A bowel cancer survivor from Hope, near Sheffield, is backing calls by Yorkshire Cancer Research for proposed improvements in screening to be urgently rolled out across the country.
Christine Ord was diagnosed with bowel cancer in July 2014 at the age of 61. She had taken part in the current screening programme, but her cancer wasn’t picked up by the test.
At the moment men and women in England are sent a home screening kit, known as the ‘faecal occult blood’ (FOB) test, when they turn 60, and then every two years until the age of 74.
The test looks for small amounts of blood in the poo which can be a sign of cancer. If the screening result is positive further tests will look for cancer, or small growths in the bowel which if left untreated could develop into cancer in the future.
The early detection of cancer before any symptoms are noticed by the patient means it can often be treated more effectively. When someone is diagnosed with bowel cancer through screening they have a 93% chance of surviving for at least three years after diagnosis, compared to 68% if they are referred to hospital through their GP 1.
With regular screening, 16% fewer people die from bowel cancer 2. However, participation in the current screening programme is low, with 4 in 10 people in Yorkshire failing to complete the test when invited 3.
The screening programme cannot pick up all cases of bowel cancer and there are concerns about the sensitivity of the current screening test. A negative result does not necessarily mean there is no cancer present.
Christine, a former teacher, completed and returned her home screening kit as soon as she received it following her 60th birthday. Her result was inconclusive, meaning she had to complete the test again, but eventually she was told she was in the clear.
Less than two years later she discovered she had cancer after noticing blood in her poo.
Christine, who had previously been diagnosed with and treated for ovarian and skin cancer, said: “Having already undergone treatment for two different types of cancer, I was quite the expert by the time I noticed the symptoms of bowel cancer. Had that not been the case, I might not have seen my doctor.
“The day before my operation to remove the tumour, I received my second screening kit in the post. I felt quite angry at that point. I had done my first screening test and had been told I was okay. I know that a normal result doesn’t necessarily mean you don’t have cancer, but it still came as a shock, especially as my cancer was diagnosed at a late stage.”
Christine underwent surgery to remove her tumour, followed by a course of chemotherapy. During the surgery, doctors carried out a colostomy – an operation to divert one end of the colon through an opening in the tummy called a stoma. This meant that Christine needed to use a colostomy bag to collect her poo for almost a year while the bowel healed, until she could undergo a reversal of the procedure.
She then underwent three years of regular scans and blood tests to ensure the cancer had not returned.
Although the FOB test failed to detect her disease, Christine is still urging people to take part in screening. She is also calling for the screening age to be lowered and is keen for a new, more effective test – known as the Faecal Immunochemical Test (FIT) – to be introduced in England.
FIT is already available to men and women aged 50 to 74 in Scotland. It is easier to use because it involves collecting one sample of poo rather than the three samples needed to complete the FOB test. Studies have shown it is more popular than the FOB test, with more people completing and returning the kit. It is also better at detecting cancers because it is more sensitive 4.
The introduction of FIT could lead to more people taking part in screening, resulting in more lives saved through the early detection of cancer.
Christine said: “Now that my follow-up checks have stopped I’ve been told that if I notice any symptoms I should see my GP. It’s worrying because I only noticed symptoms originally when the cancer had reached a late stage. I will, of course, continue to complete the screening test, and I tell all my friends to do the same. I’ve also given a talk to my local WI group to try to raise awareness.
“I think that screening should start when you’re younger, and that more should be put out there that it’s very important that you do it. Everybody’s a bit squeamish about it, but it’s so vital. People need to get tested and not have that fear that they might have something. It’s better to find out something’s wrong sooner rather than later and be able to get the treatment you need.”
Dr Stuart Griffiths, Director of Research and Services at Yorkshire Cancer Research, said: “Although the current bowel cancer screening programme is effective in picking up some cancers at an early stage, we know that many people do not complete the test. It is clear that improvements in the service are now urgently required.
“For various reasons, the implementation of the superior FIT test in England has been severely delayed. It is essential that it is rolled out throughout the country as soon as possible. People in England should be receiving the benefits of this new, more efficient screening.”
April is Bowel Cancer Awareness Month.
Bowel cancer in Yorkshire
• There are about 22,000 people living with or beyond a diagnosis with bowel cancer in Yorkshire 5.
• 3,377 people (1,427 women and 1,950 men) in Yorkshire were diagnosed with bowel cancer in 2015 6.
• 5 in 10 bowel cancers are diagnosed at a late stage in Yorkshire 7.
• Bowel cancer is more common in people aged 50 plus 6.
Bowel cancer symptoms8
More than 90% of people with bowel cancer have one or more of the following symptoms:
• Persistent change in bowel habits – e.g. going more often, looser stools
• Blood in stools without other piles (haemorrhoids) symptoms
• Abdominal pain, discomfort, or bloating always brought on by eating – sometimes resulting in a decrease in the amount of food eaten and weight loss
(Note: Constipation (passing harder stools less often) is rarely caused by serious bowel conditions)
If your symptoms persist for more than four weeks, or if they keep coming back after stopping treatment, please see your GP, regardless of severity, your age or if you’ve recently completed screening.
If you have missed a bowel screening appointment, have not been sent a kit, or are aged 75 or over, call the Freephone helpline on 0800 707 60 60 to request a FOB test kit.
1 NCIN, Routes to diagnosis 2006-2015 workbook (a), http://www.ncin.org.uk/publications/routes_to_diagnosis
3 PHE, National General Practice Profiles, Cancer, https://fingertips.phe.org.uk/profile/general-practice/data#page/0/gid/1938132829/pat/46/par/E39000029/ati/152/are/E38000001/iid/92600/age/280/sex/4
4 Moss S, Matthews C, Day TJ, Smith S, Seaman HE, Snowball J and Halloran SP, Increased uptake and improved outcomes of bowel cancer screening with a faecal immunochemical test: results from a pilot study within the national screening programme in England, Gut (2017); 66(9): 1631-1644
5 NCRAS, Cancer Prevalence in England – 21 year prevalence by demographic and geographic measures, http://www.ncin.org.uk/local_cancer_intelligence/tcst
6 CancerData https://www.cancerdata.nhs.uk/incidence
7 NCRAS, Stage data by CCG, http://www.ncin.org.uk/home
8 NHS choices, Bowel cancer, https://www.nhs.uk/conditions/bowel-cancer/
Notes to Editors
- Harrogate-based Yorkshire Cancer Research was founded in 1925 and is the largest independent regional cancer charity in England (Registered Charity 516898). We are not part of a national charity.
- We are committed to reducing the devastating impact of cancer on the lives of people living in Yorkshire.
- Our mission is to work in partnership, fund research and support initiatives that will help people in Yorkshire avoid, survive and cope with cancer.
- Current statistics show that 575 people are diagnosed with cancer in Yorkshire every week. Incidence and mortality rates are higher than the England average due to social deprivation, post-industrialisation and lifestyle choices but also availability of healthcare services and difficulties accessing early diagnostics, clinical trials and the latest treatments.
- We aim to:
- Be the leading authority on cancer in Yorkshire, understanding the problems and priorities in the region and sharing knowledge with partners.
- Raise awareness of cancer and how to prevent it by working in local communities, schools and colleges, sports clubs and with other health-related organisations.
- Promote screening programmes and fund research that can improve the diagnosis of cancer so we can detect and treat it at the earliest opportunity.
- Invest in innovative research projects at every stage of a cancer patient's journey.
- Campaign for fair and equal access to the very best healthcare services and a greater share of the money spent nationally on research.
- For further information, please visit www.yorkshirecancerresearch.org.uk or follow us on Facebook or Twitter