Download BSW - Bowel Screening Wales

Having a Bowel Test
Professional Pack
March 2010
Having a Bowel Test
A Guide for Health Professionals
• This guide has been developed for use
in conjunction with the :Having a Bowel Test
Bowel Information Pack
for
People with a Learning Disability
March 2010
Aims of the Guide
• To provide health professionals and teachers
with a background knowledge of the bowel
screening programme
• To assist in the provision of education on
bowel screening
• Provide useful website links to access further
information as required
March 2010
How to use this Guide
• Before undertaking a teaching session work through this
professional pack
• The pack allows you to develop your own knowledge base at your
own pace
• Each slide provides the key messages relating to bowel screening
• For more detailed information follow the relevant website links
• To open the links right click and select open hyperlink.
N.B Hyperlinks will only be active when you are using the pack
online
March 2010
About Bowel Screening Wales
• Bowel Screening Screening Wales (BSW) is the organisation that
manages the bowel screening programme in Wales
• It is part of Public Health Wales NHS Trust, Screening Division
• The programme was established in 2008
• The aim of bowel screening is to reduce the number of people dying
from bowel cancer in Wales by 15% by 2020
• All men and women resident in Wales will be eligible for bowel
screening when they reach 50 years of age
Bowel Screening Wales Website
March 2010
Organisation
Public Health Wales
NHS Trust
Screening Division
Breast Test
Wales
Cervical
Screening
Wales
Bowel
Screening
Wales
March 2010
Newborn
Hearing
Screening
Antenatal
Screening
What is Screening?
• Screening provides an opportunity to reduce the risk of
contracting a disease or suffering its complications
• The bowel screening programme reduces the risk of
dying from bowel cancer
• The UK National Screening Committee (NSC) assesses
screening programmes to ensure they do more good
than harm
www.nsc.nhs.uk
March 2010
Definition of Screening
UK National Screening Committee
• “A public health service in which members of a
defined population, who do not necessarily
perceive they at risk of, or already affected by a
disease or its complications, are offered a test to
identify those individuals who are most likely to
be helped than harmed by further tests or
treatment to reduce the risk of disease or its
complications”
March 2010
Principles of Screening
1.
The condition screened should pose an important
health problem
2.
The natural history of the condition should be well
understood
3.
Recognisable latent or early stage
4.
Treatment of the disease at an early stage should
be more beneficial than treatment at a later stage
March 2010
Principles of Screening
5.
There should be a suitable test or examination
6.
It should be acceptable to the population
7.
Screening should be repeated at intervals determined
by the natural history of the disease
March 2010
Principles of Screening
8.
There should be adequate diagnostic and treatment
facilities
9.
The cost – should be economically balanced against
the benefit it provides
10. The chance of physical or psychological harm should
be less than the chance of benefit
Jungner, J.M.G., Wilson, G. (1968) Principles and Practice of Screening for
Disease. World Health Organisation
March 2010
Informed Choice
UK National Screening Committee
“ The public should be given a realistic
view of the merits and flaws of screening
so that they can make an informed choice
and decline an invitation if they wish ”
BMJ 14.10.2000
March 2010
Disadvantages of bowel screening
• Bowel screening does not pick up every
abnormality
• Bowel screening is not 100% effective
• Not all cancers bleed and the screening
test is looking for blood
• Bowel screening can produce false
positive results
March 2010
Advantages of bowel screening
• Regular screening reduces the risk of
developing bowel cancer by 16%
• By detecting bowel cancer at an early
stage there is a 90% chance of successful
treatment
• Bowel screening may detect polyps which
are non cancerous but may develop into
cancer if left untreated
March 2010
What does the bowel do?
• The bowel is part of the
digestive system and is
divided into the small and
large bowel
• Food passes from the
stomach to the small bowel
• Any undigested food then
passes into the large bowel
• The large bowel is made up
of the colon and rectum
March 2010
What is bowel cancer ?
• Bowel cancer is a malignant tumour which
affects the lower part of the digestive
system, ( the large bowel and rectum)
• Bowel cancer is also called colon, rectal or
colorectal cancer
March 2010
How common is bowel cancer ?
• Bowel cancer is the third most common cancer
in Wales
• 2,000 new cases are diagnosed each year in
Wales
• 1,000 people die from bowel cancer each year in
Wales
• Bowel cancer is more common in people over
50
• About 1 in 20 people over the age of 50 will
develop bowel cancer during their lifetime
March 2010
What causes bowel cancer ?
• The exact cause is unknown
• About 1% of all bowel cancers are family
history related
• Certain families have an increased risk of
developing bowel cancer due to a variety
of reasons
• The risk of developing bowel cancer
increases with age
March 2010
What is bowel screening ?
• The purpose of bowel screening is to look for
bowel cancer at an early stage when treatment
is more likely to be effective
• It is a population based screening programme
aimed at the well population
• Bowel Screening Wales does not screen people
who have symptoms
March 2010
Why screen for bowel cancer ?
• Regular screening reduces the risk of
developing bowel cancer
• If bowel cancer is detected early enough there is
a 90% chance of treating the disease
successfully
• It has been shown that a bowel screening
programme can reduce deaths from bowel
cancer by 16%
March 2010
What does the screening test look
for?
• The screening test looks for hidden blood in the bowel
motion which may suggest a risk of bowel cancer
• It is called a Faecal Occult Blood (FOB) test
• The test can also detect polyps. Most polyps are
harmless but some can lead to bowel cancer
• The test does not diagnose bowel cancer but will
indicate if further investigations are needed
March 2010
Who will be invited for bowel
screening in Wales ?
• Men and women aged 60 – 74 who are
registered with a GP and resident in Wales
will be invited.
• They will be invited every 2 years.
March 2010
What does the test involve ?
• A home screening
test kit will be sent in
the post
• Small samples from 3
separate bowel
motions need to put
onto the test kit
• It is then returned in
the post using the
envelope provided
March 2010
How are results received ?
• Results will be posted out within 2 weeks
• Most people (98 out of 100) will have a
normal result (no blood found in sample)
March 2010
What might the results show ?
• If the test is unclear it will be necessary to do a
repeat test
• If blood is detected in the sample the person will
be referred for an assessment with a Specialist
Screening Practitioner
• The assessment may result in being offered
further investigation which may include
colonoscopy
March 2010
What is colonoscopy ?
• Colonoscopy is an investigation that directly
examines the lining of the large bowel
• A thin flexible tube with a camera attached
(colonoscope) is passed into the rectum and
guided around the bowel
• A colonoscopy is the most effective way to
diagnose bowel cancer
March 2010
How accurate is bowel screening ?
• Like all screening tests, the FOB test is not
100% reliable
• Not all cancers bleed and the FOB test is looking
for blood
• However bowel cancer screening has been
shown to reduce the risk of dying from bowel
cancer by 16%
Cancer Research Website
March 2010
What if a bowel test is declined ?
• If the test kit is not returned within 6 weeks a
reminder and repeat test kit will be sent
• If there is no response in 6 weeks the recall date
will be reset and the person invited again in 2
years time
• It is important that any unusual
symptoms are reported to the GP
March 2010
Advice to reduce the risk of bowel
cancer?
• Take part in the bowel screening programme
every 2 years
• Eat a high fibre diet with plenty of fruit,
vegetables and carbohydrates such as
wholegrain pasta, bread and rice
• Stop smoking
• Moderate amounts of exercise
• Report any unusual symptoms to your GP
March 2010
What are unusual symptoms ?
• Rectal bleeding or flecks of blood in the bowel
motion
• A change in regular bowel habits, such as
constipation or diarrhoea, for a period of 6
weeks
• Abdominal pains that are severe, continual and
started recently, especially after eating
• Unexplained weight loss
• Unexplained anaemia
N.B.These symptoms may be caused by a
range of conditions
March 2010
How can you help ?
• Update your knowledge and skills
regularly
• Ensure you are giving the correct
information
• Provide appropriate resources – leaflets,
picture books, factsheets
• If you need any further help or advice
please contact us……
March 2010
For further information….
Contact :• Bowel Screening Wales
Unit 6
Greenmeadow
Pontyclun
Llantrisant
CF72 8XT
Tel: 0800 294 3370
March 2010
• Screening Promotion
Department
Breast Test Wales
Maes Du Road
Llandudno
LL30 1QZ
Tel: 01492 860888.