Bowel cancer screening

The efficacy of colorectal cancer screening has been proven by randomized control trials. England is one of several countries that have commenced population screening. The structure and philosophy of the NHS facilitates comprehensive reach to the target population. Screening for colorectal cancer commenced in England in July 2006 and implementation for all 60–69 year olds is expected to be completed by the end of 2009. The programme is currently available on request to those 70 years of age and above and invitations for screening will be extended up to 74 year olds from 2010. The NHS Programme currently uses a guaiac-based faecal occult blood test and a complex testing algorithm which can require the participant to provide a total of 18 samples from nine stool samples. The positivity of the test in the South of England is 1.63% with 58% of the population responding to the test invitation. Colonoscopy is provided by registered Screening Colonoscopists from local accredited Screening Centres. 12% of those who have a colonoscopy are diagnosed with cancer, 13% with high-risk lesions and only 28% show no abnormality at all. All elements of the screening process are recorded on a national screening database that is used for programme organization and quality assurance purposes.