes in the Nepali community invited for bowel cancer screening – a feasibility study.Seaman HE, Snowball J, Butler P, Underwood J, Bruce H. British Society of Gastroenterology, Liverpool 2016/Cancer Data and Outcomes Conference, Manchester 2016 (poster).
5. Do haemoglobin variants affect the detection of haemoglobin by faecal immunochemical tests.Carroll MRR ACB Focus; Leeds 2017 + WEO; Barcelona 2017 (oral presentation).
6. Comparison of haemoglobin concentrations on four different faecal immunochemical test (FIT) analysers.John C, Piggott C, Benton S. ACB Focus, Leeds 2017 /IBMS Congress, Birmingham 2017 (poster).
7. The effect of different sampling techniques on faecal immunochemical test haemoglobin concentrations.Part 1: John C, Piggott C, Bruce H, Benton C.  Cancer Research UK, London 2017. Part 2: Piggott C, John C, Bruce H, Benton S.  ACB Focus, Leeds 2017 /IBMS Congress, Birmingham 2017 (poster).
8. Evaluation of a new calibrator for the Sentinel FOB Gold faecal immunochemical test.John C, Piggott C, Carroll M, Benton S. ACB Focus, Manchester 2018 (poster).
9. Faecal immunochemical testing (FIT) for post-polypectomy surveillance: an accuracy and efficiency study.Robbins E,  Wooldrage K, MacRae E, Stenson I, Patel B, Pack K, Piggott C, Pearson S, Snowball J, Duffy SW, Halloran S, Atkin W, Cross AJ. British Society of Gastroenterology Annual Meeting, Liverpool 2018 (oral presentation).