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Dr Helen Webberley MBChB MRCGP MFSRH
GMC no 3657058
Bowel screening for colorectal cancer (CRC) and polyps
Why should I have it?
Colorectal cancer is the 3rd commonest form of cancer and the 2nd commonest cause of cancer death and accounts for 10% of all cancer deaths.
The current incidence is 5% so that means in a group of 20 friends, one of the friends at least may get bowel cancer.
If caught early, the 5 year survival rate is excellent at 92% (92 out of 100 patients will still be alive at 5 years) but if caught late the 5 year survival rate is only around 10%.
We know that the vast majority of cancers originate in polyps (or adenomas). These are benign warty growths in the bowel that grow in some patients, but which have the potential to turn nasty and to develop into cancer over a period of several months to several years.
We also know that if we remove these polyps completely, we are also removing the cancer risk. We are removing the source of bowel cancer before it has even developed!
What bowel screening is currently available on the NHS?
All NHS screening programmes are based on health economics, in other words the cost effectiveness or ‘bangs for bucks’.
This unfortunately assumes that a significant number of people will not be eligible for screening. It also means that the type of screening test has to be cheap and cost effective but not necessarily the most accurate and again assumes that a certain proportion of cancers will be ‘missed’.
National screening programme (NSP)
Currently in England and Wales, patients between the age of 60 and 74 (and 50 to 74 in Scotland) are offered a test of their ‘poo’ every 2 years (FOBt), looking for traces of blood leaked from bleeding cancers. The type of test used has only a low sensitivity of 35% for cancer even lower (10%) for potentially nasty polyps and almost 0% for small polyps. If positive then patients are referred for the ‘gold standard’ test, a colonoscopy. This is the endoscopic examination of the whole colon, but is expensive and time consuming for the NHS.
This has the disadvantage of lulling patients and their doctors into a false sense of security by believing that just because their poo screen was negative, they don’t have cancer. This has been the downfall of numerous patients and even some celebrities including Lynda Bellingham.
Speaking for the first time since the actress’s death, her son said he believed a colonoscopy should have been carried out as it would have given her longer to live.
The 31-year-old added ‘routine screening tests had failed to pick up his mother’s illness for 18 months, leaving it too late for her to recover once diagnosed.’
Some centres have also been offering ‘Bowel scope’ to 55 year olds.This is the endoscopic examination of the lower half of the bowel but has had a very limited uptake by NHS Trusts because of pressures on services elsewhere. The logic for this screening method is that it is quick and relatively cheap and easy and 75% of polyps and cancers occur in the lower colon.
We are offering a bowel cancer screening service for all patients who are concerned about developing bowel cancer. This may well include patients who have already been screened by the NHS screening programme.
It is primarily aimed at patients of all ages with no symptoms but if you do have stomach symptoms you should attend your GP first as other diagnoses may be considered and other tests may be needed.
Our bowel screening service comprises a simple blood test, analysis of ‘poo’ using a much more sensitive test than is currently being used in the NHS (called a FIT test), an examination of the lower bowel (called a flexible sigmoidoscopy) and colonoscopy or any combination of the above.
We expect that the majority of users would choose a combination of the blood test, a flexible sigmoidoscopy and a FIT test although some may opt to go straight to colonoscopy.
If you would like further information please see the enclosed document NHS document on bowel cancer screening, or contact us at mywebdoctor and we can discuss the various options that would suit you best
Dr.Helen Webberley in the news!
GP Dr Helen Webberley has treated many patients with the symptoms of carbon monoxide poisoning and warns of the damage that long-term exposure to the gas can lead to.
She said: “People should not think there is a safe level of poisoning, as exposure to the gas over time, even at a low level, can lead to brain damage.
“Everyone must be vigilant to symptoms which include dizziness, headaches, breathlessness and loss of consciousness.”
In the light of an A&E and wider NHS emergency, an innovative British doctor is merging healthcare and technology with the launch of a brand new online GP service. Based in the UK, My Web Doctor offers members exclusive access to expert doctor’s advice for just £12.99 per month. Affordable, professional and available on-demand, My Web Doctor is set to emerge as a must have resource for health conscious families and individuals across the UK and further afield.