Cancer screening updates

By Dr. Ananya Mandal, MDApr 7 2011

Flexible sigmoidoscopy for bowel cancer screening in UK

Everyone in England aged 55 to 59 will be invited for a new test which could dramatically cut their chances of developing bowel cancer. This new test could save an extra 3,000 lives every year after the UK National Screening Committee gave the nod for it to be added to the NHS programme. The test known as Flexible sigmoidoscopy (FS) differs to the current faecal occult blood (FOB) test, which relies on people sending off stool samples.

With FS a thin, bendy tube is inserted a short way into the rectum and lower bowel, enabling a doctor to look at the wall of the bowel. He or she can then remove any small growths known as polyps, which have the potential to develop into bowel cancer. While this helps remove the growths at an early stage, many more lives could be saved before the disease gets a chance to take hold. Across the UK, around 40,000 people develop bowel cancer each year and more than 16,000 die from it. Data shows that one-off FS screening for bowel cancer in men and women aged 55 to 64 could reduce the incidence of bowel cancer by 33% and death rates by 43%.

It is unclear exactly how long it will take for the NHS to roll out the new screening programme. At present people aged 60 to 69 are invited to send off stool samples as part of the FOB programme, which is being extended to include people up to the age of 74.

According to a Department of Health spokeswoman, the FS test will run alongside the FOB test, adding, “We will pilot inviting men and women aged around 55 for FS. They will then be invited to complete FOB kits every two years from age 60, as is currently available.”

Harpal Kumar, Cancer Research UK's chief executive, added, “Recent trial results of this method of detecting and removing polyps before they develop into bowel cancer can truly be called a breakthrough. We believe this method will save thousands of lives every year once fully rolled out.”

Bowel cancer test kit available in New Zealand

New Zealanders will now be able to test themselves for a cancer which kills more people than breast and prostate cancer combined. A new do-it-yourself bowel cancer test kit costing around $50 was launched today by Pharmacybrands.

In this test patients will collect a small sample at home and post it off to a lab in Australia, which will then contact the patient's New Zealand GP with the results. If it is positive more investigative tests such as a colonoscopy may be required.

Supporters of bowel cancer screening say the test will allow people with a family history of the disease to monitor their own health for the first time. However the New Zealand Medical Association (NZMA) say they do not support the pharmacy-based programme. NZMA chairman Peter Foley says he is concerned the programme has been set up without consultation with the medical profession and that it appears to be a “piecemeal approach” to healthcare.

“GPs are better placed to provide this service as they are aware of a patient's history, which is a very important part of screening. General practice, the enrolled medical home of 97% of New Zealanders, is where screening must occur so that it is linked to the individual's healthcare and doctors can be properly involved,” Dr Foley says. He calls this approach to splinter integrated healthcare. Meanwhile, the government's bowel cancer screening pilot programme in Waitemata begins in six months.

Cervical cancer screening

Thanks to cervical screening and the vaccination against the human papilloma virus, women can take proactive steps to reduce the risk of developing the disease. Early detection and treatment can prevent 75 per cent of cancers developing but, like other screening tests, it is not perfect. It may not always detect early cell changes that could lead to cancer. This is why it is essential to always attend screening when invited say experts.

The important thing to remind women is that the cervical screening programme is estimated to save 5,000 lives a year in the UK and that they should take up their invitation for screening.

In Scotland, many women are still not taking up the screening invitation. The latest figures show 73.3 per cent of women in Scotland have been screened in the previous three years. This rises to 79.5 per cent who have been screened in the previous five years. But that still means that between 20 and 25 per cent of women are not taking up the offer to get screened. They are potentially putting their lives at risk.