BowelScreening. All about BowelScreening

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1 BowelScreening All about BowelScreening

2 2 This booklet may help you decide whether to take part in the free BowelScreening programme and take a bowel screening test. The booklet explains how the test can help find bowel cancer at an early stage when it can often be cured, and it provides information about the potential risks and benefits of screening. It is important you have all the information you need to decide if the BowelScreening programme is right for you. If you need more information, you can call the BowelScreening programme on , go to the website: or talk to your doctor.

3 3 What is the free BowelScreening programme? BowelScreening is a free programme to check people for early signs of bowel cancer. BowelScreening is being offered to everyone aged 50 to 74 living in the Waitemata District Health Board (DHB) area who is eligible for publicly funded healthcare. It is a four-year programme to test whether bowel screening should be introduced throughout New Zealand. Everyone eligible to take part gets an invitation letter, a consent form and a free bowel screening test, with instructions on how to use it. If you do not want to take part in the bowel screening programme, please call us on and let us know. If you complete the test kit and return it to us with the consent form, your sample will be tested even if you have not signed the consent form. If you have any bowel cancer symptoms (see page 6) talk to your doctor now.

4 Why is bowel screening important? Bowel screening can help save lives by finding bowel cancer at an early stage when it can often be cured. There may be no warning signs you have bowel cancer. Bowel screening can also detect polyps (growths). These are not cancers, but they may develop into cancers over time. Most polyps can be easily removed, reducing the risk that bowel cancer will develop. What is the bowel? rectum anus small bowel colon The bowel is part of our food digestive system. It is divided into the small bowel and the large bowel, and connects the stomach to the anus (bottom) where waste material (called a bowel motion or faeces) is passed out of the body. The function of the large bowel is to finish digesting food by absorbing water and salt. The large bowel is where cancer most often develops.

5 5 What is bowel cancer? Bowel cancer is also called colon, rectal or colorectal cancer. Bowel cancer occurs when normal cells on the inside of the bowel become abnormal and grow out of control. The cells can turn into a polyp, which may then turn into cancer over a number of years. It can take a long time before the cancer grows and spreads to other parts of the body. Bowel screening provides an opportunity to find bowel cancer and treat it early. How common is bowel cancer? New Zealand has one of the highest bowel cancer rates in the world. Bowel cancer is the second highest cause of cancer death in New Zealand. More than 2800 people are diagnosed with bowel cancer every year and more than 1200 die from the disease.

6 What are the signs of bowel cancer? Common signs of bowel cancer may include:» a change in your normal pattern of going to the toilet that continues for several weeks (such as diarrhoea, constipation, or feeling that your bowel doesn t empty completely)» blood in your bowel motion. Although these symptoms are usually caused by other conditions it s important to get them checked by your doctor. Who should do the bowel screening test? Bowel screening is for people who have no obvious signs or symptoms of bowel cancer. If you have any symptoms of bowel cancer, you should talk to your doctor now.

7 7 Who shouldn t do the bowel screening test? Bowel screening is not right for everyone. You should not be part of a bowel screening programme if you:» have had a colonoscopy within the last five years» are on a bowel polyp or bowel cancer surveillance programme» have had or are currently being treated for bowel cancer» have had your large bowel removed» are currently being treated for ulcerative colitis or Crohn s disease» are seeing your doctor about bowel problems.

8 Who should check with their doctor before doing the test? You should talk to your doctor before deciding whether to do the bowel screening test if:» you have a number of family members over two or three generations who have had bowel cancer» you or a close family member have been diagnosed with bowel cancer at a young age (under 55 years)» you and your family have a known or suspected genetic bowel cancer syndrome» you have had extensive inflammatory bowel disease such as ulcerative colitis for more than 10 years. Who is most at risk of bowel cancer? Bowel cancer is more common as you get older, especially from the age of 50. Bowel cancer affects more men than women. You can reduce your risk of developing bowel cancer by:» having a healthy diet high in fruit, vegetables and fibre» regular exercise» not smoking

9 9 What is the bowel screening test? The bowel screening test is an ifobt (immunochemical faecal occult blood) test. It can detect tiny traces of blood in your bowel motion. This may be an early warning that something is wrong with your bowel. If there is blood in your bowel motion it doesn t mean you have bowel cancer, but you will need further investigation to find the cause of the blood. How do I do the test? The test is free and is quick, clean and simple to do by yourself at home. Your test kit comes with instructions on how to use it and a consent form. The kit contains everything you need. To do the test, you will need to collect a small sample from your bowel motion. This is easy to do if you follow the instructions. When you have done the test, put the sample tube in the zip-lock bag provided, along with the signed and completed consent form. Post it as soon as possible. It is important to return the test kits within six months. Keep the sample in a cool place until you post it. To prevent any postal delays, it s best not to send it on a Friday, Saturday or Sunday.

10 How will I get my results? You will receive a letter with your results and information about what this means for you. You may also receive a phone call from your doctor or a nurse. When will I get my results? You will receive your results within three weeks of returning your completed bowel screening kit. If you don t receive your results within three weeks, please call What do the results of the bowel screening test mean? If no blood is found in your sample, this means that you don t need any further investigation at this time. You will be invited for screening every two years while the BowelScreening programme is running, if you still live in the Waitemata District Health Board area and are aged between 50 and 74 years.

11 11 If no blood is found in your sample, it doesn t guarantee that you don t have bowel cancer, or that you will never develop it in the future. If you develop any signs or symptoms of bowel cancer (see page 6), it s important you talk to your doctor. If blood is found in your sample, it doesn t mean you have bowel cancer. The blood may be caused by polyps, or other minor conditions such as haemorrhoids (piles). It does mean you will need a further investigation to find the cause of the blood. Your doctor or a nurse will contact you to discuss your results and the type of test that is right for you. If you have a colonoscopy and polyps are found and removed, it may be recommended that you have regular colonoscopies. If you have a family history of bowel cancer, you may be referred to a service for assessment and monitoring. Only a small number of people will have blood in their sample and of these, an even smaller number will be found to have bowel cancer. How accurate is my result? No screening test is 100% accurate. If no blood is found in your sample, it doesn t guarantee that you don t have bowel cancer or that you will never develop it in the future. There is a chance that cancer can be missed if there was no bleeding from it when you did the bowel screening test. Bowel cancer may also start to slowly develop between screening tests. That s why doctors recommend you take part in this bowel screening programme. If you develop any signs or symptoms of bowel cancer, it is important you talk to your doctor.

12 What further investigation might I need? The most common test used to check your bowel is a colonoscopy. A colonoscopy involves a specially trained doctor putting a thin tube into your anus (bottom). There is a very small camera on the end of the tube which is used to examine the lining of your bowel, to see if there are any problems. If the doctor sees any polyps (growths) in your bowel he/she will generally remove them and send them to the laboratory to check for any cancer cells. Removing polyps is usually painless. About six in 10 people who have a colonoscopy will have polyps which if removed may prevent cancer developing. About five in 100 people who have a colonoscopy will be found to have cancer and will require treatment. Are there any risks from a colonoscopy? Colonoscopy is considered a safe procedure with few risks. However, as with most medical procedures, unexpected problems can sometimes happen. There is a very small risk that colonoscopy will cause serious bleeding or damage to your bowel and you may need further treatment.

13 13 Do I need to pay for the colonoscopy, other tests or treatment? The colonoscopy and any follow-up tests or treatments organised through the BowelScreening programme are free. What if I have bowel cancer? If you are found to have bowel cancer you will be referred to North Shore Hospital for treatment. The main treatment for bowel cancer is surgery. In some case chemotherapy or radiotherapy may be recommended. How successfully can bowel cancer be treated? About 90% of bowel cancers detected at an early stage can be successfully treated. If there is a delay in diagnosis and treatment and the cancer is more advanced, it is harder to cure. Do I have all the information I need? It s important that you are fully informed about all aspects of bowel screening before you decide to take part in the BowelScreening programme, and do the bowel screening test. You can find more information on the BowelScreening website

14 Who can access my information? Information collected about any further assessment or treatment you may need will be collected by Waitemata DHB from both public and private health services and used to monitor and evaluate the BowelScreening programme. Personal information and data are collected, stored, accessed and destroyed to a standard that complies with the Health Information Privacy Code 1994.

15 15 If I am not satisfied with the service I have received, how do I make a complaint? The Code of Health and Disability Services Consumers Rights allows you to make a complaint in a way that is appropriate for you. If you want to make a complaint about this programme or the service you have received, you can phone the BowelScreening programme on for more information about the best options for you. You can also get help from the Office of the Health and Disability Commissioner. Call or visit For more information on the BowelScreening programme, please visit or call the programme on or speak to your doctor.

16 For more information on the BowelScreening programme, please visit: or call the programme on or talk to your doctor March 2014 HP5401