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Early stage bowel cancer more likely to be picked up by screening

More than one in five cases are late stage by the time people see their GP

Caroline White

Friday, 22 January 2016

Early stage bowel cancer is more likely to be picked up by screening than after a GP referral or presentation in emergency care, reveal new figures published today.

The figures* issued by the charity Cancer Research UK and Public Health England’s National Cancer Intelligence Network, reveal for the first time the stage at which a cancer is diagnosed.

Among the cases picked up by screening (where the stage at diagnosis was known), more than a third (37%) were caught at the earliest stage (stage 1) while fewer than one in ten (8%) were advanced (stage 4).

This is considerably higher than through other routes of diagnosis. More than one in five (22%) bowel cancers were advanced by the time people went to see their GP, while 40% of bowel cancers diagnosed as an emergency were stage 4 among those cases with known stage.

Altogether, some 46% of bowel cancers were diagnosed early (stage 1 and 2) after a GP referral, compared with one in three (32%) diagnosed as an emergency, and almost two thirds (63%) picked up by screening.

Over half (54%) of late stage cases (stages 3 and 4) were diagnosed after a GP referral compared with 68% of cases diagnosed as an emergency and 37% picked up by screening.

“Early diagnosis means better survival, and late diagnosis is bad news for patients, so we need to learn how to avoid it. This new information really helps us understand the best ways to diagnose cancer and where the health service should target resources,” explained Sara Hiom, Cancer Research UK’s director of early diagnosis.

“Bowel cancer in particular has a lot of room for improvement, so it’s great news that there's a recommendation to use a new updated bowel cancer screening test called FIT. We know this is an easier test for people to use at home and that both men and women are more likely to use it, so it’s vital this is rolled out as quickly as possible across England,” she said.

“It’s also important that people go to their doctor if they notice symptoms such as blood in their poo or a change in their normal bowel habit such as looser poo, pooing more often or constipation, even if they’ve recently had a bowel screening test,” she emphasised.

The full publication also contains data about people in England diagnosed in 2012 and 2013 by stage for bladder, breast, kidney, lung, melanoma, non-Hodgkin lymphoma, ovarian, prostate and womb cancers.

It shows that among the total 574,500 cases diagnosed in 2012 and 2013 for which screening is available (breast and bowel), screening picked up the highest proportion of early stage cancers: 63% stage 1 (19, 486) compared with 3% stage 4 (823). 

Among those diagnosed after a GP referral, just over a third (34%) were stage 1 compared with just over a fifth (22%) at stage 4.

More than half (58%) of all cancers diagnosed as an emergency were at stage 4; only around a tenth (11%) were diagnosed at stage 1.

Dr Anne Mackie, director of screening at Public Health England, said: “This new research on the stage at which people are diagnosed suggests that screening has an important part to play in achieving earlier diagnosis of bowel cancer. Everyone aged 60 to 74 in England receives an invitation to be screened along with some information to help them decide.”


* Routes to diagnosis by stage 2012-2013 workbook. Public Health England, December 2015.

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