New bowel screening test introduced in England

reposted from: http://scienceblog.cancerresearchuk.org/2013/03/21/new-bowel-screening-test-introduced-in-england/

crabsallover highlights, key points, comments / links.

Thu Mar 21, 2013 10:33 Share

A new addition to the bowel screening programme is being rolled out

Back in December we wrote about Jeremy Hunt’s announcement that six centres in England would start using Bowel Scope Screening (BSS, also known as flexi-scope or flexible sigmoidoscopy) as part of their bowel screening programme in 2013.

This week, 55 year olds in the South of Tyne region (which includes Gateshead, Sunderland and South Tyneside) received the first wave of letters inviting them to be screened.

This is great news. Cancer Research UK has been involved in Bowel Scope Screening from the beginning – we co-funded a 16 year study  which showed that it cuts deaths by over 40 per cent, and – unlike the current test – can actually prevent a third of bowel cancers among those screened.

As a result, it has the potential to save thousands of lives from bowel cancer each year.

As soon as the trial results were published in 2010, we said we wanted the Government to add BSS to the existing bowel screening programme, and later that year, they agreed, setting aside £60m to fund it.

Since then we’ve been calling for Bowel Scope Screening to start as soon as possible, so it’s fantastic to see it finally happen.

What does the test do?

The test used in Bowel Scope Screening, flexible sigmoidoscopy , uses a flexible tube with a camera and a light on the end to look into your lower bowel. It can spot both early-stage cancers and pre-cancerous growths known as ‘polyps,’ which can be immediately removed to prevent them developing into cancer.

There’s information about having sigmoidoscopy on our website, or you can watch this video.

Recent studies have shown that people find it ‘acceptable’ and ‘reassuring’.

It’s not a new test – it’s been used to diagnose bowel cancer in patients with symptoms for many years. But what is new is using it in this way to screen the population before they even have symptoms. And this could have a huge impact on bowel cancer in this country.

When will it be available?

This is the first of six ‘pilot’ centres which will iron out any potential problems in the system before rolling out BSS to the rest of the country. Over the next few months, another five centres will then start to offer Bowel Scope Screening.

By 2016, everyone in England should be invited to have a test at the age of 55.

What does it mean for me?

Bowel Scope Screening adds to the  existing bowel screening programme, which uses the Faecal Occult Blood Test (FOBT) – which looks for blood in your stools. People are invited from age 60 to participate (or age 50 in Scotland).

Under the new plans, if you live in England, you’ll be invited to be screened using BSS when you turn 55. If you decide not to go (and it is your decision), you can change your mind up until you turn 60. At that point you’ll be invited to take part in the existing bowel screening programme.

Whether or not you decide to have BSS, you will still be invited to take part in the existing screening programme at 60, to help spot any cancer that might develop later on. Although it hasn’t been shown to prevent cancer in the same way as BSS, FOBT is still an important way of helping to diagnose bowel cancer at an early stage, when treatment is more likely to be successful. The evidence so far suggests it’s made a big impact already and BSS takes this a step further.

What’s next?

This is an important first step. Now we need to make sure that everyone can benefit from Bowel Scope Screening. At the moment BSS is only being rolled out in England. We want to see Scotland, Wales and Northern Ireland develop their own plans for BSS, including making sure they have the right facilities available.

If this test is made available across the UK, thousands of deaths will be prevented, and – even better – potentially thousands of people will be spared from ever having to experience this terrible disease.

Dan

• Dan Hughes-Morgan is a policy adviser at Cancer Research UK

UK National Screening for Bowel Cancer with Flexiscope

Update 10 April 2013: 

I was referred by my GP to Bournemouth Nuffield [private] Hospital who say 'I am sorry but the self-fund initial appointment with Mr Howell is £180.00. If you have to have a flexible sigmoidoscopy no doubt he would be able to move you into the NHS to have it performed. If he performed a rigid sigmoidoscopy in outpatients at the same time as your initial appointment it would incur an extra £50 for Mr Howell and the Nuffield would send you an invoice for around £100.00 for the use of consumables etc.'

£330 for a rigid sigmoidoscopy! Ouch!! I think I'll wait till the NHS gets its free flexisig act together by 2016!

+++++++++++++++++++++++++++++++++


I blogged about Bowel Cancer Screening December 2010 and prompted by investigations on AAA, I understand Bowel Cancer Screening with a Flexiscope is available free on the NHS for those over 55 but is being rolled out to the whole country by 2016. The screening is called Bowel scope screening. See your GP for details.

LifeScanUK.org do a virtual colonoscopy for £650. NB. NOT the same test as flexible sigmoidoscopy. I can't find anybody in UK who does Flexiscope testing other than NHS trials, so booked appointment with my Doctor for further info.

"A large UK clinical trial looked into a new bowel screening test. The trial followed more than 170,000 people over 11 years to see who developed bowel cancer. More than 40,000 of those people between the ages of 55 to 64 had a test called flexible sigmoidoscopy. This test may also be called Flexi-Scope, flexi-sig or bowel scope. It involves having a thin, bendy tube put a short way into the rectum and lower bowel. The tube has a tiny camera and light on the end, allowing the doctor to look at the inside wall of the bowel and remove any small growths or polyps. 

The researchers found that the people who had screening with Flexi-Scope reduced their risk of bowel cancer by a third because any polyps were removed at an early stage. In England, the Flexi-Scope test is now being introduced into the NHS bowel screening programme. This is called bowel scope screening. This will be a one off test for all men and women aged 55. The FOB test will continue from age 60 as before. Bowel scope screening will be slowly rolled out across the country over the next few years" source: Cancer Research UK

Beating Bowel Cancer say:-

'Pilot programmes for bowel scope screening are scheduled to commence in Norwich, South of Tyne, St Mark’s London, Surrey, West Kent and Wolverhampton from March 2013. 

Beating Bowel Cancer have a factsheet (January 2013)

Flexible-sigmoidoscopy (flexi-sig) or bowel scope screening: The Department of Health in England has announced that it will fund a new, one-off, flexi-sig screening programme for men and women in England aged 55 years. This screening will be offered IN ADDITION to the FOBt (Faecal Occult Blood test) programme offered at 60 years. The decision was made following the results of a long term study,funded by CRUK. The research found that a single flexi-sig test, in those aged 55 to 64 years, reduced the risk of individuals dying from bowel cancer by 43% and the risk of individuals developing bowel cancer by 33%.

NHS Bowel Cancer Screening:-

For more information, you can read or download the excellent NHS leaflet on NHS bowel scope screening.
What about people in areas where the pilot isn't happening?It isn't possible to introduce a new type of screening test everywhere at the same time. If you don't live in one of the pilot areas, 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 by 2016.

 2011/12 development year for Flexi-sig (pdf)

•2012/13 piloting of Flexi-sig
•2013/14 first wave roll out of Flexi-sig
= 30% country open by 31 March 2014
•2014/15 second wave roll out of Flexi-sig
= 60% country open by 31 March 2015
•2016 roll out complete

•“Opt-in” for those aged 55 -59 

Self referrals (Opt ins)•Registered with GP linked to SC offering FS Screening
•Age 56-59 inclusive 

Introduction of flexible sigmoidoscopy screening into the NHS Bowel Cancer Screening Programme

Introduction of flexible sigmoidoscopy screening into the NHS Bowel Cancer Screening Programme

I phoned 0800 707 60 60 today about access to flexible sigmoidoscopy. I was advised it had been rolled out in some parts of Surrey and Kent only. She suggested I call back later in year about Dorset rollout or ask my GP to authorise the test or contact them for further details.

New campaign focuses on benefits of bowel screening

reposted from: http://info.cancerresearchuk.org/news/archive/cancernews/2011-01-19-New-campaign-focuses-on-benefits-of-bowel-screening-?rss=true

crabsallover highlights, key points, comments / links.

New campaign focuses on benefits of bowel screening

Wednesday 19 January 2011

A new campaign aims to save lives by encouraging people to take part in the NHS Bowel Cancer Screening Programme.

The 1,2,3 campaign - launched by the charity Beating Bowel Cancer and fronted by TV doctor Chris Steele - urges people to learn three simple steps that could save their life.

It includes a short film showing people how to complete the faecal occult blood (FOB) test, which is sent to all men and women between the ages of 60 and 75 in England to be completed at home.

Screening is also available to people aged 60 to 69 in Wales; and those between the ages of 50 and 75 in Scotland.

The test requires a small sample of bowel motions to be collected on a test card on three separate days. The card is then returned to the screening centre by post and analysed for tiny amounts of blood, which could indicate a need for further investigation.

It is hoped that the film, which can be viewed on the campaign website, will help to boost participation rates and reduce the number of deaths from bowel cancer - the UK's second leading cause of cancer death.

Ed Yong, Cancer Research UK's head of health information, said: "Bowel screening is one of our best weapons in the fight against bowel cancer with the potential to save thousands of lives each year. We know that people from poorer backgrounds are less likely than richer people to accept their bowel screening invitations. We urge all men and women in the eligible age groups to seize the opportunity for their free bowel screening tests."

Professor Julietta Patnick, director of the NHS Cancer Screening Programmes, said that the test aims to pick up bowel cancer at an early stage in people with no symptoms, when treatment is more likely to be effective.

"We urge all men and women to accept their bowel screening invitations and advise that you speak to your GP if you are concerned about any symptoms," she added.

Mark Flannagan, chief executive of Beating Bowel Cancer, revealed: "Bowel cancer screening tests are sent free of charge to everyone aged 60-75 in England, but currently only around half are being returned. This partly explains why more than 40 people die from bowel cancer every day.

"We have launched the 1,2,3 campaign to give people the confidence to complete the screening test when it arrives on their doorstep. If everyone took up screening when given the chance, bowel cancer would no longer be the UK's second biggest cancer killer."

Reference

• http://www.bowel123.co.uk/

Over 40? Consider taking a daily aspirin.

reposted from: http://www.mohammeddewji.com/blog/?p=27573&cpage=1#comment-86704

crabsallover highlights, key points, comments / links.

I've covered the Peter Rothwell research into aspirin over the past couple months.


From Moblog:-

The whole approach to aspirin is likely to change over the next few years. Currently people take it to prevent vascular events (such as heart attacks and stroke) but it is likely that in five years people will be taking it to prevent non-vascular diseases like cancer as well.

The drug, which is over 110 years old, was originally formulated as a painkiller but researchers are increasingly finding new benefits for it in diseases ranging from heart disease to dementia.

Prof Rothwell, of the John Radcliffe Hospital and Oxford University, said the trials looked at the benefits of taking aspirin for five years but he suspects the effect of taking it for longer would ‘undoubtably be much larger’.

The Department of Health has announced that pilots of a new colorectal screening programme will start next year in people using a scope to look for changes in the bowel that could signal cancer. Prof Rothwell said use of aspirin would dovetail perfectly with the new programme as the drug prevents more cancers at the top of the bowel which will not be detected by the screening test. Other experts have now called for guidelines to be drawn up on how aspirin should be used to prevent cancer.

Dr Robert Benamouzig and Dr Bernard Uzzan, of the Avicenne Hospital, in Bobigny, France, wrote in an accompanying editorial: “This interesting study could incite clinicians to turn to primary prevention of colorectal cancer by aspirin at least in high risk-populations. Specific guidelines for aspirin chemoprevention would be the next logical step.”

Mark Flannagan, Chief Executive of Beating Bowel Cancer said: “These are very positive results. This was a big study over a long period of time and reinforces the message that aspirin may be important in significantly reducing the number of cases and deaths from bowel cancer.

“The results suggest that taking aspirin in conjunction with a healthy diet and lifestyle might reduce your risk of developing bowel cancer. However, anyone considering starting a course of medication should first consult their GP.

“As Professor Rothwell suggests, a low dose of aspirin may fit well with the flexible sigmoidoscopy screening programme that will be launched by the Government next year. We will have to see how these results might be considered during the roll out of flexible sigmoidoscopy.”

UK National Screening Committee (UK NSC) statement on flexible sigmoidoscopy

reposted from: http://www.screening.nhs.uk/cms.php?folder=3014

Flexible sigmoidoscopy  

For immediate release (29 October 2010)

Dr Anne Mackie, UK NSC Director of Programmes, said:

“We welcome the Government’s commitment to invest in new, effective screening methods.  Initial indications suggest that flexible sigmoidoscopy could be a valuable technology and it is important that we research its effectiveness in a timely way.

“Any new screening methodology needs to be rigorously investigated.  Research has been commissioned to model how screening using FS might work in practice as part of the bowel cancer screening programme.  The UK National Screening Committee will investigate these issues in full at its next meeting in November, and final recommendations to Ministers will be made in Spring 2011.”

Professor Julietta Patnick CBE, Director of the NHS Cancer Screening Programmes said:

We’re excited by the coalition’s commitment to introduce flexible sigmoidoscopy for bowel cancer screening if it is recommended by the National Screening Committee. The addition of flexible sigmoidoscopy will allow us to build on the great success of the existing bowel cancer screening programme. If recommended, we will be busy over the next few months developing the processes and QA procedures that will be needed in order to deliver this new service safely and effectively.

Ends

Notes to editors

1.  The UK National Screening Committee

The UK National Screening Committee is chaired by the Chief Medical Officer for Scotland and advises Ministers and the NHS in all four UK countries about all aspects of screening policy and supports implementation. Using research evidence, pilot programmes and economic evaluation, it assesses the evidence for programmes against a set of internationally recognised criteria. Assessing programmes in this way is intended to ensure that they do more good than harm at a reasonable cost.

2.  UK NSC research into flexi sig

At its meeting on 16 June the UK NSC received a verbal update on the FS trial and was informed that the results of the trial were very positive.  The Committee welcomed the research, but identified a number of issues that required further investigation.  This additional work will allow the UK NSC to make a full assessment of all the available evidence against its criteria, before making a final decision.

The issues requiring further investigation are: 

• The need for further modelling to assess the impact of introducing a screening programme for bowel cancer using FS (include taking account of all available international evidence)
• The age at which the screening would be most effective to screen (the trial participants were between 55 and 64 years)
• The acceptability and uptake of the test in the general population (the trial population had all indicated before entering the trial that they would take up a screening invitation)
• The clinical management of people identified as requiring long term surveillance, the size of this group, and the resources involved
• How it would fit in with the current bowel cancer screening programme.

Modelling work to address these questions is being taken forward by the School for Health and Related Research (ScHARR) at the University of Sheffield, and is due to report in late October, ahead of the next UK NSC meeting in November. 

3. The bowel cancer screening programme

The NHS Bowel Cancer Screening Programme started rolling out in July 2006 and achieved nationwide coverage by 2010.

Programme hubs operate a national call and recall system to send out faecal occult blood (FOB) test kits, analyse samples and despatch results. Each hub is responsible for coordinating the programme in their area and works with up to 20 local screening centres.

The screening centres provide endoscopy services and specialist screening nurse clinics for people receiving an abnormal result. Screening centres are also responsible for referring those requiring treatment to their local hospital multidisciplinary team (MDT).

4. The UK NSC review process

A national screening programme is established only if certain conditions are met. These include having an accurate and acceptable screening test, being able to provide treatment and advice for people who are found to have  a particular condition, and making sure the screening programme does more good than harm to those who are screened.

Government announces new 'Flexi-scope' bowel screening test

reposted from: http://info.cancerresearchuk.org/news/archive/cancernews/2010-10-05-Government-announces-new-Flexi-scope-bowel-screening-test
crabsallover highlights

Tuesday 5 October 2010

The government has announced a revolutionary new bowel cancer screening test, after a 16-year clinical trial, co-funded by Cancer Research UK, revealed that it could save up to 3,000 lives a year.

Flexible sigmoidoscopy (also known as the 'Flexi-scope' test) involves placing a thin, flexible tube into the rectum and lower bowel. The tube has a tiny camera and light on the end, allowing the endoscopist to look at the inside wall of the bowel and remove any small growths or 'polyps'.

These symptomless growths can sometimes develop into bowel cancers, so removing them at an early stage can help to prevent the disease from developing. The test can also be used to detect existing bowel cancers so that the patient can receive the appropriate treatment.

A 16-year clinical trial, co-funded by Cancer Research UK and published in the Lancet medical journal earlier this year, revealed that 10,000 people each year will avoid bowel cancer as a result of incorporating the Flexi-scope test into the national bowel screening programme.

The study also suggests that deaths from the disease will drop by almost half (43 per cent) among those who attend screening.

Now, the government has confirmed that a £60 million investment will enable the test to be rolled out nationwide over the next four years.

The announcement was made as part of a wider action plan to deliver better outcomes for patients through earlier diagnosis and faster treatment.

Health secretary Andrew Lansley said: "I want the NHS to deliver cancer survival rates comparable to the best in the world.

"We're going to introduce an exciting new screening test for bowel cancer which could save up to 3,000 lives a year. We have secured the funding for a four-year roll out and will, subject to the green light from the UK National Screening Committee, begin pilots from spring next year."

Harpal Kumar, Cancer Research UK's chief executive, welcomed the government's decision to introduce the Flexi-scope test and said that it needs to be rolled out as quickly as possible.

"The recent trial results of this method of detecting and removing polyps before they develop into bowel cancer can truly be called a breakthrough," he said. "We believe it could cut the number of cases of bowel cancer by a third and deaths from the disease by almost half (43 per cent) among those attending screening - thousands of lives every year.

"Because it will prevent so many cancers, adding this test to the bowel screening programme will spare tens of thousands of families the anxiety and suffering associated with a cancer diagnosis, while also saving the NHS money. This procedure offers us a tremendous opportunity to push bowel cancer down the league table of cancer cases in the UK."

As well as introducing the Flexi-scope test, the government also plans to invest £50 million in additional cancer drugs this year, provide funding for an extra 1,200 cancer specialists by 2012 and expand the health service's radiotherapy capacity.

A £10.75 million awareness campaign will also focus on the signs and symptoms of breast, lung and bowel cancers.

Reference

• BBC - Andrew Marr interview with David Cameron (transcript)

"We’re delighted the Government has committed to improve bowel screening" Cancer Research UK

reposted from: http://scienceblog.cancerresearchuk.org/2010/10/04/were-delighted-the-government-has-committed-to-improve-bowel-screening/ This entry was posted on Monday, October 4th, 2010


Crabsallover blogs about bowel cancer - Flexi-scope.

Bowel screening will save lives

We don’t often talk about ‘breakthroughs’ at Cancer Research UK – science can be a slow moving and painstaking process. But every now and again researchers make a discovery that has the potential to immediately start saving lives.

In April this year, the results of a trial were published in the Lancet which universally excited the cancer research community. The trial, which had taken 16 years to carry out, and which we’d helped to support, showed that a new bowel screening technique – known as Flexi-Scope – could both reduce the risk of dying from bowel cancer and prevent the disease from developing in the first place.

We covered the trial on this blog, and many of you left comments sharing your excitement and optimism about the discovery.

Today, David Cameron announced on the Andrew Marr show that Flexi-Scope is to be included in the NHS Bowel Screening Programme. This is fantastic news. We believe that the technique has the potential to cut the number of cases of bowel cancer by a third, and cut deaths from the disease by almost half (43 per cent) among those attending screening.

This could save thousands of lives every year, and push bowel cancer down the league table of cancer cases in the UK.

But the work’s not over – we now need the Government to commit to rolling the programme out across the NHS as quickly as possible, and to ensuring proper training and resources.

Any unnecessary delay will cost lives.
Henry

October 3rd 2010 - David Cameron announces extra £164M on Flexi-scope bowel cancer screening

reposted from: http://news.bbc.co.uk/1/hi/programmes/andrew_marr_show/9055402.stm
October 3rd 2010. crabsallover highlights. Crabsallover blogs about bowel cancer - Flexi-scope.

DAVID CAMERON:

... the NHS budget is going to grow in real terms every year during the life of this government. And that means we're able to not just leave it as it is; we are going to improve it. I mean take cancer. Today we're announcing that actually we're going to be spending another £164 million on cancer provision and really updating and improving our screening processes, particularly on bowel cancer, which can save 3,000 lives a year. And I think it's very important as we take the country through what are difficult decisions, to say look there are some things that are so important to families - like my family, like the thousands of families watching this programme - and the NHS is one of those things.

ANDREW MARR:

(over) If we were as good at curing cancer as the average European country, about 5,000 to 10,000 people in this country who die would live a year.

DAVID CAMERON:

That's right.

ANDREW MARR:

Can you say that you intend to close that gap?

DAVID CAMERON:

I absolutely want to close that gap. And I think the announcement today is part of that because we're dealing with one of the problems, which is screening people when they get to about our age. We need more screening. We've got to make sure …

ANDREW MARR:

We won't go into the nasty details, thank you.

DAVID CAMERON:

Alright, we won't go … (laughs) The flexi sigmoidoscopy, I think it's called, but I won't go into the details of where the camera goes.

ANDREW MARR:

Thank you.

DAVID CAMERON:

But if we look at that. And also the other thing is the early warning signs. The truth is we're never going to get to the best in Europe levels of cancer unless we recognise the symptoms earlier and treat people earlier. And so it's not just money. This is about how well GPs do the job, and we need to improve that as well.

Digital camera 'Flexi-Scope' could save 3000 deaths in UK from bowel cancer each year

reposted from: Cancer Research UK blog http://scienceblog.cancerresearchuk.org/2010/04/28/new-study-marks-major-advance-in-bowel-cancer-screening/

crabsallover highlights in bold red. I first reported Flexi-scope research in May 2010 when it was announced.

"New study marks major advance in bowel cancer screening" Cancer research UK

A new one-off bowel test could reduce deaths by 40 per cent (click to enlarge)

What if having your bowel investigated with a tiny camera – just once – could greatly reduce the risk of dying from bowel cancer and of developing the disease in the first place? Striking new results from an important study show that this is very real possibility. We don’t often use the word breakthrough – but this is one of those rare occasions. 

Thousands of people could be saved from developing bowel cancer because of this test and thousands more could be diagnosed early when treatment is most effective.

As Harpal Kumar, our Chief Executive Officer, said, “This is one of the most important developments in cancer research for years.”

For the past 16 years, Professor Wendy Atkin from Imperial College London has been coordinating a trial of a test called flexible sigmoidoscopy or, more commonly, ‘Flexi-Scope’. It involves a tube called an endoscope, which has a tiny camera and light at the end of it.

Cancer Research UK is proud to have supported much of Professor Atkin’s work, including part-funding this trial. Doctors can use a Flexi-Scope to look for cancers in the bowel – or for early signs of the disease’s development. As with many cancers, early detection is vital for bowel cancer, and over 9 in 10 people will survive their disease for more than five years if it is diagnosed at the earliest stage.

But there’s a lot of potential for preventing the disease too. Most bowel cancers develop from symptomless growths called ‘polyps’ or ‘adenomas’. If doctors can find these, they can remove them before they have a chance to develop into cancer. This is a painless procedure and is usually quick, adding on a matter of minutes to the time needed to do the test itself.

For these reasons, Flexi-Scope could be a great way of screening people for bowel problems, and detecting or preventing cancer. But, as with any screening programme, we needed some hard evidence that it would actually save lives. Professor Atkin’s new results, published in the Lancet, show just that, and they are very promising.

What did the trial show?

Professor Atkin’s team recruited over 170,000 people to the trial, a third of whom were invited for one-off screening using Flexi-Scope. Just over 70 per cent of those invited chose to attend and, all in all, the teams screened 40,674 people.

She found that for people aged between 55 and 64, a one-off Flexi-Scope examination reduced people’s chances of developing bowel cancer by a third, compared to a control group who weren’t screened. It also reduced the death rate from bowel cancer by 43 per cent.

All in all, Prof Atkin showed that for every 1,000 people who are screened, 5.2 cases of bowel cancer can be prevented and two deaths could be avoided. Put another way, you would need to screen 191 people to prevent one case of bowel cancer and 489 people to prevent one death. And these figures can only get better with time.

But the figures are only half the story. We also need to consider the size of the prize. Bowel cancer is the third most common cancer in the UK and more than 100 people are diagnosed every day. Death rates have been falling in the past four decades, but the disease still kills around 16,000 people every year.

The prospect of preventing such a common disease that costs so many lives is extremely exciting. Doing so with a one-off five-minute test, whose benefits last for at least 11 years, is even better.

Based on the data, Prof Atkin conservatively estimates that the one-off screen could prevent at least 5,000 people from being diagnosed with bowel cancer and at least 3,000 people from dying from the disease.

To put that into perspective, official figures from the NHS Breast Screening Programme say that breast screening saves 1,400 lives a year in England. That figure is controversial but even so, adding Flexi-Scope to the existing national bowel screening programme could save twice as many lives.

A different screening programme?

The UK already has a bowel screening programme. It uses a different test called the “faecal occult blood test” or FOBT, which looks for hidden traces of blood in stools. In England and Wales, people are invited for screening between the ages of 60 and 69. They are sent a kit to use in the privacy of their own homes, and results are sent to a lab for testing.

The FOBT is also an effective way of screening for bowel cancer. Trials have found that it can reduce death rates from the disease by around 25 per cent, and countries all over the world have used it as the basis of bowel cancer screening programmes. However, Prof Atkin’s latest results suggest that the Flexi-Scope is even more effective. And, crucially, it can prevent bowel cancer as well as detecting it after it has appeared.

The two tests should complement each other well. The Flexi-Scope can only scan the lower part of the bowel. It won’t be able to detect polyps or cancers in the upper reaches, so the FOBT still has a role in detecting early cancers there.

The Flexi-Scope test is currently available in the UK, but only for people with symptoms or after a referral from a GP or specialist. Based on the new results, this could change in the future.

In fact, Cancer Research UK thinks the findings are so promising that we are calling on the UK governments to incorporate the Flexi-Scope as part of the national screening programme for bowel cancer alongside the FOBT test.

We think the Flexi-Scope test should probably be offered to people from their late 50s. This is because most polyps appear in the lower bowel before the age of 60 and slowly develop into cancer over the next few decades.

Will it be acceptable?

A key question is whether people will accept the new test. The signs suggest they will. In an earlier study of 4,400 people who went through Flexi-Scope screening, Prof Atkin showed that virtually all of them were glad they had the test and were satisfied with the procedure. Meanwhile, 91 per cent reported mild or no pain, and 97 per cent said they felt little or no embarrassment.

The risks of the test appear to be small. Removing a polyp can cause a small amount of bleeding and there is around a 1 in 50,000 chance that the tube can tear the bowel. There isn’t really a risk of a false-positive, because doctors can only detect and remove polyps if they are there.

And to top off the good news, the Flexi-Scope test could be very cost-effective, especially since it only needs to be done once in an 11 year span. The test’s costs would probably be outweighed by the fact that fewer people need to be treated, and treatments are cheaper for early-stage cancers. In 2006, a study commissioned by the UK Department of Health suggested that a Flexi-Scope screening programme would actually save £28 for every person who was screened.

Of course, Prof Atkin says that there are many practical choices that would affect these calculations, and they would need to be repeated using data from the actual trials. There’s also the pressing need to train people with the endoscopes if Flexi-Scope becomes more widely used.

The new results have closed the door on 16 years of research and opened new and exciting ones. The big question now is whether the country will step through them.

Ed

More from Cancer Research UK:

• Information for people affected by bowel cancer
• Video – How to spot bowel cancer early
• Bowel cancer – key facts
• Support a bowel cancer research project
• Our current research on bowel cancer
• Bowel cancer awareness leaflet (pdf)

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Reference:

Atkin W et al (2010). Once-only flexible sigmoidoscopy screening in prevention of colorectal cancer: a multicentre randomised controlled trial The Lancet :10.1016/S0140-6736(10)60551-X