Bowel cancer screening unacceptable to one in ten

Cancer Research UK

At least one person in ten has a negative attitude to bowel cancer screening*, particularly those from South Asian backgrounds, says research published in the British Journal of Cancer** today (Wednesday).

Researchers from the University of Birmingham sent a questionnaire to men and women aged 50-69 years who are registered with general practices in the West Midlands to study their attitude to bowel cancer screening. Some 11,355 people - 53 per cent of those who received the paper responded.

Participants were told about three bowel screening tests: faecal occult blood testing (FOBT), colonoscopy and flexible sigmoidoscopy. They were then asked: 'Screening using the above procedures can be used to look for evidence of early bowel cancer and conditions that may progress to bowel cancer in people who have symptoms. Do you think this is a good idea?' Some 14 per cent of respondents replied either 'No' or 'Not sure' indicating a negative attitude towards bowel cancer screening.

Thirteen per cent of the study population found the FOBT either very unacceptable or unacceptable. The UK's bowel screening programme uses the FOBT to screen for bowel cancer before there are any symptoms - it detects blood in stools. Men and women aged between 60-69 in England are invited to take part in the home test every two years and people over 70 can request a test if they want one.

Evidence shows that the bowel cancer screening every two years has the potential to reduce deaths from the disease in those screened by 15 per cent - and it is estimated that people who take part in the screening had a 25 per cent reduction in their risk of bowel cancer - possibly caused by being more aware of disease symptoms.

Twenty three per cent found the follow up colonoscopy test, either very unacceptable or unacceptable and 22 per cent held these views for flexible sigmoidoscopy*** - another test to diagnose bowel cancer.

Men, older people and those with a South Asian ethnic background were most likely to have a negative attitude to being screened, while people with lots of symptoms - those reporting abdominal pain, bleeding or tiredness were more likely to have a positive attitude**** towards screening.

Dr Taina Taskila, lead study author, based at the University of Birmingham, said: "Our research shows that members of South Asian communities may be less aware of bowel cancer and the associated symptoms and feel less confident about the value of screening - previous research has shown that they also tend to view their risk of bowel cancer as lower."

She added: "These research findings will help direct educational programmes - clearly part of this will involve targeting people from South Asian backgrounds to make them more aware of the importance of bowel cancer screening."

Each year more than 37,500 people are diagnosed with colorectal cancer in the UK - that's more than 100 people every day and bowel cancer is the second most common cause of cancer death in the UK - around 16,000 people die each year. More than eight in 10 bowel cancers are found in people over the age of 60.

Regular screening could significantly reduce death from this disease - and patients' attitudes are a major factor in determining whether a patient will attend screening or not.

Sara Hiom, Cancer Research UK's director of health information, said: "This interesting research shows the importance of increasing the knowledge of symptoms of bowel cancer among ethic minority groups in the UK.

"It can be embarrassing to talk about some of the symptoms, such as bleeding from the back passage or blood in stools but it is essential to visit your doctor if you notice anything unusual."

ENDS

For media enquiries please call the Cancer Research UK London office on 020 7061 8300, or the out of hours' duty press officer on 07050 264059.

Notes to Editor

**Factors affecting attitudes toward colorectal cancer screening in the primary care population. British Journal of Cancer. T Taskila et al.

***Sigmoidoscopy

Sigmoidoscopy (or sigmoidoscope) is an examination of the inside of the rectum (back passage) and colon (large bowel) as far as the sigmoid colon. The sigmoid colon is the 'S' shaped part of the large bowel on the lower left of the abdomen.

Colonoscopy

A process used in the diagnosis of bowel cancer where a flexible fibre optic instrument is inserted through the anus in order to examine the colon.

Faecal occult blood test

This detects small amounts of blood in faeces which you would not normally notice.

In England, the NHS Bowel Cancer Screening Programme will be rolled out in all areas by the end of 2009. Men and women aged between 60 and 69 years old are sent a stool testing kit every 2 years. People aged 70 and over can request a kit. From 2010, people aged 70 to 75 will also be included in the screening programme.

****Black Caribbean respondents had a more favourable attitude towards screening than white people. More Caribbean respondents were women (65%) compared with white respondents (53% female) and Indian (51% female) which could partly explain a more positive attitude.

*Bowel Screening

The national bowel screening programme in Scotland started in June 2007 to be rolled out across the whole country over two years. Men and women aged between 50 and 74 years are sent a stool testing kit every 2 years.

In Wales the NHS plans to test people between the ages of 50 and 74 every two years. Men and women aged between 60 and 69 from October 2008 receive stool testing kits. The NHS hopes to have rolled the service out to everyone else in the target age group by 2015.

In Northern Ireland the NHS plans to start screening in 2009.

Symptoms of bowel cancer

The symptoms of colorectal cancer can be

Bleeding from the back passage (rectum) or blood in your stools

A change in normal bowel habits towards diarrhoea or looser stools that lasts longer than 6 weeks

A lump that your doctor can feel in the right side of your abdomen, or in your rectum

A straining feeling in the rectum

Losing weight

Pain in your abdomen or rectum

Anaemia (a low level of red blood cells)

Because bowel tumours can bleed at times, cancer of the bowel often causes a shortage of red blood cells. This is called anaemia. It can lead to tiredness and sometimes breathlessness.

Sometimes cancer of the bowel can cause a blockage. The symptoms of this are

Griping pains in the abdomen

Feeling bloated

Constipation

Being sick

Anyone affected by cancer can contact Cancer Research UK’s cancer information nurses on 0808 800 4040 (freephone) or visit the charity's patient information website here