Bowel Screening Programme Research Articles

The changing association between socioeconomic circumstances and the incidence of colorectal cancer: a population-based study

Background:There is emerging evidence to suggest that the association between socioeconomic circumstances and colorectal cancer incidence has changed over recent decades.Methods:We conducted a descriptive population-based study to describe the relationship between socioeconomic circumstances and the incidence of colorectal cancer in a pre-screened population. Incident cases of colorectal cancer from the West of Scotland were identified from the Scottish Cancer Registry and European age-standardised incidence rates (EASR) were calculated. Socioeconomic circumstances were measured using the area-based Scottish Index of Multiple Deprivation (SIMD).Results:In total, 14 051 incident cases of colorectal cancer were recorded from 1999 to 2007. Incidence of colorectal cancer was associated with increased deprivation in men but not among women; an association that became evident from 2005 onwards. From 2005 to 2007, the deprivation gap in incidence among men was 13.3 per 100 000 (95% confidence interval 3.2–23.4), with rates 19.5% lower among the least deprived compared with the most deprived. This deprivation gap now accounts for an estimated 75 excess cases per year of male colorectal cancer in the West of Scotland.Conclusion:Deprivation was associated with higher incidence rates of male, but not female, colorectal cancer before the implementation of a national bowel screening programme.

Does colonoscopists' performance vary between bowel screening and patients with symptoms – a comparison of colonoscopy completion rates

IntroductionColonoscopy completion rates (CCR) are an important quality assurance parameter for individual endoscopists and for the national Bowel Screening Programme (BSP). The standard is set at an unadjusted completion rate...

Bowel screening programme increases early detection

Bowel screening programme increases early detection

Colonoscopic adverse events during bowel cancer screening programme in north-east italy: a preliminary report

IntroductionBowel cancer is the third most common cancer in Italy with approximately 350 cases every 100.000 inhabitants. The University Hospital of Udine began the Bowel Cancer screening programme in 2008....

Round one of the Adelaide and Meath Hospital/Trinity College Colorectal Cancer Screening Programme: programme report and analysis based on established international key performance indices

In Ireland, colorectal cancer (CRC) is the second most frequently diagnosed cancer in men, after prostate cancer, and the second most frequently diagnosed cancer in women, after breast cancer. By 2020, the number of new cases diagnosed annually in Ireland is projected to have increased by 79% in men and 56% in women. Organised screening for CRC is already underway or is in the process of being rolled out in several European countries, either at a regional or national level. The Adelaide and Meath Hospital/ Trinity College Dublin Colorectal Cancer Screening Programme (TTC-CRC-SP) is Ireland's first pilot population based bowel screening programme. Based on a biennial test model the pilot aimed to assess the accuracy of FIT and to evaluate the whole programme based on established international key performance indices. To date 9,993 individuals aged 50-74 years have been invited to participate in the TTC-CRC-SP with over 5,000 FIT's analysed. Overall uptake was 51% and FIT positivity was 10%. The programme has undertaken over 400 screening colonoscopies and detected 154 precancerous adenomas and 38 cancerous lesions. The first round of The Adelaide and Meath Hospital Tallaght/Trinity College Dublin Colorectal Cancer Screening Programme has been highly successful and confirmed that there is an advantage for FIT based two stage bowel cancer screening programmes.

Experience with a wipe guaiac-based faecal occult blood test as an alternative test in a bowel screening programme

The format of the traditional guaiac faecal occult blood test (gFOBT), particularly the collection technique, might cause difficulties for some. A multistage evaluation of alternative tests was performed. Firstly, four tests with different faecal collection approaches were assessed: a focus group recommended further investigation of a wipe gFOBT. Secondly, 100 faecal samples were analysed using two wipe tests and the routine gFOBT: no differences were found. Thirdly, a wipe gFOBT was introduced. Over 21 months, 400 requests were made and 311 wipe kit sets were submitted for analysis: 153 (49.2%) were negative, 21 (6.8%) positive (all 3 kits positive), 96 (30.9%) weak positive (1 or 2 positive) and 41 (13.2%) un-testable. Forty-three participants were referred for colonoscopy. Outcome data were provided on 39 participants: nine declined colonoscopy, two were judged unsuitable, two did not attend, two were already in follow-up, 13 had normal colonoscopy and two normal barium enema, two had diverticular disease, two had a metaplastic polyp, four had a low-risk adenoma and one had a high-risk adenoma. No participant had cancer. Detection of significant neoplasia was small. The use of the wipe gFOBT was ceased: it cannot be recommended as a screening test for bowel cancer.

Colorectal cancer screening

Colorectal cancer is the third most common cancer, and the second leading cause of cancer death in the UK, with 35,000 diagnoses and 16,000 deaths per year. It costs the National Health Service (NHS) expenditure of more than £300 million pounds in surgical, adjuvant and palliative treatment. The disease is uniquely placed for screening strategies, as 70–90% of the tumours arise from premalignant, adenomatous polyps. This transformation may take 10 years or more and provides us with a window of opportunity to detect early tumours (Dukes' A) and also prevent cancer development by excision and removal of premalignant polyps during colonoscopy. The NHS Bowel Screening Programme in the UK is based on the principle of secondary prevention whereby detection and treatment of existing preneoplastic and early neoplastic lesions would result in reduction of prevalence and improvement in survival of patients with colorectal cancer.

Acceptance quality checks for qualitative fecal immunochemical tests ensure screening program consistency

Acceptance quality checks for qualitative fecal immunochemical tests ensure screening program consistency

Cardiac ischaemia and rhythm disturbances during elective colonoscopy

BackgroundThe number of colonoscopic procedures continues to rise rapidly. With widespread adoption of colonoscopy based bowel screening programmes, this rising trend is set to continue.AimsThis study aimed to identify whether...

The impact of screening and genetic registration on mortality and colorectal cancer incidence in familial adenomatous polyposis

BackgroundRegular colonic surveillance of familial adenomatous polyposis (FAP) patients is necessary to ensure appropriate prophylactic surgery is performed before colorectal cancer (CRC) develops. Polyposis Registries have been established to coordinate...

PWE-008 The East Midlands polypectomy study

Introduction The NHS Bowel Cancer Screening Programme was introduced in 2006 for the early detection of cancer and premalignant polyps. This has resulted in a large number of polyps being found on colonoscopy and an opportunity to accumulate good data and risk stratify polypectomy complication rates. The Munich polpypectomy study was a large, prospective, multicentre study of 4000 snare polypectomies in 2257 patients. Complications occurred in 9.7% of patients (6.1% polyps) with 7.0% of these complications being minor and 2.7% major. Polyp size was identified as an important risk factor for major complications, followed by right sided location and number of polyps. However, there is a lack of large systematic prospective studies in the UK of polypectomy complications. Methods Data on all polypectomies at two DGHs were collected prospectively over 24 months as part of the normal bowel screening process. Early and late complications were recorded. The service review included patients enrolled onto the screening programme between the ages of 60–69 and who had a polypectomy. Patients were excluded if they were 70 years old and not had a polypectomy. The primary endpoints of the study were polypectomy complications which were classed as major or minor. The risk factors for complications were analysed for patient demographics, polyp size, distribution and histology. Result 1388 patients participated in the bowel screening programme and 780 patients were identified (535 male and 245 female) with a total of 2098 polypectomies. 45% of the patients had left sided polyps, 13.3% right and the remainder of polyps on both sides. 70% of polyps were 20 mm. The total complication rate was 1.79% (95% CI 0.86 to 2.72) with a polyp complication rate of 0.67% and zero mortality. There were three (0.38%) major complications (95% CI −0.05 to 0.81); 1 left sided perforation requiring surgery, one right sided perforation which was clipped and one major bleed. Left sided polyp location was a risk factor for minor bleeding complications 1.41% (95% CI 0.58–2.24). Cancerous polyps (3/14) and polyp size 5–10 mm carried an increased risk of complications. Conclusion The bowel screening programme has added another dimension due to the large volume of polyps being found and polypectomies undertaken. This study has shown that serious complications are rare. Identification of patient and polyp characteristics can be used as a predictor to reduce the incidence of major complications; however, a larger study is needed to clarify this.

Splenic injury following colonoscopy

I agree with the authors that splenic injury following colonoscopy has been under-reported and is likely to increase with an on-going National Bowel Screening Programme. In this particular case, re-anticoagulation with warfarin seems to be one of the predisposing factors causing secondary bleed. The spleen was found to be shattered with very little enhancing tissue on the computed tomography scan high-lighting that injury was due to traction injury to the atheromatous splenic vessels rather than the capsular tear as seen in our case report.1 Although possible mechanisms of injury have been postulated in this case report and previous publications,1 the type of injury to the spleen (capsular or vessel) will help delineate the exact mode of injury to the spleen. It leaves the dilemma of whether splenic trauma should be mentioned on the consent form as a complication of colonoscopy. The true incidence remains unknown as authors have high-lighted that it may remain undiagnosed or be misdiagnosed as post-colonoscopy discomfort.

A decision aid to support informed choices about bowel cancer screening among adults with low education: randomised controlled trial

Objective To determine whether a decision aid designed for adults with low education and literacy can support informed choice and involvement in decisions about screening for bowel cancer.Design Randomised controlled...

T1564 Experience with An Alternate Wipe Guaiac Fecal Occult Blood Test in a National Bowel Screening Program

T1564 Experience with An Alternate Wipe Guaiac Fecal Occult Blood Test in a National Bowel Screening Program

Response to ‘The NHS bowel screening programme – a realistic approach with additional benefits’

Response to ‘The NHS bowel screening programme – a realistic approach with additional benefits’

England′s bowel screening programme

England′s bowel screening programme, Institute honours stoma nurse Crohn′s symptoms according to sex Screening halves emergency admissions Health groups attack alcohol laws

Flying start for screening programme

Early signs are good for the national bowel screening programme: the first centre to handle patients, New Cross Hospital, part of the Royal Wolverhampton NHS Trust,has identified more than 10 cases of early stage bowel cancer in the first 8 months of operation. The trust is now hiring a health promotion coordinator to improve screening uptake.

A screen leader

Linda Colford manages the bowel screening call/recall centre in Dundee which will coordinate Scotland’s national bowel screening programme when it begins in 2007. Initially employed as the screening pilot nurse for the Fife test site in 2000, Linda gives CNP an overview of her experience in this role which demonstrates how nurses can take on such screening service lead positions

Company profits from delay to bowel screening programme

A company in Arbroath,Scotland, has come up with a way to capitalize on the Government′s delay in introducing a national bowel screening programme. Point of Care Testing Laboratories Ltd is offering a postal service of self-testing kits for bowel cancer to the public. The company has been operating for 3weeks with clients aged from 40−70 years.

Bowel cancer: Screening for early diagnosis

A national bowel screening programme is on the way. Charlotte Dawson outlines its development.