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Thursday, 11 April, 2002, 23:00 GMT 00:00 UK
Screening could prevent bowel cancer
Bowel cancer
Screening increases detection rate
A single bowel examination at around the age of 60 - with on-the-spot treatment for precancerous growths - could dramatically reduce the number of deaths from bowel cancer, say scientists.

A major new study found that screening could potentially cut deaths from the disease by 40%.

Our system doesn't just detect cancer at an early stage, it can uncover growths before they've become cancerous

Dr Wendy Atkin
The trial, which involved 170,000 people, tested the ability of a technique called flexible sigmoidoscopy to detect and prevent bowel cancer.

It found that screening is feasible, safe and effective, with the potential to prevent around 5,000 cases of the disease each year in the UK.

Bowel cancer is the third most common cancer in the UK, affecting 34,000 people each year.

It often develops from small growths called polyps, some of which are precancerous adenomas that can eventually progress to full blown cancer.

Slow process

This process takes about 10 years, during which time bowel cancer can be prevented by removing the benign growths.

With flexible sigmoidoscopy, doctors insert a long, thin tube, fitted with a miniature camera, into the lower part of the bowel.

This allows the detection of polyps and adenomas.

Small growths can be removed on the spot, while patients with larger growths may be given a whole-bowel examination, called a colonoscopy.

Researchers set up the screening trial as the NHS would run a national programme. A total of 57,000 people were invited to screening, with 40,000 of them agreeing to a bowel examination.

A quarter of people screened had polyps removed from the lower bowel, half of which were adenomas.

Cancer was detected in three people per 1,000 screened - at least 60% at a very early stage.

Early diagnosis

Not only would these detection rates significantly cut the incidence of bowel cancer, early diagnosis of people who had already started to develop cancer should also improve survival from the disease.

When bowel cancer is detected early it is curable in nine out of ten cases.

Lead researcher Dr Wendy Atkin, of Cancer Research UK's Colorectal Cancer Unit in London, said: "Using a miniature camera to screen for bowel cancer is relatively simple and easy to administer, and I believe it could work very well as part of a national screening programme.

"Unlike some tests for bowel cancer, our system doesn't just detect cancer at an early stage, it can uncover growths before they've become cancerous.

"And because it takes so long to go from the polyp stage to full blown cancer, a single bowel examination should offer protection from the disease for up to 10 years afterwards."

Dr Atkin said the cost of screening would be offset by savings made from avoiding the cost of treatment.

Cost effective

Professor Jane Wardle, head of Cancer Research UK's Health Behaviour Unit, monitored the psychological impact of the screening programme.

She said: "The great thing about this kind of screening is that it doesn't cause much worry or anxiety.

"In most cases a positive test will simply mean the detection of harmless, precancerous growths that can be removed on the spot.

"We saw a very good uptake for the scheme, with 71 per cent of those invited for screening turning up at the clinic."

Dr Peter Faircough, Consultant Physician Gastroenterologist at St Bartholomew's Hospital, London and adviser to Colon Cancer Concern, said: "Anything that goes some way to reduce the thousands of unnecessary cases and indeed deaths from this highly treatable cancer is to be welcomed."

The research is published in The Lancet.

The BBC's Karen Allen
"The government are taking this research very seriously"
See also:

01 Mar 02 | Health
Bowel cancer deaths plummet
31 Jan 02 | Health
Gene test hope for bowel cancer
25 Oct 01 | Health
Call for colon cancer screening
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