Bowel Cancer Screening in West Herts- The First 2 Years! Alistair King Consultant Gastroenterologist

How it works Nottingham ‘Hub’ send out invitation letter to all 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/ /3/2009 Initial Invites69,886 Self referrals (>70)1,634 Kits issued68,225 Kits returned41,703 % kits returned61% Abnormal FOBT816 % abnormal2%

Colonoscopies NumberPercentage Colonoscopies679 Cancers639% Polyps34351% High risk polyps598.7% Proctitis/colitis/Crohn’s162.4% (13%) Normal25738%

Cancers by stage TOTAL63% of staged Polyp Cancers1224% Duke’s A612% Duke’s B1836% Duke’s C11122% Duke’s C224% Duke’s D12% Await full staging13 72% Duke’s B or below

Nationally NumberPercentage Invitations5,711,328 Kits returned3,221,76059% Colonoscopy46,426 Polyps removed21,39346% Cancers detected4, %

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for 2 years then 50% Centre has done a full 2 yearly cycle Plans to cope with workload Permission given March 2010 then withdrawn (SSP sick/resigned) As soon as reappoint we can go ahead ?July 2010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