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More than half of new bowel cancer screen test invitees fail to take up offer

Those in the most deprived areas least likely to respond, findings show

Caroline White

Monday, 21 September 2015

More than half of those invited to take a new bowel cancer screening test don’t take up the offer, despite reminders, finds research* published in the Journal of Medical Screening today.

People living in deprived areas were less likely to take up screening, with only one in three going to their appointment compared with over half of those living in the most affluent areas, the findings show.

The researchers looked at the numbers of non-responders among the 21,000 over 55 year olds in the six pilot areas for the new flexible sigmoidoscopy test. All of them had been sent an appointment, as part of the Bowel Scope Screening Programme, during the first 14 months of the programme’s operation between March 2013 and May 2014.

South of Tyne (Queen Elizabeth and South Tyneside); West Kent (West Kent and Medway); Norwich; London (St Marks); Wolverhampton; Surrey (Guildford) made up the six pilot sites.

In the most ethnically diverse area, 39% decided to take the test compared with 45% of those in the least ethnically diverse area. More men (45%) took the test than women (42%). Overall, 43.1% of those invited had the screening test.

Co-author Dr Christian von Wagner, of the Health Behaviour Research Centre at UCL, was not unduly alarmed at the results.

“These are early days for the new bowel scope programme – there hasn’t been a publicity campaign about it yet, and bowel screening is generally not as familiar to people as breast-screening mammograms or cervical-screening smear tests,” he said.  

“With that in mind, we were encouraged by the level of uptake in the pilot areas for a fairly new and invasive test, and we were surprised that more men were willing to have the test than women,” he added.

But the divide according to ethnicity was a concern, he said. “What we found worrying was that people living in poorer areas seem less likely to take advantage of this screening.

“There are lots of reasons why people, wherever they live, might not have the test – and these can include practical barriers such as embarrassment about the procedure or problems taking time off work to keep the appointment. We’re doing more research to uncover these reasons and see what can be done to encourage as many eligible people as possible to take part,” he added.

Bowel cancer is the second most common cause of cancer death in the UK, killing around 16,200 people every year. Almost all cases develop in people aged 50 and over.

Research suggests that bowel scope screening could reduce bowel cancer cases by up to a third and cut deaths from the disease by up to 43%.

The screening programme is being phased in across England, with full roll out completed by 2018. It will run alongside and enhance the current bowel cancer screening programme which sends a DIY faecal occult blood testing kit every two years to people aged 60 to 74 in England.

Dr Julie Sharp, head of health and patient information at Cancer Research UK, which funded the study, said: “The Bowel Scope Screening Programme has great potential to both prevent bowel cancer and detect it early. You don’t need to have symptoms for this test to be effective, but people can choose whether or not to have it and it’s important that they receive clear information so they can decide what’s right for them.”

She added: “Research like this can identify practical barriers that stop people taking up the test when they would like to have it. We welcome the new ambition from the Independent Cancer Taskforce that uptake for bowel scope should reach 75% in all parts of the country by 2020, as this gives a clear signal that the NHS should be removing these barriers.”


* Lesley M McGregor, et al. Uptake of Bowel Scope (Flexible Sigmoidoscopy) Screening in the English National Programme: the first 14 months. J Med Screen September 20, 2015. DOI: 10.1177/0969141315604659

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