‘Unacceptable’ failures in bowel cancer tests

Thousands of bowel cancer cases are being missed due to “unacceptable” testing failures. British research, published in the BMJ, found that some providers carrying out colonoscopies were three times as likely as others not to spot signs of the disease. At the worst screening units, almost one in 10 cases that turned out to be bowel cancer were not picked up during the tests. Researchers said that almost 4,000 more cases could have been treated sooner with better screening.

THOUSANDS of bowel cancer cases are being missed due to “unacceptable” testing failures.

British research, published in the

BMJ, found that some providers carrying out colonoscopies were three times as likely as others not to spot signs of the disease.

At the worst screening units, almost one in 10 cases which turned out to be bowel cancer were not picked up during the tests, the study by the University of Leeds found.

Researchers said that almost 4,000 more cases could have been prevented or treated sooner had there been better screening over a nine-year period.

They warned of “unacceptable variation” between units, with the worst results seen at private providers given NHS contracts to carry out the tests.

Bowel cancer is the fourth most common cancer in the UK and the second biggest killer of all the cancers. More than 42,000 people are diagnosed with the disease every year in the UK.

The study involved more than 120,000 men and women who underwent a colonoscopy at all screening providers in England.

It examined rates of cancer among those who were diagnosed at least six months after being given the all clear.

The study found an overall improvement between 2005 and 2013. In 2005, nine per cent of cases diagnosed with bowel cancer had received a negative result in a colonoscopy between six months and three years earlier – meaning the patients could potentially have been diagnosed far earlier. By 2013, the figure was 6.5 per cent.

If the earlier figure matched the later standard, 3,900 cases of bowel cancer would have been spotted earlier, or even prevented, researchers said. Even now, some providers have rates of “post-colonoscopy colorectal cancers” three times higher than those of others, the study found.

The best rates, of 3.6 per cent, were provided by NHS screening units, while the worst, of 9.3 per cent, were seen at independent providers being used by the health service.

The study found that women, those aged 80 and over, and patients suffering inflammatory bowel disease were the most likely to receive a diagnosis of bowel cancer in the years after a colonoscopy with a negative result.

Researcher Roland Valori, a consultant gastroenterologist at Gloucestershire Hospitals NHS Foundation Trust, said: “We are seeing unacceptable variation in post-colonoscopy bowel cancers between providers in the English

NHS and this variation in quality needs to be addressed urgently.” The British Society of Gastroenterology said postcolonoscopy bowel cancers should be used as a benchmark for the quality of the testing service.

Dr Nick Burr, lead author of the study from the University of Leeds, said: “We need a targeted improvement programme to reduce this variation. Ensuring we have uniform high standards for colonoscopies will help us reduce the number of post-colonoscopy cancers further, and improve mortality from this preventable disease.”

Dr Lisa Wilde, from Bowel Cancer UK said: “It is clear from the research that variation between colonoscopy providers in England must be reduced.”

Colonoscopy is the main test used to diagnose bowel cancer and can also help to prevent it by removing pre-cancerous growths, known as polyps.