New bowel cancer test leads to screening rate rise

Bowel cancer cells Image copyright SPL
Image caption Scotland was the first country in the UK to introduce a bowel screening programme for adults over 50

A new, simpler test for bowel cancer has led to a significant rise in screening rates in Scotland, figures have shown.

For the first time uptake has risen above 60%, with the greatest rise among people living in deprived areas.

Scotland has one of the highest rates of the disease in the western world, resulting in about 1,600 deaths a year.

It was the first country in the UK to roll out the screening programme for all adults aged 50 to 74.

Bowel cancer is the third most common form of cancer in Scotland, with approximately 3,700 new cases diagnosed in 2017, and is the second most common cause of death due to cancer.

The Scottish screening programme was rolled out in 2007 and over the last 10 years, the incidence of the disease and deaths have fallen in both men and women.

'Significant rise'

A new, simpler test was introduced in 2017 and uptake has risen from 55.4% to 63.9%, the first time national uptake has been higher than the standard of 60%.

The new figures were welcomed by cancer charities.

Gordon Matheson, from Cancer Research UK, said: "This report is good news in that we're seeing a significant rise in screening uptake in the first year since this new test was introduced.

"Screening for bowel cancer saves lives, and the new test has helped make it easier for people to take part. This is encouraging because detecting cancer at an early stage means it's more likely to be treated successfully.

"To ensure the programme's continued success as demand grows, the Scottish government must ensure that staff shortages in cancer services are addressed, particularly those who help detect cancer such as endoscopists and pathologists."

Image copyright NHS Health Scotland
Image caption The new kit identifies more people with pre-cancerous growths

The new test, called FIT - faecal immunochemical test - is completed at home with a kit sent to all eligible adults. This involves collecting one sample from a bowel movement.

It replaced an earlier test, FOBT - Faecal Occult Blood Test - which was introduced to identify cancer before symptoms occurred, making treatment more effective.

The new figures show uptake of people in more deprived areas remains low (51.7%) compared to people from less deprived areas (72.5%).

However, the increase in uptake after the introduction of FIT was greatest among people from more deprived areas.

Individuals who have a positive FIT result are referred to their local hospital for assessment and, where appropriate, offered a colonoscopy as the first line of investigation.

Bowel cancer screening can identify pre-cancerous signs in men and women who otherwise have no symptoms, meaning abnormalities can be investigated and treated.

Treatment at this stage is usually very effective, but clinicians stress screening is not 100% accurate.

The Scottish government's Information Services Division (ISD0 said the percentage of people testing positive was higher using FIT, with those referred for further investigation increasing from 1.9% - using FOBT - to 3.1%.

Positive result

Its report said: "A positive result for FIT was a better predictor of finding pre-cancerous growths (adenomas) during colonoscopy than a positive result for FOBT, with 43.5% of people who tested positive for FIT having an adenoma, compared to 40.0% for FOBT."

But it added: "A positive result for FIT was a less accurate predictor of having bowel cancer than for FOBT, with 5.2% of people who tested positive for FIT having bowel cancer, compared to 6.8% for FOBT.

"Nevertheless, more cancers were detected using FIT due to the higher uptake and higher percentage of positive tests, leading to more people proceeding on to colonoscopy."

In Scotland screening starts from age 50, but in England, Wales and Northern Ireland the eligible age starts at 60.

The UK government announced in 2018 it would bring down the screening age in England to 50.

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