Faecal immunochemical tests for haemoglobin (FIT) are now used in asymptomatic bowel screening programmes and also in assessment of patients presenting with lower bowel symptoms. FIT specimen collection devices have a stick attached to the cap of the tube: this stick has dimples or grooves near the end to collect the correct amount of faeces. Our instructions are simple, namely, “dip the end of the stick into your poo” and “scrape the end of the stick along the sample”, and have pictures of exactly what sample is required. However, many seem surprised at how little faeces is collected, only 2 mg in the FIT used in Scotland for both clinical purposes. Interestingly, some assume that more must be better and do try very hard to give a little (or a lot) extra in the device! To date, very little attention has been paid to this aspect of FIT. Recently, however, a very relevant paper has been published.1
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….
Monday marked the start of #MensHealthWeek so are WE as a nation doing enough to help men look after their health?! We know when it comes to health, men are less likely to talk to each other about their concerns and are less likely to visit their GP so here are some, perhaps surprising, facts about men… Continue reading “Do We Forget About Men?”
A false positive result – a positive test for occult blood in faeces with no significant disease subsequently found on colonoscopy – is quite a common finding in bowel screening programmes. One of the reasons given for this is that bleeding into the gut could occur other than when colorectal neoplasia is present, including in participants using oral anti-coagulants (OCs) and non-steroidal anti-inflammatory drugs, including aspirin (NSAIDs). Of course, these medicines are commonly used in the 50-74 year old population invited for bowel screening in Scotland. Continue reading “Don’t Stop Taking the Medicine”
We asked SCPN friends and advisors to tell us about a report/paper/findings/work on cancer screening and prevention that has been published this year and has made them stop and think. The works span a wide range of areas from very detailed scientific investigation, reviews of physical activities, and blogs of model work. We find them a complete inspiration. When only 3% of the NCRI research budget is spent on prevention and virtually nil on implementation research; these papers provide a window on some of the very good reasons why cancer screening and prevention should be a leading part of cancer control research.
To all those using, or planning to use, faecal immunochemical tests for haemoglobin (FIT) in bowel cancer screening programmes, there was some disturbing news last week. In British Columbia (BC), Canada, use of FIT ceased due to a problem with a reagent used in analysis of the samples. On the official website, it is stated that work to resolve this as quickly as possible is underway and the organisers will have a better idea of timing in the next few weeks: however, it could take a number of months for FIT analyses to resume. The details and consequences are very well documented.
April is Bowel Cancer Awareness Month, which again offers us the opportunity to further publicise all aspects of bowel cancer screening, diagnosis and prevention. It is the UK’s second biggest cancer killer. However, if detected early, this cancer is eminently treatable and curable and almost all people diagnosed at the earliest stages will survive.
Why should receiving a diagnosis of early cancer be good news? Well the reason is simply that, in most instances, early cancer is completely curable.
This of course calls into question the definition of curable, but if we accept that a reasonable definition is dying of an unrelated cause, with no evidence of the “cured” disease in question, then the majority of cases of early cancer are truly curable.
I am 71 years old and have enjoyed reasonably good health all my life, although osteoarthritis of the knees and cataracts are now two of the joys of growing older. I have taken part in the Scottish Bowel Screening Programme every two years since the first pilot back in 2000. These are facts. The following story is fictional, but the scenario is likely to become a real conundrum for many in the not too distant future.