Screening for digestive tract cancers

Early detection of any disease is a key factor, and cancers of the digestive tract are no exception. An early diagnosis can save lives, meaning screening and surveillance are particularly important for those at higher risk.

Bowel (colon) cancer screening

Colon cancer is one of the most common cancers, with around 30,000 patients diagnosed each year in the UK alone. Once you reach 60, you’ll be invited to join a screening programme run by the NHS. Screening then occurs every two years until the age of 75 (later on request). A further test (flexible sigmoidoscopy or “bowel scope” is gradually being introduced an offered to those of us over 55. It involves taking a sample of faeces and testing them for blood. A positive result can indicate that polyps (small growths) are present in the bowel and either could be at risk of turning cancerous, or may have begun to do so.

If the initial test is positive, it will usually be followed by a colonoscopy. Your consultant will use a thin, flexible tube with a camera to see inside your large bowel. If necessary, they will be able to remove any unwanted polyps during this procedure. Patients are asked to take a laxative preparation at home the day before the procedure, and will be offered a sedative during the procedure. While not everyone chooses to take this sedation, it’s offered to ensure patients feel as comfortable as possible during the testing procedure.

A flexible sigmoidoscopy (flexisig) is used to focus on the lower part of the colon. This procedure is less invasive and doesn’t involve sedation or the need to clear the bowel.

Professor Bloom explains how effective the screening test is at detecting bowel cancer, and the importance of taking up the offer.

Oesophageal cancer screening

The UK doesn’t currently have a national screening programme for oesophageal cancer. The only group the British Society of Gastroenterology recommends for screening are patients with Barrett’s oesophagus, as they have a slightly increased risk of developing premalignant change.

Wider digestive tract screening

As stomach cancer is relatively rare in the UK, there is currently no definitive screening test available.

A simple breath test for a bacterium called Helicobacter pylori can be valuable. This bacterium is a cause of ulcers, linked to increased risk of stomach cancer and can usually be cleared up with suitable treatment.

There is no established screening test for pancreatic cancer. Patients with cirrhosis of the liver are screened for liver cancer with regular blood tests and an abdominal ultrasound.

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