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BowelScreening
All about BowelScreening
2
This booklet may help you decide whether to
take part in the free BowelScreening
programme and take a bowel screening test.
The booklet explains how the test can help find
bowel cancer at an early stage when it can
often be cured, and it provides information
about the potential risks and benefits of
screening. It is important you have all the
information you need to decide if the
BowelScreening programme is right for you.
If you need more information, you can call the
BowelScreening programme on 0800 924 432,
go to the website:
www.bowelscreeningwaitemata.co.nz or talk
to your doctor.
3
What is the free
BowelScreening programme?
BowelScreening is a free programme to
check people for early signs of bowel
cancer.
BowelScreening is being offered to
everyone aged 50 to 74 living in the
Waitemata District Health Board (DHB)
area who is eligible for publicly funded
healthcare. It is a four-year programme to
test whether bowel screening should be
introduced throughout New Zealand.
Everyone eligible to take part gets an
invitation letter, a consent form and a free
bowel screening test, with instructions on
how to use it.
If you do not want to take part in the
bowel screening programme, please call
us on 0800 924 432 and let us know. If
you complete the test kit and return it to
us with the consent form, your sample will
be tested – even if you have not signed the
consent form.
If you have any bowel cancer
symptoms (see page 6) talk
to your doctor now.
Why is bowel screening
important?
Bowel screening can help save lives by
finding bowel cancer at an early stage when
it can often be cured. There may be no
warning signs you have bowel cancer.
Bowel screening can also detect polyps
(growths). These are not cancers, but they
may develop into cancers over time. Most
polyps can be easily removed, reducing the
risk that bowel cancer will develop.
What is the bowel?
rectum
anus
small bowel
colon
The bowel is part of our food digestive
system. It is divided into the small bowel
and the large bowel, and connects the
stomach to the anus (bottom) where waste
material (called a bowel motion or faeces)
is passed out of the body. The function of
the large bowel is to finish digesting food by
absorbing water and salt. The large bowel is
where cancer most often develops.
5
What is bowel cancer?
Bowel cancer is also called colon, rectal
or colorectal cancer. Bowel cancer occurs
when normal cells on the inside of the
bowel become abnormal and grow out
of control. The cells can turn into a polyp,
which may then turn into cancer over a
number of years. It can take a long time
before the cancer grows and spreads to
other parts of the body. Bowel screening
provides an opportunity to find bowel
cancer and treat it early.
How common is bowel cancer?
New Zealand has one of the highest bowel
cancer rates in the world. Bowel cancer is the
second highest cause of cancer death in New
Zealand. More than 2800 people are diagnosed
with bowel cancer every year and more than
1200 die from the disease.
What are the signs of bowel
cancer?
Common signs of bowel cancer may
include:
»
a change in your normal pattern of
going to the toilet that continues for several weeks (such as diarrhoea, constipation, or feeling that your bowel doesn’t empty completely)
» blood in your bowel motion.
Although these symptoms are usually
caused by other conditions it’s important to
get them checked by your doctor.
Who should do the bowel
screening test?
Bowel screening is for people who have
no obvious signs or symptoms of bowel
cancer. If you have any symptoms of bowel
cancer, you should talk to your doctor now.
7
Who shouldn’t do the bowel
screening test?
Bowel screening is not right for everyone.
You should not be part of a bowel
screening programme if you:
» have had a colonoscopy within the last five years
» are on a bowel polyp or bowel cancer surveillance programme
» have had or are currently being treated for bowel cancer
» have had your large bowel removed
» are currently being treated for ulcerative colitis or Crohn’s disease
» are seeing your doctor about bowel problems.
Who should check with their
doctor before doing the
test?’
You should talk to your doctor before
deciding whether to do the bowel screening
test if:
» you have a number of family members
over two or three generations who have
had bowel cancer
» you or a close family member have been
diagnosed with bowel cancer at a young
age (under 55 years)
» you and your family have a known
or suspected genetic bowel cancer
syndrome
» you have had extensive inflammatory
bowel disease such as ulcerative colitis
for more than 10 years.
Who is most at risk of bowel
cancer?
Bowel cancer is more common as you get
older, especially from the age of 50. Bowel
cancer affects more men than women. You
can reduce your risk of developing bowel
cancer by:
» having a healthy diet high in fruit,
vegetables and fibre
» regular exercise
» not smoking
9
What is the bowel screening
test?
The bowel screening test is an iFOBT
(immunochemical faecal occult blood)
test. It can detect tiny traces of blood
in your bowel motion. This may be an
early warning that something is wrong
with your bowel. If there is blood in your
bowel motion it doesn’t mean you have
bowel cancer, but you will need further
investigation to find the cause of the blood.
How do I do the test?
The test is free and is quick, clean and
simple to do by yourself at home. Your
test kit comes with instructions on how to
use it and a consent form. The kit contains
everything you need. To do the test, you
will need to collect a small sample from
your bowel motion. This is easy to do if you
follow the instructions.
When you have done the test, put the
sample tube in the zip-lock bag provided,
along with the signed and completed
consent form.
Post it as soon as possible. It is important
to return the test kits within six months.
Keep the sample in a cool place until you
post it. To prevent any postal delays, it’s
best not to send it on a Friday, Saturday or
Sunday.
How will I get my results?
You will receive a letter with your results
and information about what this means for
you. You may also receive a phone call from
your doctor or a nurse.
When will I get my results?
You will receive your results within three
weeks of returning your completed bowel
screening kit. If you don’t receive your
results within three weeks, please call
0800 924 432.
What do the results of the
bowel screening test mean?
If no blood is found in your sample, this
means that you don’t need any further
investigation at this time. You will be invited
for screening every two years while the
BowelScreening programme is running, if you
still live in the Waitemata District Health Board
area and are aged between 50 and 74 years.
11
If no blood is found in your sample, it doesn’t
guarantee that you don’t have bowel cancer,
or that you will never develop it in the future. If
you develop any signs or symptoms of bowel
cancer (see page 6), it’s important you talk to
your doctor.
If blood is found in your sample, it doesn’t
mean you have bowel cancer. The blood may
be caused by polyps, or other minor conditions
such as haemorrhoids (piles). It does mean
you will need a further investigation to find
the cause of the blood. Your doctor or a nurse
will contact you to discuss your results and
the type of test that is right for you. If you
have a colonoscopy and polyps are found and
removed, it may be recommended that you
have regular colonoscopies. If you have a family
history of bowel cancer, you may be referred to
a service for assessment and monitoring.
Only a small number of people will
have blood in their sample and of
these, an even smaller number will
be found to have bowel cancer.
How accurate is my result?
No screening test is 100% accurate. If no blood
is found in your sample, it doesn’t guarantee
that you don’t have bowel cancer or that you
will never develop it in the future. There is a
chance that cancer can be missed if there was
no bleeding from it when you did the bowel
screening test. Bowel cancer may also start to
slowly develop between screening tests. That’s
why doctors recommend you take part in this
bowel screening programme. If you develop
any signs or symptoms of bowel cancer, it is
important you talk to your doctor.
What further investigation
might I need?
The most common test used to check your
bowel is a colonoscopy.
A colonoscopy involves a specially trained
doctor putting a thin tube into your anus
(bottom). There is a very small camera on
the end of the tube which is used to examine
the lining of your bowel, to see if there are
any problems.
If the doctor sees any polyps (growths) in
your bowel he/she will generally remove
them and send them to the laboratory to
check for any cancer cells. Removing polyps
is usually painless.
About six in 10 people who have a
colonoscopy will have polyps which if
removed may prevent cancer developing.
About five in 100 people who have a
colonoscopy will be found to have cancer
and will require treatment.
Are there any risks from a
colonoscopy?
Colonoscopy is considered a safe procedure
with few risks. However, as with most
medical procedures, unexpected problems
can sometimes happen. There is a very small
risk that colonoscopy will cause serious
bleeding or damage to your bowel and you
may need further treatment.
13
Do I need to pay for the
colonoscopy, other tests or
treatment?
The colonoscopy and any follow-up tests
or treatments organised through the
BowelScreening programme are free.
What if I have bowel cancer?
If you are found to have bowel cancer you
will be referred to North Shore Hospital for
treatment. The main treatment for bowel
cancer is surgery. In some case chemotherapy
or radiotherapy may be recommended.
How successfully can bowel
cancer be treated?
About 90% of bowel cancers detected at an
early stage can be successfully treated. If
there is a delay in diagnosis and treatment
and the cancer is more advanced, it is harder
to cure.
Do I have all the information
I need?
It’s important that you are fully informed
about all aspects of bowel screening
before you decide to take part in the
BowelScreening programme, and do the
bowel screening test. You can find more
information on the BowelScreening website
www.bowelscreeningwaitemata.co.nz
Who can access my
information?
Information collected about any further
assessment or treatment you may need
will be collected by Waitemata DHB from
both public and private health services
and used to monitor and evaluate the
BowelScreening programme.
Personal information and data are collected,
stored, accessed and destroyed to a
standard that complies with the Health
Information Privacy Code 1994.
15
If I am not satisfied with the
service I have received, how
do I make a complaint?
The Code of Health and Disability Services
Consumers’ Rights allows you to make a
complaint in a way that is appropriate for
you.
If you want to make a complaint about
this programme or the service you have
received, you can phone the BowelScreening
programme on 0800 924 432 for more
information about the best options for you.
You can also get help from the Office of the
Health and Disability Commissioner. Call
0800 112 233 or visit www.hdc.org.nz
For more information on the
BowelScreening programme, please visit
www.bowelscreeningwaitemata.co.nz
or call the programme on 0800 924 432
or speak to your doctor.
For more information on
the BowelScreening programme, please visit:
www.bowelscreeningwaitemata.co.nz
or call the programme on
0800 924 432
or talk to your doctor
March 2014 HP5401