PWE-051 Bowelscope: Early Results From The Pilot Sites.

INTRODUCTION: UK population colorectal cancer (CRC) screening has been successfully implemented with Bowel Cancer Screening Programme (BCSP) faecal occult blood testing biannually from age 60-75. A large UK study of once-only flexible sigmoidoscopy (FSIG) demonstrated a reductions in CRC incidence of 33% and death rates of 43% (1). This, with the screening centre infrastructure developed for the FOB programme, allowed provision of a new arm of BCSP, offering FSIG to 55 year olds in England, known as BowelScope screening. BowelScope screening began May 2013, with 6 pilot sites performing FSIGs in the first 7 months.

METHODS: We aim to describe procedural data from the early months of BowelScope screening. Data were obtained from The Bowel Cancer Screening System (BCSS) database for all participants invited and participating in BowelScope FSIGs May-Dec 2013. Procedural data were recorded, including insertion depth, FSIG length, adenoma detection rates (ADR), cancer detection, discomfort levels, entonox usage and colonoscopy conversion rates.

RESULTS: 13927 people were invited or opted in to BowelScope screening at 6 centres. Overall uptake is 43.5% (range 37.0-51.9%). 4 cancers were detected. Polyps were detected in 16.4-23.8% of FSIGs (mean 20.7%). Mean ADR 8.4%. One centre has a significantly higher ADR than the other five sites (p < 0.05) (see Table 1). Most (53%) procedures took 6-10 min. 79% of procedures were reported as causing no or minimal pain only, with only 34 procedures (1%) reporting severe pain. gutjnl;63/Suppl_1/A145-a/T1T1T1 Abstract PWE-051 Table 1 Outcomes by anonymised centre Screening centre Invitees* Attended* Uptake(†)% FSIG with adenomas ADR% Cancer Colonoscopy required (%) 1 3125 1128 (51.9) 100 8.9% 1 39 (3.5) 2 1866 524 37.0 64 12.1% 0 23 (4.4) 3 3779 1070 40.9 90 8.4% 0 50 (4.7) 4 986 311 46.6 25 8.0% 0 12 (3.9) 5 1970 625 47.4 38 6.1% 2 21 (3.4) 6 2181 479 37.2 30 6.2% 1 18 (3.8) Total 13927 4135 43.5 347 8.4% 4 163 (3.9) * as of 20.12.13. † Uptake is calculated from invitees invited ≥16 weeks before 20.12.13 to allow time to respond to invitations and attend for screening.

CONCLUSION: Uptake has varied between centres, but is lower than for the FOB arm of BCSP. Average ADR is 8.4% (range 6.1-12.1%), lower than in the UK flexible sigmoidoscopy screening trial (12.1%(1)) although the age range studied in the trial differs from the cohort described here. Further work will be required to investigate the variation in uptake rates and to improve these rates. ADR variations may also need to be addressed; further analysis of patient groups may explain these differences.

REFERENCE: 1 Atkin et al. Lancet 2010:375:1624-1633 DISCLOSURE OF INTEREST: None Declared.