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Nearly a third of hospitals failing bowel cancer patients

Pathologists says hospitals must offer younger patients screening for Lynch syndrome

Mark Gould

Monday, 08 August 2016

Around a third of all hospitals in the UK are failing to provide crucial screening for younger patients diagnosed with bowel cancer, according to new research.*

Royal College of Pathologists and Bowel Cancer UK have used Freedom of Information (FOI) requests to reveal that 29% of hospitals do not screen for Lynch syndrome, an inherited condition which puts people at a much higher risk of their cancer recurring as well as increasing the risk of other cancers including ovarian cancer, stomach cancer and womb cancer.

Lynch syndrome is estimated to cause 1,000 cases of bowel cancer each year, many of them under the age of 50. Yet, fewer than 5% of people with the condition have been identified.

The Royal College of Pathologists clinical guidelines state that a simple set of tests, which can help identify people with Lynch syndrome, should be carried out automatically on all people diagnosed with bowel cancer under the age of 50 at the time of diagnosis. The College says the test can detect people at greater risk of recurrence, informs treatment options and helps identify those with family members who may also have the condition and be at risk of bowel cancer. For people with Lynch syndrome there is a 50% chance that children, brothers or sisters also have the condition.

Where the syndrome is present patients and their families can be offered a surveillance programme to receive regular colonoscopy, which the College says can reduce their chance of dying from bowel cancer by 7%.

Research found that 29% of hospitals across the UK do not test patients under 50 diagnosed with bowel cancer, but tested varied across the UK. In Northern Ireland, 100% of hospitals that responded to a freedom of information request were conducting the screening. In Scotland, 93% of hospitals were offering the screening. This fell to 69% in England and just 29% in Wales.

Even those that do carry out the test, just over half (5%) perform the test automatically as stated in the guidelines. In many cases, hospitals are even delaying the test until after treatment for bowel cancer with only one in 10 (1%) testing prior to treatment.

Asha Kaur, policy manager at Bowel Cancer UK said: “Since we carried out the last Freedom of Information (FOI) request on this issue in 2015, there has been a 46% increase in the number of hospitals testing those under 50 diagnosed with bowel cancer.

"However, the guidelines have now been in place two years and there are still 40 hospitals in England alone not doing the test at all plus a huge variation in approach to testing across the UK.

"We understand that a number of hospitals face challenges implementing the guidelines however many have developed innovative solutions and local approaches to overcome these barriers. Testing should be performed at diagnosis and that’s just not happening. We urge hospitals across the UK to work together to carry out this lifesaving test."

* 2016 Data Briefing: Reflex testing for Lynch syndrome in people diagnosed with bowel cancer under the age of 50. Royal College of Pathologists and Bowel Cancer UK, 2016.

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