The United Kingdom National Screening Committee (UK NSC) reviews the evidence for screening conditions every three years as per its published evidence review process. When bowel screening using Faecal Occult Blood testing was fully implemented in England in 2010 the Cancer Programme and the NHS Bowel Cancer screening programme assessed what the best combination of screening would be to reduce the burden of bowel cancer in England for people aged 50-75. As a result, a one off examination of the bowel at 55 followed by regular screening for blood in the stool at 60 every two years to the age of 70 (later extended to 74) was concluded to be the best combination of tests to discover, prevent and treat the most bowel cancer within existing resources.
The first test is the Bowel Scope Screening (BSS). This is a direct examination of the left hand large bowel with a camera mounted on a flexible tube. It allows a trained professional to see and remove small polyps (growths) from the bowel. If they are not removed they can slowly develop into cancer. Both men and women are invited to attend this around their 55th birthday. If people are not screened at 55, they can request BSS up to the age of 59. Evidence shows that men and women aged 55-64 attending a one-off bowel scope screening test for bowel cancer could reduce their individual mortality from the disease by 43% (31% on a whole-population basis) and reduce their individual incidence of bowel cancer by 33% (23% on a whole-population basis).
In addition to BSS, the UK NSC recommended the move to use Faecal Immunochemical Test (FIT) in November 2015 as the primary screen for bowel cancer. Evidence has shown that use of the self-sampling FIT test kit can increase screening uptake by around 10% due to the test being easier to use, more acceptable and more accurate. Introduction of FIT will result in around 200,000 more people a year being tested, potentially saving hundreds of lives. FIT will be implemented across England from April 2018.
It is expected that the introduction of FIT will have a significant and positive impact on helping us tackle bowel cancer. The acceptability and accuracy of the test will allow the programme to screen, treat and save lives from bowel cancer.