A five-minute screening test could cut the risk of developing bowel cancer by a third and save thousands of lives from the UK's second biggest cancer killer, according to a team of researchers from institutions including Queen Mary, University of London.
The new 16-year study showed that a single flexible sigmoidoscopy examination in men and women aged between 55 and 64 reduced the incidence of bowel cancer by a third, compared with a control group who had usual care. Screening with flexible sigmoidoscopy (named the 'Flexi-Scope test' by the research team) was particularly effective in the lower bowel, where it halved incidence of the disease.
Over the course of the study, bowel cancer mortality was reduced by 43 percent in the group that had the Flexi-Scope test compared with the control group.
The randomised trial followed 170,432 people over an average period of 11 years, of whom 40,674 underwent a single Flexi-Scope exam.
Co-author of the study, Stephen Duffy, Professor of Cancer Screening at the Wolfson Institute of Preventive Medicine, Queen Mary, University of London, said: "This research shows for the first time that we could dramatically reduce the number of bowel cancer cases and the number of people killed by the disease.
“The results suggest that screening with Flexi-Scope could save thousands of lives by detecting and removing growths on the bowel wall, known as polyps, which can become cancerous if they are left untreated. It is able to prevent cancer from developing by removing polyps before they become cancerous."
About one in 20 people in the UK will develop bowel cancer during their lifetime. In the UK, it causes over 16,000 deaths each year, and is the third most common cancer. Worldwide, it accounts for more than one million cases and 600,000 deaths each year. Around nine in ten cases of bowel cancer occur in people aged 55 and above.
The new results suggest that the Flexi-Scope procedure confers long-lasting protection from developing bowel cancer. In the UK, the Flexi-Scope exam is currently only available through a referral from a GP or specialist, for patients with symptoms.
The researchers behind the study suggest that in addition to saving lives, a screening programme using Flexi-Scope could also reduce the costs associated with treating people with bowel cancer. Research commissioned by the UK Department of Health, published in the journal Gut in 2006, suggested that if a screening programme based on this test was effective, this could save an average of £28 for every person screened.
Professor Max Parmar from the Medical Research Council, which part-funded the study, said: "Most people are unaware that bowel cancer is one of the biggest causes of cancer deaths - only lung cancer tops it. When a study like this generates unprecedented results, it shows the importance of long-term research into the biggest health challenges of the day and also showcases the need for people to volunteer for clinical trials.”
The current screening method for bowel cancer, called the faecal occult blood test, looks for traces of blood in stools and helps to detect cancer at an early stage. Routine screening using the faecal occult blood test is offered every two years for older people in England, Scotland and Wales, although the exact age groups that qualify for screening vary from country to country. This method of screening has been shown to reduce mortality from colorectal cancer by 25% in people who use the test, but it has not been shown to reduce the risk of developing cancer.
This study was funded by the Medical Research Council, the National Institute for Health Research, and Cancer Research UK, and carried out by at team of researchers from Queen Mary, University of London, Imperial College London, University College London, the University of East Anglia and St Mark's Hospital, the University of Oxford.
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