Bowel cancer screening
1-in-14 men and 1-in-19 women will be diagnosed with bowel cancer during their lifetime. Bowel cancer is the fourth most common cancer and the second most common cause of death from cancer in the UK (Office for National Statistics, 2015).
Regular bowel cancer screening has been shown to reduce the risk of dying from bowel cancer. The NHS Bowel Cancer Screening Programme is a nationally co-ordinated programme that aims to identify bowel cancer at an early stage before it becomes symptomatic. The screening programme invites eligible men and women to self-complete a test kit at home every two years.
The Derbyshire NHS bowel cancer screening programme health equity audit examined the local variations in bowel cancer screening uptake and identified approaches to reduce inequalities in uptake. Between 1 April 2014 and 31 March 2016 there were 180,176 invitations to screen sent out to people registered with a Derbyshire County or Derby City GP. The overall uptake of bowel cancer screening was 60.55% (55.68% in Derby City specifically). However, the stand alone average masked significant inequities in access to the programme and contributes to known health inequalities in communities.
The 2018 report highlighted significant geographical and demographic variation in bowel cancer screening in Derby City. It was found that low uptake was associated with: men, socio-economic deprivation, younger age groups eligible for screening, specific ethnicities and particular geographies (areas characterised by high levels of social-rented accommodation, multicultural urban communities and transient populations). There was also wide variation by GP Practice, wards and LSOAs.
Test positivity was generally higher in places with lower uptake. For instance, uptake was lowest in the most deprived decile group (38.09%) but this decile had the greatest proportion of abnormal (positive) screening test results.
What's more it was discovered that just 1-in-10 individuals who had overlooked previous screening invitations went on to be screened in the current screening round. Suggesting repeat postal invitations to previous non-participants is likely to be an inefficient way to engage with this population for bowel cancer screening.
The audit findings has led to targeted approaches and the development of strategies to increase the awareness of bowel cancer and screening uptake in communities that have the greatest capacity to benefit.
The full Derbyshire NHS bowel cancer screening programme health equity audit 2018 report is available for download in the hyperlink included below. In addition, the insight generated from the use of market segmentation tools in our public health practice has been published in a peer reviewed paper in the Journal of Epidemiology & Community Health.