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Health - SCREENING for HEALTH PROBLEMS - Bowel cancer screening

 

active  Topic # 59

30/08/2016 @ 5:58 PM
by NHS_UK

Anonymous

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Introduction 

Bowel cancer is the fourth most common cancer in the UK. If it's detected at an early stage, before symptoms appear, it's easier to treat and there's a better chance of surviving it.

To detect cases of bowel cancer sooner, the NHS offers two types of bowel cancer screening to adults registered with a GP in England:

  • All men and women aged 60-74 are invited to carry out a faecal occult blood (FOB) test. Every two years, they're sent a home test kit, which is used to collect a stool sample. If you are 75 or over, you can ask for this test by calling the freephone helpline on 0800 707 60 60.
  • An additional one-off test called bowel scope screening is gradually being introduced in England. This is offered to men and women at the age of 55. As of March 2015, about two-thirds of screening centres were beginning to offer this test to 55-year-olds. It involves a doctor or nurse using a thin, flexible instrument to look inside the lower part of the bowel. 

Taking part in bowel cancer screening reduces your chances of dying from bowel cancer, and removing polyps in bowel scope screening can prevent cancer. However, all screening involves a balance of potential harms, as well as benefits. It's up to you to decide if you want to have it.

To help you decide, read on to learn about what the two tests involve, what the different possible results mean, and the potential risks for you to weigh up.

What does the FOB screening test involve?

The home testing kit is used to collect tiny stool samples on a special card. The card is then sealed in a hygienic freepost envelope and sent to the screening laboratory, where it will be checked for traces of blood that may not be visible to the naked eye, but could be an early sign of bowel cancer.

About the FOB test  

The FOB test is a home test kit offered to all 60-74 year olds in England. It checks for the presence of blood in a stool sample, which could be an early sign of bowel cancer. If you are 75 or over, you can ask for this test by phoning 0800 707 60 60.

FOB stands for "faecal occult blood" ("occult blood" means "hidden blood"). It can detect tiny amounts of blood in your poo that you cannot normally see.

Why does the NHS offer FOB testing?

Regular bowel cancer screening using the FOB test has been shown to reduce the risk of dying from bowel cancer by 16%.

When are you offered the test?

Men and women in England are offered an FOB test every two years from the age of 60 to 74. As long as you’re registered with a GP and your GP has your home address, you should automatically be sent the home test kit by post.

People aged 75 and older can still be screened for bowel cancer. They can request an FOB screening kit by calling the freephone helpline on 0800 707 60 60.

What does it involve?

You carry out the FOB test in the privacy of your own home. The screening kit provides a simple way for you to collect small samples of poo, which you wipe onto a special card. You send this card in a hygienically sealed freepost envelope to the screening laboratory for testing. There are detailed instructions with each kit – read the kit instructions here (PDF, 374kb). If you have any questions about how to use the home test kit, you can call the helpline on 0800 707 60 60.

You may think that doing the test sounds a bit embarrassing or unpleasant, but it will only take a few minutes and is a good way of detecting bowel cancer early.

The FOB test does not diagnose bowel cancer, but the results will tell you whether you need an examination of your bowel (a colonoscopy).

FOB test results

You should receive a results letter from the laboratory within two weeks of sending in your sample. There are three types of results you could receive.

Most people will have a normal result

A normal result means that blood was not found in your test sample. Most people (about 98 out of 100) will receive a normal result. A small number of these people will have repeated the test because they had an unclear result previously.

A normal result does not guarantee that you do not have or will never develop bowel cancer in the future, so being aware of the symptoms of bowel cancer is still important.

A few people will have an unclear result

An unclear result means there was a slight suggestion of blood in your FOB test sample.

Receiving an unclear result does not mean you have cancer, just that you need to repeat the FOB test.

If you receive an unclear result, you will be asked to complete the FOB test up to twice more. This is necessary because polyps and cancers do not bleed all the time.

About 4 in 100 people will initially receive an unclear result. Most people who repeat the test will then receive a normal result.

A few people will have an abnormal result

An abnormal result shows that blood may have been found in your FOB test sample – it is not a diagnosis of cancer, but it does mean that you will be offered a colonoscopy. The abnormal result may have been caused by bleeding from bowel polyps, rather than a bowel cancer. It may also have been caused by other conditions, such as piles (haemorrhoids).

About 2 in 100 people doing the test will have an abnormal result. Sometimes, someone will have an abnormal result after their previous result was unclear.

If you receive an abnormal result, you'll be offered an appointment with a specialist screening practitioner at a local screening centre, to discuss having a more detailed examination of your bowel (a colonoscopy), to see whether or not there is a problem that may need treatment.

A colonoscopy uses a longer tube, which can look for polyps further up the bowel. 

What happens during the colonoscopy?

If polyps are found, most can be removed painlessly, using a wire loop passed down the colonoscope tube.

These tissue samples will be checked for any abnormal cells that might be cancerous.

  • About 5 in 10 people who have a colonoscopy will have a normal result (they do not have cancer or polyps).
  • About 4 in 10 will be found to have a polyp, which if removed may prevent cancer developing.
  • About 1 in 10 people will be found to have cancer when they have a colonoscopy.

A colonoscopy is the most effective way to diagnose bowel cancer. For most people, having a colonoscopy is a straightforward procedure.

However, as with most medical procedures, there is the possibility of complications. These can include heavy bleeding (about a 1 in 250 chance) that needs further investigation or medical advice. The colonoscope can cause a hole (perforation) in the wall of the bowel (about a 1 in 1,000 chance). In extremely rare cases, colonoscopy may result in death. Current evidence suggests that this may only happen in about 1 in 10,000 cases.

Remember: most people who complete the FOB test will not need a colonoscopy.

If you want to opt out...

If you don't want to be invited for bowel screening in the future, call the programme helpline on 0800 707 6060 and the staff will guide you through the opting-out process. If you change your mind at a later date, you can simply ask your GP to put you back on the list.

Frequently Asked Questions (FAQs)

Read some FAQs on the FOB test.

Your results

You'll receive the results of your FOB test within two weeks of sending in the test kit. There are three types of result:

  • Most people will have a normal result – no further tests are needed and you'll be invited to take part in screening again in two years (if you're still aged 60-74).
  • A few people will have an unclear result – you'll be asked to repeat the FOB test up to twice more.
  • A few people will have an abnormal result – you'll be offered an appointment to discuss colonoscopy at a local screening centre.

Read more about FOB test results.

If you're outside the age range...

People aged 75 and older can still be screened for bowel cancer. They can request an FOB screening kit by calling the freephone helpline on 0800 707 60 60.

People younger than 60 are not eligible for the FOB screening test, but can have bowel scope screening (see below). If you have symptoms, are worried about a family history of bowel cancer, or are worried about your bowel health in any way, speak to your GP.

What does bowel scope screening involve?

Bowel scope screening is done by a specially trained nurse or doctor at an NHS bowel cancer screening centre.

The doctor or nurse will put a thin flexible tube into your bottom to look inside the lower part of your bowel and remove any small growths, called polyps, that could eventually turn into cancer.

Read more about bowel scope screening.

Your results

You'll receive the results of your bowel scope screening test within two weeks of your appointment. 

  • Most people will have a normal result.
  • Some people will have polyps,which may mean having another examination of the bowel (a colonoscopy).
  • Rarely, the test will find cancer.

Read more about bowel scope screening results.

What are the risks?

No screening test is 100% reliable. There's a chance a cancer can be missed if it was not bleeding when the screening test was taken. This means you might be falsely reassured.

Bowel scope screening is usually safe, but in rare cases it can cause harm to the bowel. Learn more about the risks of bowel scope screening.

If you get an abnormal result, you'll be offered a colonoscopy. Although rare, there are risks associated with having this investigation. Most people who have a colonoscopy will not have cancer. Learn more about having a colonoscopy (PDF, 270kb).

Bowel screening helpline

Call the bowel screening helpline on 0800 707 60 60:

  • to request a home test kit if you are 75 or over
  • if your home test kit hasn’t arrived when you expected it
  • to find out if bowel scope screening is available in your area
  • if you want more information about bowel cancer screening

If you have a question about bowel cancer screening, you can also check to see if it’s already been answered in our FAQs.

Web site NHS_UK
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