MORE than half of people invited to take a new bowel cancer screening test didn’t take up the opportunity – even though it could stop them developing or dying from the disease, according to a Cancer Research UK report published in the Journal of Medical Screening today (Monday).*
Cancer Research UK scientists found that people from poorer neighbourhoods were less likely to take up screening, with only one third in the most deprived neighbourhood going for their appointment compared to over half in the most affluent.**
Researchers looked at how many of the 21,000 people in six pilot areas*** of England, who were sent an appointment, did not go ahead with the new test.
In the most ethnically diverse area, 39 per cent decided to have the test compared to 45 per cent of people in the least ethnically diverse area. And more men (45 per cent) took the potentially life-saving test than women (42 per cent).****
The NHS Bowel Scope Screening Programme offers a one-off test to 55-year-olds that involves a specially trained nurse or doctor using a flexible tube, with a tiny camera on the end, to look inside the large bowel. The test helps prevent bowel cancer by finding and removing pre-cancerous polyps. It can also detect cancer that has already started to develop, before symptoms are noticed and when it’s easier to treat.
Analysis leader Dr Christian von Wagner, senior lecturer in Behavioural Research in Early Diagnosis of Cancer at the Health Behaviour Research Centre at UCL, said: “These are early days for the new bowel scope programme – there hasn’t been a publicity campaign about it yet, and bowel screening is generally not as familiar to people as breast-screening mammograms or cervical-screening smear tests. With that in mind, we were encouraged by the level of uptake in the pilot areas for a fairly new and invasive test, and we were surprised that more men were willing to have the test than women. What we found worrying was that people living in poorer areas seem less likely to take advantage of this screening.
“There are lots of reasons why people, wherever they live, might not have the test – and these can include practical barriers such as embarrassment about the procedure or problems taking time off work to keep the appointment. We’re doing more research to uncover these reasons and see what can be done to encourage as many eligible people as possible to take part.”
Bowel cancer is the second most common cause of cancer death in the UK, with around 16,200 people dying each year, and 95 per cent of cases developing in people aged 50 and over. Studies have indicated that bowel scope screening could reduce bowel cancer cases by up to 33 per cent and deaths by up to 43 per cent among those who took the test.
The screening programme is being phased in across England and is due to be fully rolled out by 2018. It will run alongside and enhance the current bowel cancer screening programme which sends a DIY faecal occult blood testing kit (FOBt) every two years to people aged 60 to 74 in England. This test looks for hidden blood in stool samples, a possible sign of cancer.
Dr Julie Sharp, head of health and patient information at Cancer Research UK, said: “The Bowel Scope Screening Programme has great potential to both prevent bowel cancer and detect it early – and research funded by Cancer Research UK will help to ensure the programme is introduced successfully. You don’t need to have symptoms for this test to be effective, but people can choose whether or not to have it and it’s important that they receive clear information so they can decide what’s right for them.
“Research like this can identify practical barriers that stop people taking up the test when they would like to have it. We welcome the new ambition from the Independent Cancer Taskforce that uptake for bowel scope should reach 75 per cent in all parts of the country by 2020, as this gives a clear signal that the NHS should be removing these barriers.”
* Uptake of Bowel Scope (Flexible Sigmoidoscopy) Screening in the English National Programme: an analysis of the first fourteen months – Lesley M McGregor, Bernardette Bonello, Robert S Kerrison, Claire Nickerson, Gianluca Baio, Lindy Berkman, Colin J Rees, Wendy Atkin, Jane Wardle and Christian von Wagner.
Researchers were based at: Health Behaviour Research Centre, UCL (University College London); NHS Cancer Screening Programmes, Sheffield; Department of Statistical Science, UCL; South Tyneside NHS Foundation Trust; School of Medicine, Health and Pharmacy, University of Durham; Department of Surgery and Cancer, Imperial College London.
Overall, 43.1 per cent of invited people had the screening test
** Uptake in the most deprived location was 32.7 percent, and in the least deprived it was 53.2 per cent.
***The six centres were: South of Tyne – Queen Elizabeth and South Tyneside; West Kent (West Kent and Medway); Norwich; London (St Marks); Wolverhampton; Surrey (Guildford).
This analysis covers 21,187 invitations sent to eligible people in six screening centre areas, as part of the Bowel Scope Screening Programme, during the first 14 months of the programme – March 2013 to May 2014. A pre-invitation explanatory letter was sent to all men and women who had their 55th birthday during this time. This was followed by a screening invitation letter offering a specific screening appointment. People who did not confirm that they would attend the appointment were sent a reminder letter.
****Uptake in the least ethnically diverse area was 44.9 per cent, and in the most diverse it was 38.7 per cent. In total, 44.6 per cent of all invited men were screened, compared to 41.5 per cent of all invited women.