The NHS bowel cancer screening programme in England is on track to cut bowel cancer deaths by 16%, according to an analysis of the first 1.08 million faecal occult blood tests, but there are concerns that the current method is not picking up diseases as well on the right side of the body as on the left. A paper on the analysis appeared online in the journal Gut on 7 December.

A current statement from the Bowel Cancer Screening Programme (BCSP) says that to date, around 12 million faecal occult blood (FOB) test kits have been sent out and over 11,000 cancers have been detected.

The FOB test does not diagnose bowel cancer, but it will detect tiny amounts of blood that cannot normally be seen in bowel motions. The result will indicate whether further investigation, such as a colonoscopy, is needed.

Under the BCSP in England, patients are automatically sent an FOB test kit by post within a few weeks of reaching their 60th birthday.

The patient uses spatula-like sticks provided in the kit to scrape small samples of faeces from toilet tissue used when they passed a stool. They are asked to take samples from three separate bowel motions. They place the samples under “window” flaps on a card and mark them with the date they retrieved each sample, and then return the sealed kit in a reply-paid envelope in the post.

The results of the analysis of the first 1.08 million FOB tests done in England show that a much higher proportion of the cancers detected through the screening were on the left side of the body. This suggests that a different approach may be needed to pick up cancers on the right side, the side where it is thought more aggressive tumors develop, said the authors.

The authors conclude:

“In this first round of screening in England uptake and fecal occult blood test positivity was in line with that from the pilot and the original European trials. Although there was the expected improvement in cancer stage at diagnosis, the proportion with left-sided cancers was higher than expected. “

Professor Julietta Patnick CBE, Director of the NHS Cancer Screening Programmes is one of the co-authors of the paper, who along with her fellow co-authors, conducted the analysis on behalf of the English Bowel Cancer Screening Evaluation Committee.

Patnick says they are “delighted” with the findings, as they show the programme is “on track” to match research findings and cut bowel cancer deaths by 16%.

“Early detection is crucial to lowering the number of deaths from bowel cancer which is currently the second most common cause of cancer deaths in the UK. The earlier cancer is detected, the higher the chances of successful treatment,” she added, noting that the finding that the test appears to be picking up more cancers on the left than on the right side of the body “mirrors a general global trend and is subject to on-going evaluation and investigation into different screening strategies.”

Written by Catharine Paddock PhD