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Many patients at risk of bowel cancer ignore follow-up screening

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More than a third of people with abnormal results from faecal occult blood testing drop out of future bowel cancer screening, UK researchers have warned.

They found almost 40% of patients with abnormal results from bowel cancer screening tests and who were referred for further investigation ignored their next screening invitation two years later.

In contrast, only 13% of those who had a normal result failed to continue with screening, said the researchers in the British Journal of Cancer.

“We urgently need to understand why people are dropping out of bowel cancer screening”

Siu Hing Lo

The team, from the Health Behaviour Research Centre at University College London, investigated the behaviour of almost 40,000 people to find out if their experience of bowel cancer screening affected the likelihood of doing the same test two years later.

Lead author Dr Siu Hing Lo said: “Our research has identified a small but high risk group who are failing to continue with bowel cancer screening tests.

“We urgently need to understand why people are dropping out of bowel cancer screening and not attending the follow up investigations as we know the test saves lives,” she said.

The research team, which is funded by the charity Cancer Research UK, has previously found that 11-12% of those referred for further investigations do not attend the appointments for colonoscopy.

Under the NHS Bowel Screening Programme, men and women aged 60-74 in England, Wales and Northern Ireland, and 50-74 in Scotland, are sent an invitation letter and a home screening kit.

Faecal occult blood testing is used to search for blood in stool samples and if detected invited for a colonoscopy. If cancer is not initially diagnosed, they are sent follow-up invitations for screening every two years.

Julie Sharp, head of health information at Cancer Research UK, said: “Only 58% of people who are offered bowel screening in England complete their testing kits, and it’s a concern to see that people who have abnormal results are dropping out of the screening programme. 

“It’s really important to repeat the test every two years,” she added.

Bowel cancer is the fourth most common cancer in the UK, accounting for 13% of cancers diagnosed in the UK.

More than 41,000 people are diagnosed with bowel cancer each year and over 16,000 people die from it each year.

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