Presentation on theme: "Wilson and Jungner Criteria for Screening 1968"— Presentation transcript:
1 Wilson and Jungner Criteria for Screening 1968 Knowledge of disease:The condition should be important.There must be a recognisable latent or early symptomatic stage.Natural course of condition, including development from latent to declared disease, should be adequately understood.Knowledge of test:Suitable test or examination.Test acceptable to population.Case finding should be continuous (not just a "once and for all" project).Treatment for disease:Accepted treatment for patients with recognised disease.Facilities for diagnosis and treatment available.Agreed policy concerning whom to treat as patients.Cost considerations:Costs of case finding (including diagnosis and treatment of patients diagnosed) economically balanced in relation to possible expenditures on medical care as a whole.
3 Why Screen for Bowel Cancer? 1 in 20 of UK population will develop bowel cancer.3rd most common cancer.2nd biggest cancer mortality – 16,000 deaths from bowel cancer per yr in UK.Screening has been shown to decrease mortality by 16%.
4 What is the purpose of screening? Early (pre-symptom) detection at time when more likely to be curable.Polyp detection and excision can reduce incidence of future cancers.
5 How is the screening organised? Nationwide coverage since 2010.All 60-69yr olds every 2 yrs – over 70s can request test.Program hubs organise call and recall and co-ordinate with local screening centres.Piloted in North Warwickshire (2006-7).Approx ½ Million residence with 57% uptakeApprox 2% postive and 1.6/1000 dx Bowel CaHigher rates in men and in Scotland.552 cancers detected.92 (16.6%) Polyps.48% Dukes A1% MetastasisedCost £76.2 Million per yr.
6 The Test Bowel Cancer – the facts leaftlet sent out. Kits opposite sent out a week later.Sample smeared from paper on to 6 test areas.Positive: samples positive.Unclear: samples positive.Negative: All samples negative.
7 What Happens?Majority of people approx 98% have normal result and will be invited back in 2 yrs.Approx 2% will have a positive result and will be called for discussion re colonoscopy.Approx 4% will have equivocal result and have further test sent – most of these will be normal.
8 Colonoscopy 5 of 10 will have a normal colonoscopy. 4 of 10 will have a polyp – which if removed will reduce the risk of cancer.1 of 10 will have bowel cancer.Risks:-1 in 150 heavy bleeding.1 in 1,500 perforation.1 in 10,000 – death.
9 Predicted Outcomes and The Screening Pathway outcome-flowchart.pdfscreening-pathway.pdf