Uptake trends in the Scottish Bowel Screening Programme and the influences of age, sex, and deprivation

Quyn, Aaron; Fraser, Callum G.; Stanners, Greig; Carey, Francis A.; Carden, Claire; Shaukat, Aasma; Steele, Robert

doi:10.1177/0969141317694065

Cited by 25 publications

(24 citation statements)

References 27 publications

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“…Within 6 months of making FIT available, around two-thirds of all referrals to secondary care submitted FIT samples. The uptake of FIT in this symptomatic population proved better than the uptake of gFOBT in the Scottish Bowel Screening Programme in our region,22 suggesting good patient acceptability. Knowledge of f-Hb was of benefit to the gastroenterologists.…”

Section: Discussionmentioning

confidence: 65%

Impact of introducing a faecal immunochemical test (FIT) for haemoglobin into primary care on the outcome of patients with new bowel symptoms: a prospective cohort study

Mowat

Digby

Strachan

et al. 2019

BMJ Open Gastroenterol

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ObjectiveTo determine whether a faecal immunochemical test (FIT) for faecal haemoglobin concentration (f-Hb) can be safely implemented in primary care as a rule-out test for significant bowel disease (SBD) (colorectal cancer (CRC), higher risk adenoma (HRA) and inflammatory bowel disease (IBD)) when used as an adjunct to the clinical assessment of new bowel symptoms.DesignSingle-centre prospective cohort study of all patients who attended primary care and submitted a FIT in the first calendar year of the service beginning December 2015. f-Hb was estimated using HM-JACKarc (Kyowa Medex) with a clinical cut-off of ≥10 µg Hb/g faeces. Incident cases of CRC were verified via anonymised record linkage to the Scottish Cancer Registry.Results5422 patients submitted 5660 FIT specimens, of which 5372 were analysed (positivity: 21.9%). 2848 patients were referred immediately to secondary care and three with f-Hb <10 µg/g presented acutely within days with obstructing CRC. 1447 completed colonoscopy in whom overall prevalence of SBD was 20.5% (95 CRC (6.6%), 133 HRA (9.2%) and 68 IBD (4.7%)); 6.6% in patients with f-Hb <10 µg/g vs 32.3% in patients with f-Hb ≥10 µg/g. One CRC was detected at CT colonoscopy. 2521 patients were not immediately referred (95.3% had f-Hb <10 µg/g) of which four (0.2%) later developed CRC. Record linkage identified no additional CRC cases within a follow-up period of 23–35 months.ConclusionIn primary care, measurement of f-Hb, in conjunction with clinical assessment, can safely and objectively determine a patient’s risk of SBD.

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Section: Discussionmentioning

confidence: 65%

Impact of introducing a faecal immunochemical test (FIT) for haemoglobin into primary care on the outcome of patients with new bowel symptoms: a prospective cohort study

Mowat

Digby

Strachan

et al. 2019

BMJ Open Gastroenterol

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“…Although women are more likely to accept an invitation to screening using gFOBT, they seem to benefit less as the number needed to screen to detect a CRC is higher in women than in men at all ages [ 62 ]. In part, this can be explained by the discrepancy in incidence between the sexes at the screening ages, but it is also now well established there are more interval cancers in women, indicating that gFOBT is less sensitive in women than in men [ 63 ].…”

Section: Discussionmentioning

confidence: 99%

“…For instance, variation in the uptake of screening and CRC outcomes have previously been attributed to ethnicity and the individual’s socio-economic circumstances [ 92 – 96 ]; this was not able to be determined from our data. However, previous studies on screening uptake have demonstrated that sex differences exist even after adjustment for other factors [ 22 , 62 , 92 ].…”

Section: Discussionmentioning

confidence: 99%

A review of sex-related differences in colorectal cancer incidence, screening uptake, routes to diagnosis, cancer stage and survival in the UK

et al. 2018

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BackgroundColorectal cancer (CRC) is an illness strongly influenced by sex and gender, with mortality rates in males significantly higher than females. There is still a dearth of understanding on where sex differences exist along the pathway from presentation to survival. The aim of this review is to identify where actions are needed to improve outcomes for both sexes, and to narrow the gap for CRC.MethodsA cross-sectional review of national data was undertaken to identify sex differences in incidence, screening uptake, route to diagnosis, cancer stage at diagnosis and survival, and their influence in the sex differences in mortality.ResultsOverall incidence is higher in men, with an earlier age distribution, however, important sex differences exist in anatomical site. There were relatively small differences in screening uptake, route to diagnosis, cancer staging at diagnosis and survival. Screening uptake is higher in women under 69 years. Women are more likely to present as emergency cases, with more men diagnosed through screening and two-week-wait. No sex differences are seen in diagnosis for more advanced disease. Overall, age-standardised 5-year survival is similar between the sexes.ConclusionsAs there are minimal sex differences in the data from routes to diagnosis to survival, the higher mortality of colorectal cancer in men appears to be a result of exogenous and/or endogenous factors pre-diagnosis that lead to higher incidence rates. There are however, sex and gender differences that suggest more targeted interventions may facilitate prevention and earlier diagnosis in both men and women.

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“…Reported uptake in this group of men, who have traditionally been resistant to screening, is between 79 and 90 per cent. In comparison, uptake of bowel screening in the 65–69‐year age group is only 55 per cent in Scotland.…”

Section: Introductionmentioning

confidence: 96%

Participation in bowel screening among men attending abdominal aortic aneurysm screening

Quyn

Fraser

Rodger

et al. 2018

British Journal of Surgery

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Background Uptake of population‐based screening for colorectal cancer in Scotland is around 55 per cent. Abdominal aortic aneurysm (AAA) screening has recently been introduced for men aged 65 years and the reported uptake is 78 per cent. The aim was to determine the impact of a brief intervention on bowel screening in men who attended AAA screening, but previously failed to complete bowel screening. Methods Men invited for AAA screening between September 2015 and March 2016 within NHS Tayside were included. Attendees who had not responded to their latest bowel screening invitation were seen by a colorectal cancer clinical nurse specialist. Reasons for not completing the faecal occult blood test (FOBT) were recorded; brief information on colorectal cancer screening was communicated, and participants were offered a further invitation to complete a FOBT. Those who responded positively were sent a further FOBT from the Scottish Bowel Screening Centre. Subsequent return of a completed FOBT within 6 months was recorded. Results A total of 556 men were invited for AAA screening, of whom 38·1 per cent had not completed a recent FOBT. The primary reason stated for not participating was the time taken to complete the test or forgetting it (35·1 per cent). Other reasons included: lack of motivation (23·4 per cent), confusion regarding the aim of screening (16·2 per cent), disgust (19·8 per cent), fear (6·3 per cent) and other health problems (9·9 per cent). Following discussion, 81·1 per cent agreed to complete the FOBT and 49 per cent subsequently returned the test. Conclusion A substantial proportion of previous bowel screening non‐responders subsequently returned a completed FOBT following a brief intervention with a nurse specialist. Attendance at non‐bowel screening appointments may provide a valuable opportunity to improve bowel screening uptake.

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Uptake trends in the Scottish Bowel Screening Programme and the influences of age, sex, and deprivation

Cited by 25 publications

References 27 publications

Impact of introducing a faecal immunochemical test (FIT) for haemoglobin into primary care on the outcome of patients with new bowel symptoms: a prospective cohort study

Impact of introducing a faecal immunochemical test (FIT) for haemoglobin into primary care on the outcome of patients with new bowel symptoms: a prospective cohort study

A review of sex-related differences in colorectal cancer incidence, screening uptake, routes to diagnosis, cancer stage and survival in the UK

Participation in bowel screening among men attending abdominal aortic aneurysm screening

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