Bowel Screening

 

Bowel Cancer Screening 

Description of Service

The Cumbria and Morecambe Bay Screening Centre is part of the National Bowel Cancer Screening Programme (BCSP) and provides a free screening service identifying people who appear healthy but may be at increased risk of the disease or condition. 

The University Hospitals of Morecambe Bay NHS Foundation Trust hosts the programme for the population of Cumbria and North Lancashire.  

The Bowel Cancer Screening Centre is run in strong partnership with The Rugby Programme Hub, North Cumbria University Hospitals NHS Trust, Commissioning Groups and Public Health England. 

The Centre aims are to promote the service and provide education and awareness locally through workplace and community engagement activities, as well as provision of the highest level of holistic care to individuals accessing the Screening Programme.

 

Faecal Occult Blood Testing (60 – 74 years)

All G.P. registered individuals within the target age range of 60 -74 are invited to be screened for bowel cancer from the central hub at Rugby.  Those accepting screening are sent a simple test kit to complete at home and post it back to the hub laboratory.  The test kit tests for traces of blood in the stool sample.  Individuals with a positive result are invited to attend a clinic appointment with a specialist screening practitioner, where the results are explained, a detailed assessment is undertaken and a colonoscopy appointment is offered and booked.  During the colonoscopy any polyps found are removed and analysed by histology with results given to the patient usually by the specialist screening practitioner.

Individuals with polyps are risk-stratified according to the size and number of polyps:

BCSP services are provided against strict timescales and performance safety targets.  The centre performance is monitored through data on the national Bowel cancer screening system database by Public Health England, Cumbria CCG and North Lancashire CCG.

The Cumbria and Morecambe Bay Bowel Cancer Screening Centre undertakes diagnostic  services from the endoscopy unit at Westmorland General Hospital, Kendal; and Cumberland Infirmary, Carlisle;  following a rigorous accreditation programme.  The accreditation process leads to certification administered by the Joint Advisory Group on Gastrointestinal Endoscopy.   JAG accreditation is one of the many  criteria required for site approval from the NHS Bowel Screening Service to run screening services in NHS Trusts.

Illustration of the screening process 

It can be helpful to think of screening like a sieve.  In this diagram, a large group of people accept the offer of a screening test

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 The sieve represents the screening test and most people pass through it.  This means they are at low risk of having the condition screened for

The people left in the sieve are at higher risk of having the condition.  A further investigation is then offered to them. 

Identification through this process can show that they have the condition screened for.  The person may need further confirmatory tests.

At each stage of the screening process, people can make their own choices about further:

Limitations of screening

Ethics of populations screening

Because the NHS invites apparently healthy people for screening, healthcare professionals have to ensure individuals receive:

Screening expectations

The public needs to have realistic expectations of what a screening programme does.

Screening can:

Screening does not guarantee protection. Receiving a low risk result does not prevent the person from developing the condition at a later date.

In any screening programme there are a false positive and false negative results:

Other Resources:

http://www.senseaboutscience.org/resources.php/7/making-sense-of-screening

http://www.healthknowledge.org.uk/interactive-learning/screening

Bowel Scope Screening (55 years)

From March 2013, the NHS Bowel Cancer Screening Programme has been piloting a new screening test at the following 6 bowel cancer screening centres: 

Bowel scope screening involves a flexible sigmoidoscopy.  The aim is to find any small growths called ‘polyps’, which may develop into bowel cancer if left untreated. Bowel scope screening is an addition to the existing NHS Bowel Cancer Screening Programme that starts at age 60.

A further implementation system of 3 waves is taking place across England.  Cumbria and Morecambe Bay screening centre are currently in wave 2 of the National roll-out plan.  The service is currently available to those people registered with GPs in and around the Kendal locality and will be available in the following hospital sites over the next few years. 

 How is bowel scope screening carried out?

 If you are age 55 and 2 months you will receive an invitation, you will be offered an appointment at your local bowel cancer screening centre.  If the appointment isn’t convenient, you can change it.  If you decide not to come, but later change your mind, a new appointment can be made any time up until your 60th birthday.   After you reach 60, you will be offered the existing home testing kit for bowel cancer (the FOB kit).

For more information, you can read or download the leaflet on NHS bowel scope screening.

What about people in areas where the service isn’t happening?

It isn’t possible to introduce a new type of screening test everywhere at the same time.  If you don’t receive and invitation around the time of your 55th birthday this means that bowel scope screening is not yet available to you. The plan is to make bowel scope screening available to all 55 year olds in England.

If you have bowel symptoms that you are worried about (regardless of whether you have had any bowel cancer screening), you should go and see your GP.

Further Information

Details about the national bowel cancer screening programmes and a number of patient information leaflets are available in a variety of languages on the Public Health England Cancer Screening website, please click on the links below:

 NHS Bowel Cancer Screening Programme – Information Resources

NHS Bowel Cancer Screening Programme – Public Resources

http://www.cancerresearchuk.org/about-cancer/type/bowel-cancer/

 

Reviewed Sept 2016

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Contact us

0800 7076060

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