What is Colorectal Cancer Screening?
Colorectal cancer screening aims to find large bowel (colon and rectal) cancer in its early stages before any symptoms occur. When colorectal cancer is diagnosed at an early stage around 90% of people survive.
There are several screening tests to help doctors find colorectal cancer before symptoms begin and when it is most treatable. During some endoscopic colorectal cancer screening tests, polyps can be removed if they are cancerous or before they become cancerous. This means colorectal cancer screening can prevent, detect and treat cancer in your colon or rectum.
In England, the colorectal cancer NHS screening programme aims to be available to everyone between the age of 50 to 74 years. People between these ages are thought to be more at risk of colorectal cancer than other age groups.
What is colorectal cancer?
Cancer in the large bowel (colon and rectum) is known as colorectal cancer. It is where abnormal cells in your large bowel divide uncontrollably and form a cancerous tumour. It is also known as bowel cancer.
Colorectal cancer is mostly diagnosed in people over 60 years old. Similar numbers of men and women are affected.
Symptoms of colorectal cancer
The most common symptom of colorectal cancer is a change in bowel habits. You may have:
- increasing constipation, alternating bouts of constipation and diarrhoea
- blood in your stools
- a feeling that you haven't completely emptied your bowels or that you constantly need to go to the toilet
- pain, bloating or discomfort in your stomach
- a general unwell feeling such as tiredness due to anaemia caused by a loss of blood
- a lack of appetite and unintentional significant weight loss.
If you have symptoms, you should see your doctor, especially if you are over 60.
How is a colorectal cancer screen done and how long does it take?
On the NHS a colorectal screen is done using a faecal immunochemical test (FIT). This is a simple home kit where you send a poo sample to the laboratory for testing. A FIT only takes a few minutes and results should be available in about two weeks. You may also be invited for a colonoscopy if you have an abnormal FIT result. An abnormal FIT test does not mean you have cancer.
Private colorectal cancer screening can include the use of a variety of diagnostic tests as well as a FIT. It can be useful to have these screening tests done privately if you are worried about bowel cancer but you are not eligible for NHS screening, you have a family history of bowel cancer or polyps, or you are worried about other bowel or abdominal problems.
Ramsay’s colorectal cancer screening includes:
- Colonoscopy - takes 30 to 45 minutes. Using a long, thin, flexible tube with a very small camera, called a colonoscope, your doctor sees inside your entire large bowel on a monitor. They may take a sample biopsy of any abnormal-looking areas and send it to a laboratory for investigations. Polyps may be removed during a colonoscopy procedure. Your doctor will feedback on any results either on the same day or when they have received them from the laboratory.
- Flexible sigmoidoscopy - takes around 15 minutes. A thin and flexible tube, called a sigmoidoscope, is inserted into your rectum to look at your back passage and the lower part of your large bowel. A sample biopsy may be taken to investigate suspect cells in the laboratory. Small polyps may be removed.
- CT colonography- usually takes around 30 minutes. An outpatient CT scan is performed that involves lying on your front on a scanning table that moves into the CT scanner to scan the inside of your bowel. Results take one to two weeks.
When is a colorectal cancer screen required and how often?
In England, a colorectal cancer screen is offered to everyone aged 60 to 74 who is registered with a GP. They are sent a colorectal cancer home screening kit every two years, called a faecal immunochemical test (FIT). This test simply requires a stool sample to be sent to a laboratory for testing. Most people require no further investigations. A colonoscopy may be required as a follow-up test depending on the FIT results.
A colorectal cancer screen is also offered to people who have a higher risk of developing bowel cancer and maybe younger than 60 years. Screening for high-risk people is usually done using a colonoscopy. High-risk people include those with:
- a genetic condition such as familial adenomatous polyposis (FAP) or Lynch syndrome
- ulcerative colitis or Crohn’s disease
- a strong family history of bowel cancer – where two or more close family members on the same side of the family have bowel or womb cancer or one person was diagnosed when they were under 50 years of age.
- polyps in the bowel
- a previous bowel cancer.
You should speak with your doctor if you might have a higher risk of developing bowel cancer.
Is a colorectal cancer screening the same as a colonoscopy?
A colonoscopy can be part of a colorectal cancer screening programme. A colorectal screening can include many tests. These include a faecal immunochemical test (FIT), flexible sigmoidoscopy and CT colonography.
How effective is colorectal cancer screening?
Unfortunately, no screening test is 100%. This means that there is a small chance that cancer could be missed and you are wrongly reassured by a screening test. However, early detection of colon and rectal cancer increases with colorectal cancer screening.
It is thought that colorectal cancer screening works well in reducing colon and rectal cancer deaths in people between 50 to 74 years of age.
What age does colorectal cancer screening start and stop?
Currently, in England, bowel cancer screening starts for men and women aged 60 to 74. It is offered every two years.
From April 2021, the NHS is gradually reducing the age range for bowel screening in England. This will be phased over the next four years to include people aged 50-59.
Although not automatically offered, people older than 74 years old can request a screening kit every two years by calling the NHS helpline on 0800 707 60 60.
Colorectal Screening at Ramsay Health Care
Privately and at Ramsay, you can see a colorectal doctor and request a colorectal cancer screening test at any age if you have cancer concerns.
Our conveniently located Ramsay hospitals offer screening for colorectal cancer without having to wait with oncology experts.
You can read more about our cancer care and treatments or please get in touch if you’d like to talk to us about any concerns.