Are you aged between 60 and 69? Have you received a free test in the post from BowelScreen, the National Bowel Screening Programme?

If so, doing the test and returning it every two years could save your life.

It only takes a few minutes and could alert you to early-stage cancer of the bowel (colorectal cancer) that could be easily dealt with if caught at the pre-cancerous polyp stage.

Men, in particular, are being asked to take note as fewer men than women are responding in what is the first cancer screening programme in Ireland that includes men.

Getting the test done is a ‘no-brainer’

Paddy Byrne from Dublin is certainly glad he availed of this free BowelScreen test.

While his first test came back clear his second, two years later, requested he attend for a colonoscopy because of some concern with the results.

He tells us about how, when the first test envelope arrived, he didn’t hesitate in doing the test.

“When I turned 60, this envelope arrived in the post advising me of the process,” he says.

“I read through the whole lot and thought it was a no-brainer to do it. I was in the target group, I was over 60, the test was free and it’s simple to do – no big deal. I thought I’d fill out the form and send it back and that there was no need to dodge it. I thought that if I didn’t do it and I ignored it then I’d be wondering and worrying about it afterwards.

“It’s a bit like golf with a hazard in front of you, just take the hazard out. Take the test and, in my case, it came back clear the first time – happy days. The second time, two years later, it came back saying they wanted to do more investigations and, again, I wasn’t going to ignore it.

“When they did the colonoscopy after the second test they found a couple of polyps and removed them,” he continues.

“The colonoscopy is a very simple process. Believe it or not, when the camera is doing its work the surgeon can snip the polyps if he finds any. You don’t even feel it. When it’s all over he tells you there and then what he saw. In my case he took two snips. ‘You’re clear, I snipped them off and glued them. I’ll do a biopsy on one and get back to you,’ he said.

“About three weeks later, the results of the biopsy came back with the magic words ‘no cancer’. BowelScreen is a great service and I’ve had great follow-up since. The team reviewed my file and now I get a test kit in the post every January.

“The relief is there that if there is anything they’re going to find it. It’s very reassuring. A lot of men put their heads in the sand, but if you do that then up the road it could come back and bite you. You have to take responsibility for your own health. You’re the skipper of your own body. The test is free. For me, getting the test done means peace of mind.”

Clinical director calls on people to participate

Professor Padraic MacMathúna is clinical director of the BowelScreen service and is appealing to people to do the test, particularly men who are statistically less likely to participate.

That’s in spite of the fact that bowel cancer is the third-most-common cancer in men and the fourth-most-common cancer in women in Ireland. Around 2,800 people are diagnosed with bowel cancer in Ireland every year.

“If bowel cancer is found early, it’s easier to treat and there’s a better chance of recovery,” Professor MacMathúna says.

“It’s a bit like cervical screening in that we are attempting to find pre-cancerous polyps,” he continues.

“About 50% of people who have pre-cancerous polyps end up having a colonoscopy. There is a lot of benign disease out there that’s waiting to become cancer. The real benefit is catching that early and preventing it because of early intervention.”

At present, only 45 in every 100 people who receive the test bother to return it.

“The challenge is to get more participation,” says Professor MacMathúna.

“This screening programme has the potential to reduce deaths from colorectal cancer by 36% after 10 years of screening, so we’re asking people to check that they are on the register and do the free test.”

First test should arrive between ages 60-62

Remember, the risk of bowel cancer increases as you get older.

“This is why people between the ages of 60 and 69 are invited to take a bowel screening test every two years,” Professor MacMathúna says.

“Kits should arrive (based on birth date information from the Personal Public Service Number system – PPSN) after a citizen reaches the age of 60 and before the age of 62.”

There have, however, been some delays in contacting people due to the COVID-19 pandemic.

“That’s because colonoscopies couldn’t be done, so there was no point in calling people in, but we are getting back up to speed now,” he explains. “The screening programme, like BreastCheck, has taken a huge hit during the pandemic, but it was unavoidable.”

Three to five people in every 100 of those who return the tests are offered a colonscopy after blood – microscopic amounts – is found in their sample of faeces.

“Compliance is 80% with colonoscopy,” says the Professor, “with most people attending when requested to do so.”

Bowel cancer is as common as breast cancer

Bowel cancer (colorectal cancer) affects both men and women, but it may surprise many to know that it is almost as common as breast cancer in women and much more common than cervical cancer.

“Ninety women die from cervical cancer each year, whereas 500 die from bowel cancer, which isn’t hugely different to the number of women dying with breast cancer,” he says.

“As regards to men’s health, prostate cancer gets a lot of coverage. Perhaps because bowel cancer affects both sexes it doesn’t get as much traction, publicity wise, but it is a cancer to be energized about (preventing).”

While the test can be done at home, the aesthetics aren’t very pretty, he admits, (it involves dipping a probe into a sample of one’s faeces to get a tiny sample to send to the lab).

The bottom line is that if cancer cells are detected at an early or pre-cancer stage, bowel cancer is easier to treat and there is a better chance of a cure.

“Doing the test could help save your life.”

Limitations of the test

“Nothing is infallible in medicine,” he says. “There will be some false negatives and false positive results. The test being positive depends on two things: one being if there is a cancer or polyp there and two, that the cancer or polyp is bleeding quietly. The polyp may bleed on a Monday or Friday but not on the day you’re doing the test, therefore it will be a false negative. Also some cancers or polyps don’t bleed at all. That said, and very importantly, using this screening programme on a population basis has been shown to reduce deaths from bowel cancer.”

Results procedure

You will get the results of your FIT (fecal immunochemical test) within three weeks, says Professor MacMathúna.

“It’s an automated system that sends the information back to the national screening centre and we write then to the individual and to their GP. Around 95% of the tests are negative.”