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 Aim – reduce mortality from bowel cancer in population screened by15% by 2020 No self referrals

Welsh Bowel Screening Centre Invitation to visit

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 (1.8% females, 3.0% males)

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

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