Introduction
1.1 – Policy Statement
The purpose of this document is to provide guidance for staff at Godiva Group of Practice’s in relation to the NHS Bowel Cancer Screening Programme which aims to identify bowel cancer at an early stage when treatment is more likely to be successful.
Bowel screening is an NHS national population screening programme that is available in all UK nations and invites individuals for screening for patients to receive:
- Guidance to help them to make informed choices
- Support throughout the screening process
It is the responsibility of all staff to ensure that they are aware of their individual and collective efforts to support the national screening programmes.
This document must be read in conjunction with the referenced publications and NHS screening programme guidelines. Further reading on colorectal cancer can be found at NICE guidance NG151 and DG30.
It should be noted that while this guidance document is to support bowel cancer screening, NICE guidance DG56 was updated in August 2023 to support faecal immunochemical testing for all patients who are suspected to have colorectal cancer.
Policy
2.1 – Aim
Bowel cancer is a common type of cancer in both men and women. About one in 20 people will get it during their lifetime. Screening can help to detect bowel cancer at an early stage when it is easier to treat. It can also be used to help to check for and remove small growths in the bowel called polyps which can turn into cancer over time.
The faecal immunochemical test kit, known as the FIT kit, is used for screening and will automatically be sent to the home address of eligible patients.
Staff are reminded that no screening test is 100% reliable and patients may be falsely reassured when they receive their test results. It is therefore imperative that they are advised to make an appointment to discuss any concerns they may have. This includes a family history of bowel cancer and other associated symptoms.
In addition to the screening programmes as detailed below, should patients present with suspected colorectal cancer symptoms then the care pathways as detailed within NICE guidance DG56: Quantitative faecal immunochemical testing to guide colorectal cancer pathway referral in primary care are to be followed.
2.2 – Screening In England
Screening is offered in England as follows:
- Patients aged 54 to 74 will automatically be sent a FIT kit every two years. The programme is expanding to make it available to everyone aged 50 to 74 years. This is happening gradually over four years having started in April 2021.
- Patients aged 75 or over can request a FIT every two years by calling the free bowel cancer screening helpline on 0800 707 60 60
- Patients who are worried about a family history of bowel cancer or have any symptoms must be directed to speak to a GP for advice
Guidance for patients can be found on the PHE webpage for both males and females. Furthermore, instructions in various languages on how to conduct a FIT can be found here.
Bowel Cancer Screening Process
3.1 – FIT
An invitation letter including information on the possible benefits and risks of screening followed by a FIT kit is sent to the patient’s home address. This includes instructions on how to use the FIT kit which are also available here.
This organisation will be informed of the result electronically which is usually received within two weeks of the laboratory receiving the completed test.
3.2 – Colonoscopy
A colonoscopy may be required for patients whose FIT shows they require further examination. Patients in England are automatically sent an invitation approximately two weeks before the colonoscopy. This is in letter format and includes an enema and instructions how to use it.
The whole procedure is usually completed within 90 minutes and the results are sent via letter to the patient within two weeks.
There are three outcomes:
| Result | Action |
| No polyps or cancer found | This is normal so no further action required |
| Polyps found and removed during the test but are not cancerous | · Patient may be offered a colonoscopy
· Patient may be offered surgery to remove any polyps |
| Polyps were found, removed and found to be cancerous | Patient will be referred to see a specialist as soon as possible |
It should be noted that fewer than one in 100 people are found to have cancer and for those that do, there is at least a 90% chance of survival should the cancer be found and treated early.
Further Reading and Guidance
While the delivery of the NHS Bowel Cancer Screening Programme does not directly involve primary care, this organisation can support the programme by:
- Promoting the update of screening
- Providing information on the screening process and the need for repeat screening when invited
Further reading and patient information resources are available from the following:
| Region | |
| UK | NICE guidance NG151: Colorectal cancer
NICE guidance DG56: Quantitative FIT to guide colorectal cancer pathway referral in primary care |
| England | NHS guidance |
| Scotland | NHS Inform |
| Wales | Bowel Screening Wales |
| Northern Ireland | HSCNI Bowel Cancer screening |