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Bowel cancer screening halves emergency admissions and cuts deaths

Bowel cancer screening halves emergency admissions for the disease and significantly cuts death rates, reveal the fifth year results from one of the first UK pilot sites.

The figures, published ahead of print in the journal Gut, refer to tests carried out in Coventry and Warwickshire in the Midlands.

This was the only area in England to try out the feasibility of bowel cancer screening for those aged 50 to 69, using postal tests that pick up hidden traces of blood in the stool (faecal occult blood tests).

Blood in the stool is a cardinal sign of cancerous and pre-cancerous changes in the bowel.

One in 20 people in the UK will develop bowel cancer, which is the second leading cause of cancer deaths, claiming more than 16,000 lives every year.

The research team tracked the number of emergency admissions for, and deaths within 30 days from, bowel cancer to the largest hospital trust in the region.

The timeframe spanned from 1999, a year before the pilot began, to 2004, when the programme had been running for five years.

During the entire period, 1236 new cases of bowel cancer were diagnosed, equating to 200 cases a year.

In 1999, just under 30% of bowel cancer patients had to be admitted as an emergency. By 2004, this figure had fallen to just under 16%.

Consequently, the number of emergency operations required halved, and the number of patients dying within 30 days also fell.

In 1999 almost half (48%) of those undergoing emergency surgery died. By 2004, this figure had fallen to just 13%.

The number of Dukes C or stage 3 relatively advanced bowel cancers also fell from 38 in 1999 to 16 in 2004, although the proportion of these cases requiring emergency care remained the same.

The authors conclude that bowel cancer screening is effective, yet take-up of the test among those who are eligible appears to be falling, they say.

The government has also decided to limit the target age group to those aged 60 to 69, which may have some impact on the overall effectiveness of the national programme, they warn.

Its important that patients and their family doctors are aware of the benefits of screening, they say.


Contact: Emma Dickinson
BMJ-British Medical Journal

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