The Scottish Bowel Screening programme is over ten years old. Scotland was the first country in the world to introduce systematic screening for bowel cancer and the first in the UK to offer testing to people aged 50. Lots of lessons have been learned along the way including how to improve the screening test and uptake.

Here are some reflections on current screening from Professor Bob Steele….

It is now well known that in the Scottish Bowel Screening Programme, the old card based test is now being replaced by a tube test called a Faecal Immunochemical Test (FIT).  The advantage of this test is that it only has to be done once, as opposed to three times with the old test, and that it comes with a more hygienic collection device.  It is also more sensitive for blood than the old test.  After extensive piloting the FIT was introduced into the Scottish Bowel Screening Programme in November of 2017 and it is evident that it is performing much better than the old test.  To start with, many more people are doing it and the uptake has now increased from around 55% to around 65%.  In addition it appears to be detecting about 20% more cancers than before.  We can therefore be confident that, although not perfect, FIT has made a big difference and we expect the programme to prevent significantly more deaths from bowel cancer than previously.  This does not come without challenges, however, as the increased uptake and sensitivity results in an appreciable increase in colonoscopy demand.  This is recognised by Scottish Government’s and is currently being addressed by their Endoscopy Action Plan.

Professor Bob Steele – Co-director SCPN