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Frequently Asked Questions

About screening

Bowel screening aims to find cancer at an early stage when treatment is likely to be more effective. Early detection is key. At least 9 out of 10 people will survive bowel cancer if it’s found and treated early.
 
What is changing?
Research has shown that a new screening test kit called a Faecal Immunochemical Test (FIT) kit is simpler and more reliable than the old style test.
 
Why is a new test being introduced?
The new test kit is easier for people to use as only one poo sample is needed. The new test kit has been shown to increase the number of people taking part in bowel screening. It is also more accurate; it measures how much blood is in your poo and your diet and medication are unlikely to affect the results.
 
Evidence supports population screening in the 50 - 74 age group. In Wales, there is an improvement plan to offer screening to those aged 50- 59 by 2024 and we have developed a plan to achieve this in stages. You will be invited by Bowel Screening Wales according to this plan. 
 
I am over 74, can I be screened?
Evidence does not support population screening for those aged over 74. Bowel Screening Wales do not facilitate for individuals to opt into the programme beyond the age of 74 years. Once the programme has fully optimised we hope to work with Welsh Government to allow for opt-ins.
 
I think I had a colonoscopy last year should I take part?
Yes- it's safer to take part as the test that you had may not have been a full screening colonoscopy or it may be that more than a year has passed since you had it. The new FIT measures tiny amounts/micrograms of human haemoglobin per gram of faeces (μgHb/g faeces) in the test sample.
If your result shows that you need further tests you will have an assessment with a screening nurse who will check your past medical history with you and help you decide if a colonoscopy at this time is right for you.
 
I don’t have a GP practice, will I still be invited?
You need to be registered with a GP in Wales to receive an invitation from the Bowel Screening programme. If you aren’t registered with a GP but would like to take part please contact the helpline on 0800 294 3370.
 
When will I be invited?
All eligible participants are called every two years from either their birthday, date of arrival/registration in Wales or from the date of their last result.
 
I'm already on symptomatic bowel surveillance should I take part?
You should discuss taking part with your treating medical team, GP or by calling our Freephone helpline and speaking to one of our nurses.
 

About the test kit

I have lost or damaged my kit can I get another one?
Yes – Bowel Screening Wales can issue a replacement test kit by visiting our website or by calling the helpline on 0800 294 3370.
 
What do I have to do to complete the test kit?
Instructions are enclosed with your test kit. Collect one sample of poo. Use folded toilet paper or a clean disposable container placed in the toilet to catch your poo. Unscrew the lid of your test tube and scrape the stick along the poo to collect a very small amount on the end of the stick. Return the stick into the tube and twist the top to close it securely. Place it in the return envelope and post the same day if possible. You can expect the result in under 10 working days from when it is received in the laboratory.
 
How does the laboratory test my sample?
All samples need to be tested within 14 days of the sample being applied. Do not apply your sample until you are ready to post it back to us. Bowel Screening Wales tests for the amount of blood that is present. The laboratory machine will give a figure of how much blood is found in the poo sample. Welsh Government and Public Health Wales have agreed a cut-off level where further tests will be offered to participants to explore why blood has been found.
 
Can you tell me my result level measured?
Based on the result of the screening test, Bowel Screening Wales will advise whether further tests are recommended for you. You can ask for your numerical test results by contacting our Freephone helpline on 0800 294 3370, in writing or via the website.  We will send your result by post.
 
Can FIT be used in the assessment of patients with symptoms?
Screening is for people with no apparent symptoms. If you are worried about any symptoms you should see their GP. In primary care (a separate setting from the screening programme) there is growing evidence that the FIT test can be used to help doctors triage people with possible bowel cancer symptoms. This involves using FIT in a completely different way, with a different cut off level to ‘rule in’ or ‘rule out’ further diagnostic tests such as a colonoscopy. A normal FIT screening test is not a guarantee that you do not have cancer – please tell your GP if you have symptoms.
 
Should I stop my medication before doing this test?
No, you should continue your medication as normal and do the test. If you taking Warfarin, Aspirin, anti-inflammatories, some antibiotics or blood thinning medication there may be a higher chance of a result that needs further tests.
 
I may have an infection of my bowel should I take part?
If your GP has told you that you have an infection in your bowel you may want to wait a few days until this has cleared up. All samples are treated as potentially hazardous so no additional precautions are needed.
 
Once I post off my kit, how long will it take to receive my result?
Bowel Screening Wales will send you the result within 2 weeks of it arriving in the laboratory.
 
I have lost my pre-paid envelope, can I just use an ordinary envelope.
No, the prepaid envelope has been specially approved and has been designed to meet postal regulations. If you need a replacement envelop please contact us via our website or call the Freephone helpline on 0800 294 3370.
 
I forgot to write the date on the test tube
If the kit has arrived at our laboratory within 14 days of the day it was issued we will be able to process your test kit. If it is returned after 14 days the laboratory will not be able to process the test kit and we will send you another test kit. Please take a look at your instruction leaflet or you can call the helpline again for further help and we can advise you on what went wrong.
 
Why do I have to repeat the test?
There are a few reasons why you may need to repeat the test. We will write and tell you with an offer for you to complete another test kit. Please take a look at your instruction leaflet or you can call the helpline again for further help and we can advise you on what went wrong.
 
Will my GP be notified of my result?
Your GP records will be automatically updated with your result or if you have not responded to the invitation. Your GP may discuss your decision with you.
 
Can I reuse the stick if I've made a mistake?
Please do not re-use the stick if you've already put them in your sample but have made a mistake. You can get another kit on our website or by calling the Freephone helpline on 0800 294 3370.

About results

What if my result shows that I do not need further tests?
You will be invited again in 2 years’ time until you reach the age of 74. You should be aware that no screening test is 100% effective and therefore it is important to watch out for these symptoms:
• Bleeding from your bottom and/or blood in your poo.
• A persistent and unexplained change in bowel habit.
• Unexplained weight loss.
• Extreme tiredness for no obvious reason.
• A pain or lump in your tummy.
 
These symptoms can be caused by a number of conditions, not just cancer. If you have noticed any of these yourself, make an appointment to see your doctor.
 
I have received my result letter which says I don’t need further tests - does this mean I definitely don't have bowel cancer?
No - the screening test is not 100% accurate because not all cancers bleed all of the time, and blood is what the screening test is looking for. Changes can also happen in between one screening test and the next, so it is important that you repeat the screening test every 2 years and never ignore symptoms.
 
I saw blood in my poo but I have a result not needing further tests?
Sometime blood streaks on the outside of the poo can be caused by external bleeding such as "piles". If you can see blood you need to tell your GP so that your symptoms can be assessed and a different test may be suggested for you. The screening test can only be done at two yearly intervals. Usually blood from a bowel cancer is broken down and it would be unusual to see it with the naked eye. If you have any concerns you should discuss your symptoms with your GP.
 
 
A colonoscopy is a way of looking at the lining of your large bowel (colon), to see whether there is any disease present. This test also allows us to take small samples of your bowel (biopsy) for analysis in the laboratory if necessary. The instrument used is called a colonoscope (scope) and is flexible. Within each scope is a light which can be directed onto the lining of your bowel. The pictures can be seen on a screen so the colonoscopist can then check whether or not disease or inflammation is present.
 
 
Because a colonoscopy takes samples of your bowel sometimes there are complications.  These are rare but you need to know about them so you can make your decision about having the test.
The risks must be compared to the benefit of having the test.
The main risks of a colonoscopy are:
  • Perforation – for 1 in every 1,000 tests there is a tear of the lining of the bowel.  An operation is nearly always required to repair the hole.  The risk of perforation is higher when polyps (small growths) have been removed.
  • Bleeding - this may occur where the sample of your bowel was taken or where a polyp has been removed. The risk is about one for every 100-200 tests where this is done. Bleeding is not usually serious and often stops on its own.

Should I take part?

Yes - although you may have an increased chance of blood being found in the poo, it is recommended that you take part in bowel screening. Should your kit test result show you need further tests, your medical condition will be assessed by a screening nurse who will refer you for colonoscopy.
 
The best way to find out what is causing a result needing further tests is to examine the bowel by colonoscopy. It is possible to have bleeding haemorrhoids and also have another bowel condition or a bowel cancer.
 
Yes, if you still have part of your large bowel, you can take the samples from your stoma bag. Remember the poo has to have passed though large bowel or rectum for the test to be useful.
 
No, if you no longer have a large bowel and have a permanent Ileostomy then there is no need for you to complete the test. We will contact your GP and have this confirmed so that you no longer receive the invitation every 2 years.
You can't use a sample from an ileostomy bag as the fluid has passed through the small bowel and not the large bowel. The poo sample has to have passed through the large bowel or rectum for the test to be useful.
 
Please try to use this test kit sent out to you. You do not need to date it if it will arrive for testing within 14 days of the day that it was issued. You can telephone the Freephone helpline and speak to one of our nurses to discuss other ways we may be able to help.
 
These symptoms may be caused by a number of conditions including cancer, but if you are experiencing any of them, you should make an appointment to see your GP. If you have been sent a test kit we recommend that you still take part in the screening programme.
A number of common bowel conditions can have similar symptoms to bowel cancer. These include:  Haemorrhoids (piles), Anal Fissures (a tear in the lining of the back passage or the skin around it), polyps (‘wart’ like growths in the bowel), Irritable bowel syndrome, Diverticular Disease or Inflammatory Bowel Diseases such as Ulcerative Colitis or Crohn's disease.
 
We would recommend discussing further with your oncologist. If you have any further queries please contact the helpline again to speak to one of our nurses.
 
No, you will be recalled for screening every two years, providing you are still within the eligible age range, 58-74. Your decision not to take part this time will not affect any care you receive from your GP or hospital.
 
What if there’s a family history?
Some people have a family history of bowel cancer. Your GP may refer you to the all Wales Genetics Service if you have a family history. If you are not having colonoscopic surveillance for family history you should still complete the test kit.
 

I don’t want to take part

I don't want to be contacted for bowel screening ever again! Can you remove my name from bowel screening invitation please?
Yes - We can send you a disclaimer form to sign and return to us and we can stop further invitations being sent to you. If you change your mind and are still within the eligible age range, 58-74, you can opt back in at any time by contacting Bowel Screening or speaking to your GP practice.
 
What personal information do you hold on me?
Bowel Screening Wales records only your name, date of birth, contact address and the results of your screening tests. Only staff within the screening centre and appropriate health care professionals will see your personal screening information. The statistics/results of the data are used to improve the service. If you require more information, please contact the helpline in writing and further explanation can be posted out. You can also view our privacy policy.
 
I feel well so I don't need to do this test - there's no family history of cancer, and I don't have any symptoms - I'll not bother with this - so take my name off.
The idea of screening is to pick up disease at an early stage before symptoms develop and when the chances of cure are more likely. We would encourage you to do the test, however we respect your decision if you decide not to take part in Screening.
 
I am a carer: Can I help do the test for someone I care for? Can I opt someone else out of screening?
It is important that the individual who is invited to take part in bowel screening can make an informed choice about taking part. It would not be appropriate to carry out testing on behalf of someone who is not capable of making this decision unless you been given the legal authority to do so; for example you have the Power of Attorney for Health and Welfare on behalf of the individual. For more information please visit our website www.bowelscreening.wales.nhs.uk or contact the helpline to speak with one of our nurses.
 

Other questions

You may find it helpful to know that participants are also reminded that no screening test is 100% effective and that problems can arise between screening tests.
It is therefore important that there is an awareness of these symptoms:
  • Bleeding from your bottom and/or blood in your poo.
  • A persistent and unexplained change in bowel habit.
  • Unexplained weight loss.
  • Extreme tiredness for no obvious reason.
  • A pain or lump in your tummy.
These symptoms can be caused by other conditions, including bowel cancer.
 
This is an NHS national screening programme, approved by the Welsh Government, and as such, we are required to ensure that all eligible individuals are offered the chance to take part. We are provided with details of all eligible individuals from the Welsh Demographic System, a national NHS GP database containing details of the names, addresses, dates of birth and GPs of all Welsh residents.  This enables us to send screening invitations to all eligible people and to ensure that everyone is offered the chance to participate if they wish. The same method is used to invite people for all other national screening and immunisation programmes.
 
Access to information from the Welsh Demographic System is very strictly controlled and complies fully with the Data Protection Act. We have full approval from the appropriate local and national NHS bodies to use this data in the way described.  No medical details are held on the Welsh Demographic System and bowel screening has no access to any medical records.
 
Staff at a GP Practices, long term care institutions or HM prisons or forces bases can request a replacement test kit by visiting our website www.bowelscreening.wales.nhs.uk
The screening test is not expected to be used to investigate symptoms.  There are Referral Guidelines for Suspected Cancer published on the Wales Cancer Network Website under Lower Gastrointestinal Cancer. You cannot refer someone for bowel screening – the public will be invited if they are on the Welsh Demographic System by Bowel Screening Wales.
 
I've received bowel screening mail for someone who does not live as this address - what should I do with the mail?
Please return the mail you have received marked “Not at this Address" so that we can update this information on our system.
 
What can I do to help prevent bowel cancer? 

·        Take part in the bowel screening programme every two years.

·         Move more

o   Being active helps you feel better and can reduce your risk of developing a serious illness.

o   Aim to be active for at least 2½ hours a week.

·         Drink less

o   Drinking alcohol can also increase your risk of heart disease, cancer and liver damage.

o   If you want to keep the risks low, drink no more than 14 units a week.

o   If you want to cut down, have several drink-free days a week.

·         Eat well

o   Eating fruit and vegetables may help reduce your risk of developing serious diseases such as cancer and heart disease.

o   Try to eat at least five portions of fruit and vegetables every day.

·         Don’t smoke

o   Stopping smoking will improve your health.