THE BLOG

A Screening Programme FIT For Purpose

02/04/2015 09:52 BST | Updated 31/05/2015 10:59 BST

Every day I hear about the fear and devastation bowel cancer brings to families all over the UK.

Claiming more lives than either breast or prostate cancer, it is currently the UK's second biggest cancer killer, yet it shouldn't be.

Early diagnosis is the key to saving lives with nine out of ten people surviving if the disease is diagnosed at its earliest stage.

However early diagnosis is also a big challenge, because the symptoms can be vague, the age range of people affected is broad and both men and women can develop the disease.

With one or two notable exceptions, such as genetic conditions like Lynch Syndrome, we also don't really know who is at risk, apart from some broad categories such as older people or people with an inflammatory bowel condition for more than ten years.

That is why a population based screening programme is so important.

Since its introduction, the NHS bowel cancer screening programme has been shown to be the most effective method of detecting bowel cancer early. Not only does screening pick up bowel cancer in the earliest stage of disease, it can also detect dangerous polyps which may develop into bowel cancer.

Around 50% of people detected through screening are at these early stages. This is significantly higher than national figures, where only 18% of people diagnosed with bowel cancer are at the earliest stage of the disease, Stage 1.

However the current faecal occult blood test (FOBt) used in screening - which looks for hidden traces of blood in stools - has been shown to be effective, but it is not flawless. The test has been shown to miss a large number of cancers and uptake is worryingly still too low - just over 50% across all 4 nations. In some areas, such as East London, it is as low as 34%.

At the recent National Awareness and Early Diagnosis conference, ground breaking results were published by the Bowel Cancer Screening Hubs and Queen Mary University of London following pilots of a new faecal immunochemical test (FIT).

FIT has a number of advantages over the current FOBt:

1. FIT is a simpler and therefore more 'acceptable' test. The FOBt requires individuals to take three separate stool samples within 14 days whereas FIT only requires one stool sample.

2. FIT increased participation by nearly 10% amongst all groups. But importantly it was significantly higher in those who have previously not participated in the screening programme (26.6% vs 14.5% for FOBt), first time invitees (61.4% vs 50.2%) and across all quintiles of deprivation. It also increased participation in men who traditionally have had a lower uptake of bowel screening but have a higher risk of the disease.

3. FIT is a more accurate and sensitive test than the FOBt and is therefore likely to detect more cancers or pre-cancerous polyps. In fact the pilot showed that FIT had a positivity of 8% compared to 2% for FOBt.

Bowel Cancer UK has backed the introduction of FIT, beginning with this pilot phase, for many years and now the evidence to support its introduction is overwhelming. With survival rates for bowel cancer already lagging behind much of Europe (where the FIT test is widely used) and other developed nations, we must not slip further behind.

We were delighted by Scotland's recent announcement that it planned to introduce the test over the next two years and now urge the rest of the UK to do the same. 16,000 people are dying every year in the UK of bowel cancer, this test can help us change that and should be introduced as a matter of urgency.