Bowel cancer is one of the most common cancers in the UK. Bowel scope screening is now used across the four nations to detect and prevent bowel cancer following research demonstrating the effectiveness of the FIT test (faecal immunochemical test). The 2013 study used patient data to recruit to a clinical trial and to follow up on what happened to the people who took part in the trial.

Why was this work needed?

Bowel cancer is the fourth most common cancer in the UK and the second most common cause of cancer death. A person’s chance of survival is strongly linked to when their bowel cancer is diagnosed, so it is vital that bowel cancer cases are caught as early as possible and, where possible, prevented. Previously, bowel scope screening had only been used to diagnose bowel cancer in symptomatic patients and prevent it by removing pre-cancerous polyps. This research went further to show the benefit of using it across a whole population as part of a routine screening programme.

What happened?

A clinical trial looked at the potential for a new type of bowel screening to save lives. Patient data was used to identify appropriate people for the trial and then to monitor what happened to them after screening. Following 170,432 people for an average of 11 years, the trial showed that this one-off screening could save thousands of lives through early diagnosis and prevention, and led to it being adopted as routine screening programmes by the public health systems in England, Wales, Scotland and Northern Ireland.

What were the benefits?

Bowel scope screening uses a flexible tube, equipped with a camera and a light, to look into the lower bowel. It doesn’t just diagnose bowel cancer, it can also prevent it by removing polyps from the bowel which could eventually develop into cancer. The research suggested that this will be a lifesaving development. Based on this research, bowel scope screening has been rolled out across the four nations – in Scotland, this is for those between 50 and 74 years, in Wales between 55 and 74, and in England and Northern Ireland between 60 and 74 years. Plans are being made to expand this to include those between 50 and 74 years in England and Wales.

What type of data was involved?

The study took place across 14 UK centres: 11 in England, two in Wales and one in Scotland. People who were eligible for the trial were identified through their GPs (certain GP practices participated in the research) and were then sent a questionnaire to ask whether they would like to participate in the screening. Participants were also followed up after screening. The information came from the Office of National Statistics (death data), cancer registries, Hospital Episode Statistics and the NHS Bowel Cancer Screening database.

Local research ethics committees provided approval for the work and those involved in the trial who received the bowel scope screening provided written, informed consent. The researchers subsequently gained approvals to access cancer registry data, death data, Hospital Episode Statistics and NHS Bowel Cancer Screening databases.

Who funded and collaborated on this work?

This work was funded by the Medical Research Council, National Health Service R&D, Cancer Research UK, and KeyMed.

Where can I go for more information?

Cancer Research UK - Bowel cancer screening information

Once-only flexible sigmoidoscopy screening in prevention of colorectal cancer: a multicentre randomised controlled trial