Bowel Screening in Wales
The First Two Years
Hayley Heard
Head of Programme
Bowel Screening Programme
•
Implemented October 2008
•
National coverage
•
Initial eligible age range 60-69 years
•
Eligible population identified and invited
•
Home faecal occult blood test kit
•
Tested centrally
•
Positive – referred to SSP
•
Colonoscopy if appropriate
Welsh Bowel Screening
Centre
Local Assessment Centres
First Round of Screening
Invitation and Testing
• People invited 412,000
• Uptake 55%
• Spoilt test kit 1.7%
• Positivity rate 2.8%
• People contacted helpline 57,620
• People booked SSP appointments 6,807
First Round of Screening
Specialist Screening Practitioners
• 16 SSP’s
• Referrals to SSP 7,293
• Waiting time average 2 weeks
• Appointments attended 82.7%
• Found fit for colonoscopy 90%
First Round of Screening
Colonoscopy
• 16 approved Screening Colonoscopists
• Waiting time average 10 weeks
• Colonoscopies undertaken 5,230
• DNA colonoscopy 0.2%
• Decline colonoscopy 2.8%
First Round of Screening
Pathology
• Cancers detected 414 (7.9%)
• Dukes A 32.7%
• Polyps detected 3,224 (62%)
• Inflammatory Bowel Disease 120 (2.3%)
First Round of Screening
Radiology
• Referrals 2.1%
• CT 2.07%
• Barium enema 0.07%
First Round of Screening
Adverse Events
• Events reported 55
• Bowel perforations reported 3
• No deaths
First Round Challenges
• High Positivity Rate
• Local Assessment Centre Capacity
• Assessment of Screening Colonoscopists
• Information Management System
Ongoing Challenges
• Improve Uptake
• Age Extension
• Surveillance
• Recruiting Screening Colonoscopists
• Electronic Quality Assurance Data
Potential Developments
• Flexible Sigmoidoscopy Screening
• Revised Testing Strategy
• Network MDT for Complex Polyps
• National Referral Centre for Complex Polyps
• Screening for Hard to Reach Groups
• Research
Thank You