A study looking at a new way to screen for bowel cancer

Cancer type:

Bowel (colorectal) cancer

Status:

Results

Phase:

Pilot

This study looked at adding a screening test called a bowel scope to try to improve the NHS Scotland Bowel Cancer Screening Programme.

It was for people due to have bowel screening who were around 60 years old.

This study was open for people in Scotland to join between 2014 and 2015. The team published the results in 2019.

More about this trial

Bowel cancer screening aims to detect bowel cancer at an early stage when treatment is more likely to work.

When this trial was done, people in Scotland aged between 50 and 74 years old were sent a poo testing kit every 2 years. At the time, they used the faecal occult blood test or FOB test. It looks for tiny traces of blood in your poo.

The researchers wanted to see if they could improve screening for bowel cancer. So they offered some people a type of screening test called a bowel scope or flexible sigmoidoscopy. This test was already used to find small growths (polyps Open a glossary item ) in the bowel that could possibly become cancerous.

In this trial, some people had an FOB test, and some people were offered a bowel scope test. The researchers compared these results.

The main aims of the study were to find out:

if people were willing to have the bowel scope test
how well the bowel scope screening test worked to detect bowel cancer
whether to offer everyone a bowel scope test due to have bowel cancer screening in Scotland

Summary of results

The study team found that not that many people who were due to have bowel screening wanted to have a bowel scope. And they found low numbers of bowel cancer in this round of screening. They also found that having a bowel scope didn’t find more bowel cancer but it did find more adenomas Open a glossary item which can become cancerous.

About this study
51,769 people who were due to have screening in Scotland were put into 1 of 2 groups at random. There were:

25,851 people in the bowel scope group (the intervention group)
25,918 people in the poo test (FOB test) group (the control group )

Diagram 1

People who didn’t want to have a bowel scope and those with a normal bowel scope went on to do the poo test later on.

Everyone who had an abnormal bowel scope or a poo test that showed traces of blood had a colonoscopy. This is a test that looks at the whole of the inside the large bowel.

Results
The team looked at who agreed to screening. They found that:

9,345 people (36%) agreed to have the bowel scope
just under half of those people (4,597) went on to have the scope
15,366 people (59%) in the control group did the poo test

More men than women agreed to have a bowel scope. And the number of people willing to have the scope was lower in people from poorer (deprived) backgrounds.

The team analysed the results of everyone included in this round of screening. They looked at the number of people diagnosed with bowel cancer. This was:

23 people who had the bowel scope test
18 people who did the poo test

They also looked at the number people who had a type of polyp called an adenoma Open a glossary item . Adenomas are not cancerous (benign) but can develop into cancer over time. Most bowel cancers develop from polyps.

They found the number of people who had an adenoma was:

463 people who had the bowel scope test
80 people who did the poo test

So the team didn’t find more bowel cancer in people who had the bowel scope. But they did find the number of people who had an adenoma was much higher compared to the control group.

Conclusion
The team concluded that adding the bowel scope to the poo test wouldn’t improve bowel screening in Scotland. They didn’t find that many people were willing to have the bowel scope. And other factors such as waiting times to have the bowel scope made it harder to deliver.

The team did find more adenomas in the group who had the bowel scope compared to those who did the poo test alone.

All trial results help doctors and researchers understand more about different cancers and the best way to diagnose or treat them.

Where this information comes from

We have based this summary on information from the research team. The information they sent us has been reviewed by independent specialists (peer reviewed Open a glossary item ) and published in a medical journal. The figures we quote above were provided by the trial team who did the research. We have not analysed the data ourselves.