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Consultant Laparoscopic Colorectal and General Surgeon

All posts in Bowel cancer

What’s the latest on bowel cancer screening

The faecal immunochemical test (FIT), a greatly improved test kit for people to use at home to screen for bowel cancer, has now been approved and adopted for use in the UK.

The new test is already available and people all over the country who are eligible for bowel cancer screening will be getting the new kit as we go through 2016 and into 2017. Find out more…

Is flexible sigmoidoscopy used for bowel screening?

Not yet but it will be soon. As of autumn 2013, six centres in the UK are running a pilot for bowel screening using flexible sigmoidoscopy. Adding flexible sigmoidoscopy at the age of 55 to the National Bowel Screening Programme should help detect more cases of bowel cancer early.

The NHS bowel scope screening pilot started in March 2013 and has been set up in six areas of England:

  • Guildford in Surrey
  • West Kent and Medway
  • Norwich
  • Queen Elizabeth and South Tyneside
  • Wolverhampton
  • London (St Marks)

If you live in these areas and you are around 55 years old, you may receive an invitation to have a flexible sigmoidoscopy.

Mr Jonathan Wilson, Colorectal SurgeonA lot of research has been done to establish ways to detect bowel cancer that are affordable in the current economic climate. There will be a lot of people tested whose results come back completely normal, or who have problems that are not cancer. It’s the few people whose cancer is picked up early that benefit: screening does certainly save lives.

Adding flexible sigmoidoscopy to faecal occult blood testing for people over 55 is a major step forward in this country and when the combination is fully rolled out to all regions, it is likely to continue to chip away at the death rate from colon cancer, which is still the second most common cause of cancer death, claiming 16,000 lives each year.

What is the NHS bowel screening programme?

This is a national screening programme now running all over the country to detect early signs of bowel cancer:

  • People aged between 60 and 69 (this will soon be extended up to age 74) are contacted to let them know they are eligible for screening.
  • They are then sent a kit to test if their faeces contain any blood.
  • The screening kit, known as the Faecal Occult Blood (FOB) test, is used at home. The small faecal samples are collected on cards that are sealed and posted to be tested in the lab.
  • The results come through in two weeks. If the test is normal, there is nothing to worry about but it’s important to carry on doing the test every two years.
  • If there is a problem, you may need to repeat the test and you may then need a colonoscopy.
  • A pilot is currently running to see if more lives can be saved by having a flexible sigmoidoscopy at the age of 55 years. If it does, flexible sigmoidoscopy could be added to the NHS bowel screening programme in the future.

Mr Jonathan Wilson, Colorectal Surgeon

If you are sent an invitation to have bowel cancer screening, do take it up. One of the earliest signs of bowel cancer is blood in poo. If this is detected earlier it can mean an early diagnosis. The earlier the better as treatments are much more effective when performed on small tumours that haven’t yet spread.

What is flexible sigmoidoscopy?

Flexible sigmoidoscopy is a type of endoscopy, a bit like a colonoscopy but it doesn’t examine as much of your bowel. The test is done using a flexible sigmoidoscope.

This flexible tube has a camera inside it and it is very thin, thin enough to be passed through the anus into the rectum and first part of the large bowel without causing too much discomfort.

Small instruments can be passed through a tiny channel in the scope to either remove a polyp or take a small sample (biopsy) of bowel tissue – both of these manoeuvres are pain-free.

This tissue is examined later under a microscope by a histologist to find out if there are any cancerous cells.

The UK is planning to introduce flexible sigmoidoscopy as a one-off test for people aged between 55 years and 60 years to detect more cases of bowel cancer early.

This screening program is known as Bowel Scope.

What’s it like to have a flexible sigmoidoscopy?

  • It’s not that bad – having a bowel scope examination takes about 10 minutes and it’s only mildly uncomfortable.
  • You don’t need to prepare by using a laxative the day before and you won’t need a sedative. This is not as extensive as a colonoscopy.
  • You will have an enema just before, emptying the lower bowel, and then lie on a couch on your side. The flexible sigmoidoscope is inserted through the anus and into the rectum and the lower part of the large bowel.
  • Some air is usually passed into the bowel to make the test easier and to produce clearer images of the wall of the large bowel. A sample may be taken but this will not cause you any pain.
  • These bowel scope appointments are often scheduled in the evening to fit in around your work and you can drive there and home.

Mr Jonathan Wilson, Colorectal Surgeon

If you have symptoms, such as passing blood when you open your bowels, the scope test should show what is causing that so it’s worth the minor discomfort and time to have it done.

It may be that you have internal haemorrhoids or a polyp or polyps that need to be treated.

It may detect early-stage cancer that can then be treated early, giving you the best chance of having it cured by surgery and follow up treatment.