Bowel Cancer Screening in West Herts- The First 2 Years!

Alistair KingConsultant Gastroenterologist

How it works Nottingham ‘Hub’ send out invitation

letter to all 60-69 year olds 1 week later send FOB test kit Perform test at home 2% abnormal – notified + booked to

be seen in SSP clinic at local screening centre

At screening centre SSP counsels, assesses fitness and

books colonoscopy Colonoscopy done on dedicated

screening list (3/week) by accredited colonoscopist (AK, SC, BM)

11% cancer- referred to surgeon/MDT Waits: 10d to SSP clinic, 2 weeks to

colonoscopy

Our experience so far:3/3/2008-31/3/2009

Initial Invites 69,886

Self referrals (>70)

1,634

Kits issued 68,225

Kits returned 41,703

% kits returned 61%

Abnormal FOBT 816

% abnormal 2%

Colonoscopies

Number Percentage

Colonoscopies 679

Cancers 63 9%

Polyps 343 51%

High risk polyps 59 8.7%

Proctitis/colitis/Crohn’s

16 2.4% (13%)

Normal 257 38%

Cancers by stageTOTAL 63 % of

staged

Polyp Cancers 12 24%

Duke’s A 6 12%

Duke’s B 18 36%

Duke’s C1 11 22%

Duke’s C2 2 4%

Duke’s D 1 2%

Await full staging

1372% Duke’s B or below

Nationally

Number Percentage

Invitations 5,711,328

Kits returned 3,221,760 59%

Colonoscopy 46,426

Polyps removed 21,393 46%

Cancers detected 4,804 10.35%

Quality assurance All colonoscopy data collected by

SSPs on to BCSS This data is now being compiled

into detailed QA reports Sent to PCTs and to National Office QA visits this summer

Age expansion Age extend to include 70-75yrs This retains central funding: 160K PA 30% increase for 2 years then 50% Centre has done a full 2 yearly cycle Plans to cope with workload Permission given March 2010 then

withdrawn (SSP sick/resigned) As soon as reappoint we can go

ahead ?July 2010

GP electronic communications

3,000,000 result letters sent from BCSS to GP practises per year

BCSS able to send results electronically but GP systems unable to receive them

Minor changes to make these visible ‘Booked in’ by practice staff and

automatically linked to the patient record

May 2010?

Summary 2 year cycle complete:

Everyone now invited Now being invited for second round

41,703 people screened (61% + opt ins)

63 cancers detected- earlier stage 4,802 cancers detected Nationally Age extension 70-75years- ?July

2010

And finally…..

FOBT may miss 45% cancers- if symptomatic please refer!

Currently 61% uptake Any help with publicity

appreciated

GP packs with posters