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Bowel screening detects early cancer

By Lilian Anekwe

The UK Bowel Cancer Screening Programme can successfully detect early stage bowel cancers, new research from one of the programme's two key pilot sites has shown.

Faecal occult blood testing was able to detect treatable early cancers without throwing up large numbers of false positives or clogging up the system with unnecessary GP referrals, the study found.

It eases fears that testing would not be able to detect cancers at a sufficiently early stage – which have led to a push for use of sigmoidoscopy to pick up the earliest signs of cancer.

The proportion of patients with bowel cancer detected by screening rose from 0 to 43% in five years – covering the first two waves of the screening programme's rollout.

Overall, the number of symptomatic cancers diagnosed fell by 49% over the five years, while there was a 2.6-fold increase in the number of asymptomatic malignancies detected through screening.

Cancers were also diagnosed at an earlier stage in the screened population, with 40% of patients diagnosed through screening having early-grade tumours, compared with 12.3% of patients diagnosed by conventional routes – including the NICE two-week referral pathway.

Researchers at University Hospitals Coventry and Warwickshire invited more than 187,000 patients aged between 50 and 69 for twice-yearly FOBT between September 2000 and 2005.

But Dr Richard Stevens, chair of the Primary Care Society for Gastroenterology and a GP in Oxford, said sigmoidoscopy was still needed.

‘These results confirm other findings that suggest you can detect earlier bowel cancers with a screening programme. Signoidoscopy only detects cancers on the left side of the bowel. FOBT only detects cancers where there is blood present in the stools. They both have their limitations.'

The analysis, by researchers at the University of Warwick, is published in the September issue of the British Journal of Surgery.

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