OC-043 Outcomes of the Bowel Cancer Screening Programme in England after the first 1 million tests

Abstract

IntroductionThe Bowel Cancer Screening Programme (BCSP) in England was started in 2006 with the aim of full roll out across England by December 2009. Subjects aged 60–69 are being invited to complete three guaiac faecal occult blood tests (6 windows) every 2 years. Those with 5–6 positive windows on the first test or 1–4 positive windows on the first test but 1 or more positive on 2 further tests are referred for colonoscopy or other definitive investigation. The Programme aims to reduce the mortality from colorectal cancer by 16% in those invited for screening.MethodsThere is a national IT system with all patients eligible for screening in the National Health Service (NHS) in England on one database. The system is populated from NHS registration data which cover about 98% of the population of England. Call and recall is managed and data are collected via this system. Data can be analysed by local screening centre, by 5 regional hubs and at a national level. This analysis is only of subjects invited to participate in the first (prevalent) round of screening.ResultsBy October 2008 2.1 million kits despatched had been returned by 49.6% of men and 54.4% of women invited. Uptake was lower in London (40%) but in the rest of England uptake ranged between 55–60% across the other 4 regional hubs. Of the 1.08 million returning tests 2.5% of men and 1.5% of women had a positive test. 17 518 (10 608 M, 6910 F) underwent investigation (98% had a colonoscopy as the first investigation performed). Cancer (n=1770) and advanced adenomas (n=6543) were found in 11.6% and 43% of men and 7.8% and 29% of women, respectively, investigated. 71% of cancers were “early” (10% polyp cancer, 30% Dukes A, 30% Dukes B) and 77% were left-sided (29% rectal, 45% sigmoid) with only 15% being right-sided compared with expected figures of 67% and 24% for left and right side from UK cancer registration.ConclusionIn this prevalent round of screening uptake of the BCSP and FOB test positivity is in line with that from the pilot and the Nottingham and Funen trials.1 2 Although there was the anticipated improvement in cancer stage at diagnosis the proportion with left sided cancers is significantly higher than expected. Nevertheless these early results indicate that the anticipated reduction in mortality will be achieved.