Bowel Cancer Screening Q&A
Common questions and answers about bowel cancer and bowel screening.
What is the purpose of Bowel Cancer Screening?
Bowel Cancer Screening aims to detect bowel cancer at an early stage (in people with no symptoms), when treatment is more likely to be effective.
Bowel Cancer Screening can also detect polyps. These are not cancers, but may develop into cancers over time. They can be easily removed, reducing the risk of Bowel Cancer developing.
How does the screening test work?
The screening test detects tiny amounts of blood, which you cannot normally see, in bowel motions. It is called Faecal Occult Blood (FOB).
Polyps and bowel cancers sometimes bleed which is why screening for blood is carried out.
The FOB test does not diagnose bowel cancer, but the results will establish whether the participant requires examination of the bowel (Colonoscopy)
How is the screening test carried out?
Participants carry out the test in the privacy of their own home. The screening kit provides a simple way to collect a small sample of bowel motions. The samples are wiped on a special card which is then sent in a hygienically sealed freepost envelope to a laboratory for testing. There are detailed instructions with each kit.
Participants may think that the test sounds embarrassing or unpleasant but it will only take a few minutes and it is an effective way to detect bowel cancer early.
What role will GP's have in the screening process?
It is intended to keep GPs and Primary Care staff workload to a minimum.
The Screening Programme Hub in Gateshead is responsible for the invitation and recall of patients, despatching and processing of the testing kits, sending out results and notifying GP's. It is also responsible for booking participants into the nurse-led specialist screening clinics set up across the Calderdale, Kirklees and Wakefield.
The office for the Calderdale, Kirklees and Wakefield screening programme office is based at Calderdale Royal Infirmary and most queries will be directed from the Gateshead Hub to this office.
The only way it may impact on GP practice staff is if a patient mistakenly calls their GP practice when they first receive the pack and do not understand what it is about.
What are the possible results and what do they mean?
Participants and GP's will receive a results letter from the laboratory within two weeks of sending in the sample.
A normal result means that blood was not found in the test sample. About 98 out of 100 tests will be normal. A small number of people may need a repeat test due to an unclear result.
A normal result does not guarantee that participants do not have or will never develop bowel cancer in the future, so being aware of symptoms of Bowel Cancer is very important. Participants will be offered bowel screening again every two years.
An unclear result means there was a slight suggestion of blood in the FOB test sample. This could have been caused by conditions such as Haemorrhoids or stomach ulcers. Receiving an unclear result does not mean that the participant has cancer, just that they need to repeat the FOB test.
If an unclear result is obtained, the participant will be asked to complete the test up to two more times. This is necessary because polyps and cancers do not bleed all the time and it is important to find out whether or not there is blood in the stool. About four people out of every 100 will receive an unclear result. Most people who repeat the test receive a normal result.
An abnormal result shows that blood may have been found in the FOB test sample. It is not a diagnosis of cancer, but does mean that the participant will be offered a colonoscopy. The abnormal result may have been caused by bleeding from bowel polyps rather than bowel cancer. It may also have been caused by other conditions such as Haemorrhoids.
Participants who receive an abnormal result will be offered an appointment with a Screening Nurse Practitioner at a community-based clinic to discuss the results and he/she will fully explain the colonoscopy procedure and assess the participants fitness for it.
If the participant is assessed fit and consents, the Screening Nurse Practitioner will arrange the colonoscopy appointment and the participant will leave the clinic with an appointment for colonoscopy and all pre-medications and information. About two in every 100 people doing the test will have an abnormal result.
Colonoscopy
The colonoscopy is the investigation that involves looking directly at the lining of the large bowel. Colonoscopy is the most effective way to diagnose bowel cancer.
The Screening Nurse Practitioner will fully assess, provide information, counselling and support to all participants who attend a screening assessment clinic.
The colonoscopy will be performed at either Pinderfields General Hospital or Calderdale Royal Infirmary depending upon the participants GP address. This is to ensure participants receive the test at the hospital closest to their home.
The Screening Nurse Practitioner will be present when the participant arrives for their colonoscopy and will remain with them during the procedure.
The Screening Nurse Practitioner will arrange follow-up appointments after the procedure.
Diagnosis
In the event that a participant is diagnosed with Bowel Cancer, the specialist Multi-disciplinary team will look after the patient to ensure the best care is provided. The patient will be advised of the result immediately and treatment options discussed.
If Bowel Cancer is detected at the earliest stage, there is over a 90% chance of survival.
What happens to the sample once it has been tested?
Once the FOB sample has been analysed, the result is recorded into a database and the sample card is destroyed.
