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Bowel cancer screening can be improved by new test (FIT)

Screening for bowel cancer can be significantly improved by adopting the Faecal Immunochemical Test (FIT), say experts. The UK National Screening Committee (UK NSC), which advises the NHS and government, recommended that the FIT should replace the current test used in the NHS Bowel Cancer Screening Programme.

The current method used in the national screening programme is the Faecal Occult Blood (FOB) test, but the panel of experts concluded that not only is FIT considerably easier to use, it is also more reliable, and would provide the opportunity to detect and prevent more cancers.

Faecal Occult Blood Testing – also called FOBT or FOB – works by testing for hidden traces of human or animal blood in faeces. According to Cancer Research UK, out of every 1,000 people in England who have the FOB test, around 20 (2%) will have an abnormal result. Around 16 out of every 20 people with an abnormal result will have an examination of the bowel called a colonoscopy to see whether there is a problem that needs treatment. Of the 16 people, about eight will have nothing abnormal found, about six will have polyps, and about two will have cancer.

The test can return false negative and false positive results, however. Other medical conditions or recent dental work can cause an abnormal FOB result, because the test cannot easily distinguish between human blood and other similar substances that may have been ingested with food, red meat, turnips or horseradish eaten in the three days before the test. These foods therefore can all generate a false positive result. Most people who have an abnormal FOB result do not have cancer.

FIT, however, only detects human blood from the lower intestines. Medicines and food do not interfere with the test, so it tends to be more accurate and have fewer false positive results. The test can also be self-administered in the home.

Gordon Wishart, Professor of Cancer Surgery and Medical Director of Check4Cancer, comments: “FIT is the method we have been using at Check4Cancer and BowelHealth UK for over four years now, and it has proven its worth during that time. It is very simple to administer, but – crucially – it has a significantly higher degree of accuracy. That means it can reduce the number of unnecessary, invasive investigations among those who do not have cancer with all the anxiety this causes – but also, more importantly, it will save more lives.”

The UK National Screening Committee – an independent group of experts – exists to advise ministers and the NHS in the four UK countries about all aspects of population screening and supports implementation of screening programmes.

In its report published on 15 January 2016, following a meeting on 19 November 2015, it made a total of 11 recommendations, which included improvements to existing screening programmes for Down’s syndrome and other related conditions, cervical cancer, bowel cancer and eye screening for people with diabetes.

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