Outcomes of the Bowel Cancer Screening Programme (BCSP) in England after the first 1 million tests

Abstract

IntroductionThe Bowel Cancer Screening Programme in England began operating 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. The programme aims to reduce mortality from colorectal cancer by 16% in those invited for screening.MethodsAll subjects eligible for screening in the National Health Service in England are included on one database, which is populated from National Health Service registration data covering about 98% of the population of England. This analysis is only of subjects invited to participate in the first (prevalent) round of screening.ResultsBy October 2008 almost 2.1 million had been invited to participate, with tests being returned by 49.6% of men and 54.4% of women invited. Uptake ranged between 55–60% across the four provincial hubs which administer the programme but was lower in the London hub (40%). Of the 1.08 million returning tests 2.5% of men and 1.5% of women had an abnormal test. 17 518 (10 608 M, 6910 F) underwent investigation, with 98% having a colonoscopy as their first investigation. Cancer (n=1772) and higher risk adenomas (n=6543) were found in 11.6% and 43% of men and 7.8% and 29% of women investigated, respectively. 71% of cancers were ‘early’ (10% polyp cancer, 32% Dukes A, 30% Dukes B) and 77% were left-sided (29% rectal, 45% sigmoid) with only 14% being right-sided compared with expected figures of 67% and 24% for left and right side from UK cancer registration.ConclusionIn 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.

Decomposing socio-economic inequality in colorectal cancer screening uptake in England

“…Finally, in agreement with previous findings at different stages of BCSP implementation (Logan et al, 2012;von Wagner, Baio, et al, 2011), we found significant regional differences in CRC uptake. Uptake was highest in the North East across all wealth quintiles and lowest in London, although in multivariate regression models we did not see significant differences between London, the South East, the South West, and the North West.…”

“…There is evidence of substantial variation in uptake by socio-economic status, with one study finding participation in the most deprived quintile of residential areas to be only 35%, compared with 61% in the least deprived quintile (von Wagner, Baio, et al, 2011). Previous studies have also shown systematic differences in CRC screening participation between geographical regions of England, with London and the North East reporting the lowest and highest rates of screening, respectively (Logan et al, 2012;von Wagner, Baio, et al, 2011).…”

Colorectal Cancer Screening among Government Servants in Brunei Darussalam

“…Our FIT positive rate was only 1.9% and this is again comparable to rates reported from other screening programs (Logan et al, 2012). Literature has reported rates of between 1 and 5%.…”

“…Among those invited for screening, only 66.9% returned their FIT, a participation rate that is comparable or better to what has been reported in the literature (Logan RF et al, 2012). However, in any screening program, it is very important to maximise the participation rate to reduce to impact of CRC.…”

Prevalence of appropriate colorectal cancer screening and preferences for receiving screening advice among people attending outpatient clinics

“…This aligns with previous data that finds males are less likely to participate in CRC screening. 28,30,31 Given that males are more likely to be diagnosed and more likely to die from CRC, 32 interventions that specifically target males are needed. No other variables were significantly associated with being under-screened; however, this does not mean the other variables are not important.…”