Bowel Screening in Wales

1. Bowel Screening in Wales The First Two Years Hayley Heard Head of Programme

2. 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

3. Welsh Bowel Screening Centre

4. Local Assessment Centres

5. 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

6. 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%

7. 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%

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%)

9. First Round of Screening Radiology • Referrals 2.1% • CT 2.07% • Barium enema 0.07%

10. First Round of Screening Adverse Events • Events reported 55 • Bowel perforations reported 3 • No deaths

11. First Round Challenges • High Positivity Rate • Local Assessment Centre Capacity • Assessment of Screening Colonoscopists • Information Management System

12. Ongoing Challenges • Improve Uptake • Age Extension • Surveillance • Recruiting Screening Colonoscopists • Electronic Quality Assurance Data

13. 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

14. Thank You