Bowel cancer screening and coronavirus
When you will receive a screening invitation
The bowel cancer screening programme was paused in March 2020 in response to the coronavirus pandemic.
Screening colonoscopy services were reintroduced by Trusts from June 2020, for those who had had a positive screening result and were on a waiting list for this investigation.
Routine invitations for bowel cancer screening started again from week commencing 17 August 2020, beginning with those who were due to be sent a test at end March 2020.
All routine invites will continue to be delayed by about five months until the programme has the capacity to catch up.
Completing your screening test kit
When you receive your test kit, you should follow the instructions of how to collect your sample and return it to the laboratory in the envelope provided.
What to do while you wait for your screening invite
While you wait for your invite it is important to be symptom aware. If you are concerned about symptoms of bowel cancer you should seek advice from your doctor. Symptoms may include:
- unexplained bleeding/blood in your stools
- a change in bowel habit
- pain or swelling in your abdomen
- unexplained weight loss
- unexplained tiredness
Your safety if you need further investigations
If your screening test shows traces of blood in your bowel motion, you will be asked to contact the freephone helpline on 0800 015 2514.
Appointments with the Specialist Screening Practitioner (nurse) have mostly moved to telephone appointments. A suitable time for the nurse to call you will be arranged by the helpline staff. The nurse may call from a withheld number at the time of this appointment.
The Specialist Screening Practitioner will assess your fitness for further investigations and will advise you on all the measures the Trust is taking to keep you and their staff safe at this time. The Trust will advise you of all safety requirements and instructions for attending your investigation.
When attending the hospital for any investigations you will be asked to wear a face covering, you may be asked to attend alone and you may have to wait outside until the time of your appointment.
If you have symptoms of coronavirus, or have been in contact with someone who does, you must not go to your colonoscopy appointment. Contact the Trust and let them know you have coronavirus symptoms. Your appointment can be rearranged for a time after you have isolated.
Northern Ireland Bowel Cancer Screening Programme
The bowel cancer screening programme is for people who have no signs or symptoms of bowel cancer. The programme covers all of Northern Ireland.
All people aged between 60 and 74 registered with a GP are automatically sent a screening kit every two years so you can do the test at home. You should make sure your GP has your correct contact details.
The home screening kit is used to collect a small sample of bowel motion. This is sent to a laboratory to be checked for tiny amounts of blood that you can’t normally see. If the test detects some blood, it does not mean you definitely have bowel cancer.
Other possibilities include:
You will need to have further tests to find the cause. The bowel cancer screening programme will arrange this for you.
Bowel cancer screening process
Screening involves collecting a sample of your bowel motion.
Follow the instructions in the leaflet that comes with your screening invitation. You then send the test kit to the screening laboratory in the provided prepaid envelope.
You can view the information leaflet and watch an animated video on how to complete the bowel cancer screening test at the links below.
- How to take the bowel screening test - leaflet
- How to take the bowel screening test - animated video
Post your completed test kit as soon as possible. Delays in returning your kit may prevent the sample from being processed. You should receive your results within two weeks.
The test used within the bowel cancer screening programme has recently changed. The new test is called a Faecal Immunochemical Test (FIT). This test is easier to use and is better at detecting individuals who require further investigations.
This test is different to the previous test in that it looks specifically for human blood within your bowel motions. The previous test detected blood from any source, and therefore sometimes may have been affected by dietary factors.
If you have recently completed a bowel screening test before this change in the test you do not need to repeat your bowel screening test. You will be invited to take part in the screening programme again every two years while you are in the eligible age range.
When is screening offered
Screening is only offered to people aged 60 to 74. Eight out of ten people who get bowel cancer are over the age of 60.
Screening is not available to people outside of the age range. If you have a family history of bowel cancer or are worried about symptoms or changes in your bowel movements you should make an appointment with your GP.
Limitations of bowel cancer screening
Screening can’t tell if you have bowel cancer. It divides people who have been screened into two groups:
- those who need more tests
- those who don’t
No screening test is completely reliable. Not everyone who has bowel cancer experiences bleeding, so there is a chance a cancer could be missed. If you are concerned about bowel cancer symptoms, you should contact your GP, even if your last screening test was negative.
There is also a small risk that some of the further tests you might have after a positive screening result could damage your bowel, but this is rare. There are no risks to your health from the home testing kit.
People who may not need bowel cancer screening
You may not need to complete the bowel cancer screening test if you:
- have had your large bowel removed
- have had a routine colonoscopy or a CT colonoscopy within the last 12 months
- are on a bowel surveillance programme
- are currently being treated for bowel cancer
- are currently awaiting bowel investigations
If you think you are in any of these categories and you receive a test kit, contact the Bowel Cancer Screening freephone helpline on 0800 015 2514 for advice.
Helping someone else complete the test
If you take care of the toilet needs of a person with a physical disability you can help them complete the test.
Before helping them you should make sure:
- they have asked for your help
- they understand the screening process (including colonoscopy)
- they don’t have a medical condition which means they shouldn’t be screened
If you take care of someone who does not have the capacity to give their consent to take part in screening, you should speak with the person’s GP to decide if screening is in their best interests.
Bowel cancer screening results
For most people, the result will suggest that no further investigations are needed at this time. In this case, routine screening will continue to be offered to you every two years until you reach the age when screening stops.
For about three in every 100 people, the result will show that further investigations are needed.
This result does not mean that you have bowel cancer; it means that some blood was detected in your sample and this needs to be investigated.
You will be referred to a specialist screening practitioner (SSP) for assessment. This nurse will discuss your result with you and give you details about the next step, which is usually a colonoscopy.
A colonoscopy is a test where a thin tube (a colonoscope) with a camera at the end is inserted into your bottom to look for signs of bowel cancer. You may be offered a sedative to help you relax.
Polyps are clumps of cells that aren’t cancer but may develop into cancer over a number of years. They can usually be removed without any pain during the colonoscopy.
Any polyps or biopsies which are removed will be sent to the laboratory for examination.
Treatment after the colonoscopy
If your colonoscopy finds that you have polyps, you may be called back for a further colonoscopy in three years’ time to check that they haven’t recurred.
If the examination detects cancer, you will be referred to a specialist for further treatment. The person who does your colonoscopy will be able to answer any questions you may have.
Reducing your risk of bowel cancer
Regular bowel cancer screening has been shown to reduce the risk of dying from bowel cancer by 16 per cent.
As well as taking part in bowel cancer screening, there are some further steps you can take to reduce your risk of bowel cancer:
- eat a healthy diet - make sure you get five portions of fruit and vegetable each day, and include wholegrains, beans and pulses for fibre
- limit the amount of red meat you eat, especially processed red meat
- be active - moving more and sitting less can reduce your risk of serious illness (aim for at least 2 and a half hours each week)
- maintain a healthy weight - avoid gaining weight and try losing weight if overweight
- drink less - to keep risks to a low level, don’t drink more than 14 units of alcohol a week
- stop smoking