The incidence of bowel cancer in the lowermost portion of the large bowel has decreased by approximately 15% following the introduction of the English Bowel Cancer Screening Programme (BCSP) in 2006. The findings also show that the most pronounced reductions in incidence were observed in men and in patients living in areas of greatest socioeconomic deprivation.
In this new study researchers wanted to investigate the impact of the BCSP on incidence rates of bowel cancer among adults in England. After its introduction in 2006, the BCSP was expanded in 2010 to offer screening to all adults aged 60 to 74 years registered with a GP in England. As part of the programme, adults in this age group are automatically sent an NHS bowel cancer screening kit every two years. The age of screening onset is currently being reduced with the NHS Long Term Plan committed to lowering the age threshold to 50 years by 2025.
While the incidence rate of bowel cancer initially peaked in the years following the introduction of the BCSP, it subsequently decreased with the greatest reduction in incidence being observed in tumours of the lowermost portion of the large bowel. In 2001, the incidence of tumours of the lowermost portion of bowel was 11% higher in patients from the most deprived compared to the least deprived areas, reducing to 4% by 2017. Furthermore, men were also noted to have experienced a greater reduction than women over time-period of the study for tumours of both the uppermost and lowermost portions of the large bowel.
Results show that one of the benefits of screening people for bowel cancer is that there is a significant lowering of colorectal cancer incidence rates that is primarily driven by detecting and removing pre-cancerous polyps at colonoscopy.
Future work should be focused on reducing the incidence of tumours of the uppermost portion of the large bowel by increasing screening uptake through use of the new faecal immunohistochemical test (FIT) and improving the quality of colonoscopy. We welcome the reduction in the screening age threshold, as our research group have previously demonstrated that bowel cancer incidence is rapidly increasing in young adults.
Paper: 'Colorectal cancer incidence trends by tumour location among adults of screening-age in England: a population-based study' by Adam. C. Chambers et al. in Colorectal Disease [open access]
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Adam was also interviewed on BBC Radio Bristol (Interview starts at 2:08:50).