Jeremy Laurance: Detection, diagnosis and treatment in one appointment

Comment

The biggest obstacle to screening for bowel cancer is the "yuck" factor.

Or so critics of the major research trial released today thought. "Many people told us that this was a complete non starter," said Professor Jane Wardle, director of the health behaviour research centre at University College and a member of the trial team. "People were not going to come and have things shoved up their behind, British people will not go through that sort of thing."

Embarrassment and squeamishness are major killers in Britain. Bowel cancer is not an especially nasty type of cancer yet it claims 16,000 lives a year – second only to lung cancer. The reason is it is too often diagnosed too late to treat. It is 90 per cent curable if caught early yet half of those who get it, die from it because they are too embarrassed or squeamish to look for the warning signs – eg blood in the faeces – or to see a doctor when they appear.

Despite our reserve about bodily functions, the gloomy predictions by critics of the trial proved wrong. Once details of the screening test were explained, and its potential advantages spelled out, 71 per cent of the 55 to 64-year-olds offered the examination with a flexi-scope accepted.

Professor Wardle said: "To our surprise screening seemed to make people happier. They watched the monitor [displaying the pictures of their bowel] and were delighted the polyps were going to be removed so they would never cause any trouble. They said the bowel looked like the inside of the mouth – pink and shiny."

With today's dramatic results, interest in the test is certain to soar. Not only is it more effective than existing screenings for breast and prostate cancer, but detection, diagnosis and treatment are delivered all at the same time, in one five or 10-minute appointment, with no need for a repeat – ever.

There is no anxious wait for results, no recall for further investigation, no biopsies or other painful invasive tests and no mutilating surgery. Moreover, the test does not detect cancer but "pre-cancer" – polyps that could one day develop into cancer which can be simply and painlessly removed. So the "treatment" is preventative, stopping cancer before it starts. The incidence of bowel cancer has remained unchanged for decades but if this test was introduced in a national screening programme it ought to fall. Cancer screening has never looked so worthwhile.