Bowel cancer screening

Bowel cancer screening is offered to people aged 60 to 74 to check for bowel cancer. Screening can help detect cancer at an early stage when treatment is more effective. Screening can also check for and remove polyps which can go on to develop into cancer over time.

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 approximately 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.

The process for collecting your sample has not changed.

You should receive your screening test result within two weeks.

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. Appointments with the Specialist Screening Practitioner (nurse) have mostly moved to be telephone appointments. A suitable time for the nurse to call you will be arranged by the helpline staff.

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.

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.

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. 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.

Bowel cancer screening process

Screening involves collecting a sample of your bowel motions over three separate visits to the toilet.

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.

Once you have decided to start the process, you must complete all of the samples and post your kit within 10 days of taking the first sample.

You should receive your results within two weeks.

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 assistance
  • 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 participate in screening ,you should speak with the person’s GP to decide if screening is in their best interests.

Bowel cancer screening results

Your results will be one of the following:

  • negative (no blood present) - this is the result for the large majority of people and routine screening will continue to be offered to you every two years until you reach the age when screening stops
  • unclear - this is the result for a small number of people and you will be asked to take another test to provide better results
  • positive (blood has been detected) - this is the result for approximately 3 in every 100 people

If you have a positive result 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

Colonoscopy examination

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.

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