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Bowel Cancer Screening

Introduction

Bowel cancer is the second commonest cause of cancer death in the UK. Bowel cancer is also known as colorectal cancer. It includes cancer of the colon and rectum. The first thing that develops is usually a small growth in the lining of the bowel called a polyp or an adenoma,. Over a period of up to 10 years, this transforms into cancer which can then grow through the muscle wall and spread to other parts of the body.

Bowel Cancer Screening

According to Cancer Research UK, 95% of men and almost 100% of women are likely to survive bowel cancer if it is caught in the early stages. However, if the disease is left to develop to an advanced stage (stage 4), the chance of surviving for another five years reduces to 5% for men and 10% for women. Therefore, it is vital that we catch this disease early.

Causes and symptoms

The cause of many types of cancer is not known, but certain factors such as older age, smoking, alcohol, diet as well as a medical history of cancer as well as a family history of cancer can increase the risk of developing bowel cancer.

Patients with bowel cancer may experience any of the following:

  • abdominal pain
  • change in bowel function – particularly to looser motions
  • blood in stool
  • unintended weight loss
  • loss of appetite
  • bloating
  • fatigue
  • nausea and vomiting.
Who is screening for?

Screening for bowel cancer is an effective means of detecting the disease in its early and most curable stages and preferably before the cancer has even started when there are small polyps which can be easily removed. Most people do not realise that polyps are common and are very easy to remove. Between one in four and one in five people over the age of 50 have important pre-cancerous polyps. Not all of these will become cancerous, but early removal significantly reduces the chance of cancer developing.

The world-leading American College of Gastroenterology recommends screening every 10 years for all those over the age of 50. If you have a family history of colorectal cancer, or you have symptoms such as abdominal pain, blood in your stool, or a change in bowel habits which lasts for more than 3 weeks, you should consider more frequent screening starting at an earlier age.

How does our screening programme work?

Our private screening programme typically comprises three stages: an initial consultation in a private hospital, a colonoscopy in a dedicated private endoscopy suite and a follow-up appointment.

At the initial consultation, you will meet with one of our specialist gastrointestinal consultant to discuss your medical history, lifestyle and family background. The doctor will also explain about how to prepare for your colonoscopy and will check that the test is suitable for you.

Preparation involves taking a laxative medicine which clears the bowel so that it is easy to inspect. The colonoscopy is a routine procedure which involves examining the colon through a flexible tube called a colonoscope. The colon will be gently inflated to enable the doctor to inspect the bowel lining. If the doctor spots any polyps or other abnormalities a small sample (biopsy) will be removed safely and painlessly and sent to a laboratory for further testing. Most patients chose to be sedated throughout the procedure so there should be minimal pain or discomfort. The entire procedure usually takes less than 30 minutes although you should expect to be in hospital for 2-3 hours in total.

After the procedure, you will be invited to a follow-up appointment with the doctor to discuss the results of your colonoscopy and any biopsy samples that have been investigated in the laboratory.

How is this different from UK Bowel Cancer Screening Programme run by the NHS?

The NHS provides a Faecal Occult Blood (FOB) home test to people who are registered with GPs between the ages of 60‑74 in England and Wales and 50-74 in Scotland,. This test looks for hidden blood in the stool (poo) – which may indicate bowel cancer. The FOB test involves smearing poo on a card three times over a two-week period. If it is positive, patients will be offered a colonoscopy. The FOB test will not pick up potentially cancerous polyps which aren’t causing bleeding. In fact, it is estimated that it picks up less than 30% of polyps. It is therefore better as a test to detect people who already have cancer than a test for people who might develop cancer. The FOB test also isn’t cancer specific and can give false positives – indicating blood in the stool from non-cancerous sources such as haemorrhoids. FOB is particularly problematic in people who have symptoms, such as change in bowel habits, weight loss etc. If you would like to read more on the problems with the NHS Bowel Cancer Screening Programme see here.

Our colonoscopy screening has been shown to be far more effective in correctly identifying and diagnosing bowel cancer at an early stage.

The NHS has recognised that FOB testing is not ideal and now offers ‘Bowel Scope’, a once-in-a-lifetime screening test at the age of 55. This is not a full colonoscopy but rather a partial colonoscopy. It looks only at one side of the colon. It can detect just over half the polyps made in the bowel but as it does not look at the other half of the bowel, it misses all the rest of the polyps. It also is not repeated so polyps that develop after the age of 55 will not be detected with this test.

Is it covered by my insurance?

If you have private medical insurance and have any symptoms, you are likely to be reimbursed in full by your insurer. Otherwise you can fund the screening yourself. The exact cost depends on the doctor and hospital you choose to have the procedure with. You should expect the total cost for the initial consultation, the colonoscopy and the follow-up appointment to be in the region of £2,000. Please note that this is a private service and not covered by the NHS.

What happens after a colonoscopy?

After the colonoscopy, you will be invited to a follow-up appointment with the doctor to discuss the results of the procedure and any biopsy samples that were taken.

If you are given the all clear, you will be advised as to how long you should wait until your next screening, usually 10 years.

If any polyps were found and removed we will advise you on how long you should wait until your next colonoscopy in line with the state of the art national screening guidelines.

In the unlikely event that the colonoscopy and biopsy results indicate that you have bowel cancer you will be given clear advice about how to proceed, which tests are required for further diagnosis and what treatment options are available to you. We can organise all the relevant tests and ensure you receive the very best care available. Thankfully, when we do detect bowel cancer, it is usually at an early and curable stage. And even better, most polyps have not become cancerous at the time we remove them.

Remember, screening saves lives. Please call us to arrange your appointment. If you have any symptoms, your private medical insurer is likely to pay for your colonoscopy.