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Screening is where you are checked for a disease even if you don’t have any symptoms.
It is an important way in which serious conditions can be identified and treated before symptoms are present, by which time the condition has developed to a stage that can often be more difficult to treat.
If a disease, such as cancer is detected early then treatment is often more successful and longer term risks to your health are significantly reduced.
Screening programmes are available for various conditions such as bowel cancer, aortic aneurysm screening and other common cancers including breast, cervix and prostate cancer.
To make screening successful:
- It needs to be performed in individuals with identifiable risk factors for a common condition, such as age or family history of bowel cancer. The benefits of screening should not outweigh the inconvenience to the rest of the people being screened.
- It needs to be carried out using diagnostic tests that are reliable and cheap and have a high pick-up rate.
- It needs to have effective treatment if abnormal results are found.
- Gives you absolute peace of mind if nothing unusual is discovered
- Detects the early signs of bowel cancer so you can begin treatment quickly
- Highlights anything that needs to be monitored, such as a finding of non-cancerous growths (polyps)
Screening tests are never urgent, as they are not responsive to symptoms and bowel cancers generally grow over many years.
The NHS carries out bowel cancer screening for anyone over the age of 60. However, the risk of bowel cancer increases after the age of 45.
Higher risk people include:
- Over 50 years of age – 90% of bowel cancer cases are in over 50 year olds
- Over 60 years of age – 80% of bowel cancer cases are in over 60 year olds
- Family history of colon polyps or bowel cancer
- Family history of Lynch Syndrome – this type of colon cancers runs in families and tends to cause cancer from a younger age, under 45 years old
- If you are experiencing any bowel cancer related symptoms
- If you are suffering from Inflammatory Bowel Disease (IBD) e.g. Crohn’s Disease or Ulcerative Colitis
A simple assessment of your stools can show signs of bowel cancer, such as blood, or abnormal DNA.
Blood may not necessarily mean that you have bowel cancer, however if the doctor sees anything unusual, they will refer you for a colonoscopy.
The “virtual” colonoscopy uses a CT scan to assess the colon. It is an effective, non-invasive test to spot bowel polyps and signs of cancer.
Small polyps hide in the many twists and turns on the colon, which can get missed when assessment is made via a scan though.
Also, unlike the full colonoscopy procedure, it isn’t possible to obtain tissue samples that can be sent for further testing to detect for cancer.
A flexible sigmoidoscopy procedure is used to check for bowel cancer in the last part of the colon and the rectum, by passing a flexible camera (on a thin agile tube) up through the back passage. You need to have an enema prior to the procedure.
When necessary a biopsy (tissue sample) can be taken, or a polyp can be entirely removed.
It is more accurate than a CT scan but doesn’t assess the whole length of the bowel.
There is a very small risk of perforating the lining of the bowel, quoted at 1 in every 10,000 procedures.
The colonoscopy is a similar procedure to the sigmoidoscopy, but allows assessment of the entire length of the colon. It requires prior preparation of the bowel using strong laxatives so that clear views are obtained.
A thin, agile tube with a camera and bright light, called a colonoscope, is inserted into the back passage and can work all the way up to the top of the colon and back down again, whilst projecting images onto a screen for the doctor to see.
It is the best examination for bowel cancer and if any other prior test shows anything unusual, then a colonoscopy is usually needed. Sometimes patients just opt for a colonoscopy in the first instance to ensure that results are the most accurate available.
There is a higher risk of perforating the lining of the bowel quoted at 1 in every 1,400 procedures.