The first 3 years of national bowel cancer screening at a single UK tertiary centre
Article first published online: 10 JAN 2012
© 2011 The Authors. Colorectal Disease © 2011 The Association of Coloproctology of Great Britain and Ireland
Volume 14, Issue 2, pages 166–173, February 2012
How to Cite
Gupta, S., Saunders, B. P., Fraser, C., Kennedy, R. H., Ignjatovic, A., Sala, S., Marshall, S., Suzuki, N., Vance, M. and Thomas-Gibson, S. (2012), The first 3 years of national bowel cancer screening at a single UK tertiary centre. Colorectal Disease, 14: 166–173. doi: 10.1111/j.1463-1318.2011.02567.x
- Issue published online: 10 JAN 2012
- Article first published online: 10 JAN 2012
- Accepted manuscript online: 25 JAN 2011 11:48AM EST
- Received 12 August 2010; accepted 10 December 2010; Accepted Article online 25 January 2011
Aim St Mark’s Bowel Cancer Screening Centre commenced screening in October 2006 as a contributor to the national programme. The first 35 months’ experience is reported.
Method Individuals with a positive faecal occult blood test (FOBT) were offered colonoscopy or alternatives if they had significant comorbidity. All screening data were collected prospectively.
Results Of the 98 815 FOBT kits issued, 42 523 were returned (43% uptake; 20.79% men). In total, 1339/1488 (90%) FOBT-positive participants attended the nurse clinic (57% men). Of these, 1057 had an index colonoscopy, 115 had a computed tomography colonoscopy (CTC) and eight had a flexible sigmoidoscopy. Five hundred and seventeen (44%) procedures were ‘normal’ (no polyps/cancers). Eighty (6%) individuals had colorectal cancer. The polyp detection rate in index procedures, including colonoscopy, CTC and flexible sigmoidoscopy, was 50%. The adenoma detection rate of all colonoscopies was 62.8%. The median polyp size was 5 (1–80) mm. In total, 1200 colonoscopies were performed by five accredited colonoscopists (96% completion rate). There were 13 (1%) adverse events with < 1 in 500 patients undergoing polypectomy requiring a transfusion. There was one 30-day postsurgical mortality, one perforation and no colonoscopy-related mortality. Almost all 39/40 (97%) patients in the BCS programme felt that the findings were adequately explained compared with 21/32 (64%) elective patients (P < 0.001) within the same unit.
Conclusions At this bowel cancer screening single centre, colonoscopy completion rates were high (unadjusted caecal intubation rate of 96%) and complication rates were low. In contrast to other published data, the uptake and cancer-detection rates were lower.