Bowel Cancer UK has highlighted a lack of surveillance screening and is calling for this to be addressed to ensure early detection of the disease, particularly for younger people who are at higher risk of bowel cancer.
Genetic factors contribute to up to 30% of bowel cancer cases and people with inflammatory bowel disease may also be at higher risk. People in the higher risk groups are likely to develop bowel cancer much younger than the general population.
Clinical guidance recommends that people in high-risk groups should be in a surveillance screening programme, which is proven to reduce deaths in these groups. However, evidence shows that people diagnosed are not routinely tested for genetic conditions, and only one-third of centres identify and manage high-risk patients through a registry.
Even those in a surveillance programme may have to wait a long time for their screening colonoscopy. Thirty-five hospitals which undertake surveillance have a waiting time of over 26 weeks (for people at higher risk, while more than half of centres do not have a programme for managing high-risk groups.
Deborah Alsina, chief executive of Bowel Cancer UK, said: “Surveillance screening is proven to be a highly effective way of preventing and detecting bowel cancer early but recent evidence has shown there is an inconsistent approach to the management of people at higher risk. If, in the UK, we are serious about saving lives from this treatable disease, we must make sure that people at high risk of developing bowel cancer are identified, have access to proper surveillance screening, and do not have an undue wait for tests. The current inconsistency, lack of capacity or clinical ownership must be addressed as a priority or lives will be unnecessarily lost.”
Bowel Cancer UK has produced five recommendations designed to improve services for people in high-risk groups:
• Better surveillance screening for those at high risk of developing bowel cancer.
• Clear information for GPs and the public about who may be at higher risk of bowel cancer.
• As people with a genetic condition, such as Lynch syndrome, typically develop bowel cancer at a young age, anyone diagnosed with bowel cancer under the age of 50 should have a genetic test for these conditions, so they and their families can be included in a surveillance programme.
• Adequate endoscopy service capacity to ensure that people at high risk do not have a long wait for their colonoscopy.
• Designation of a person in each hospital Trust with responsibility for a registry of people at higher risk.
Photo Credit: National Cancer Institute
