24 Sep

What were the results of the study and what impact have they had?

When the first results of the UKFSST were analysed in 2010, they showed that people who were screened just once with flexible sigmoidoscopy (also known as bowel-scope) were:

  • less likely to get bowel cancer – it prevented about one in three new cases of bowel cancer;
  • less likely to die from the disease – it prevented four in every 10 deaths from bowel cancer.

The protective effects of the once-only flexible sigmoidoscopy also appeared to be long lasting. The UKFSST results were published in The Lancet in 2010.

Because the UKFSST demonstrated that flexible sigmoidoscopy screening can prevent bowel cancer from developing, this suggested that offering a once-only flexible sigmoidoscopy (bowel-scope) screening test to people in the UK should reduce the numbers of people getting bowel cancer and dying from this disease. In 2010, the UK government announced a £60 million investment to introduce bowel-scope screening as part of the English NHS Bowel Cancer Screening Programme. Roll-out of bowel-scope screening began in 2013 and is expected to cover the entire population by 2018. It has been estimated that bowel-scope screening could prevent up to 5,000 people from getting bowel cancer and up to 3,000 deaths from the disease in the UK each year. It is hoped that cancer of the rectum, the lowest part of the bowel examined, could one day become a rare disease.

The results of a further 7 years of follow-up were published in The Lancet in Feb 2017 and show that a single flexible sigmoidoscopy continues to provide substantial protection from bowel cancer diagnosis and death, with protection lasting at least 17 years. News articles were also published by Cancer Research UK and by Imperial College London.

In  addition to the original study objectives, the UKFSST study team has identified the following potential questions  which could be addressed by further analysis of the UKFSST dataset. These analyses will be conducted by the CSPRG medical statisticians and published in peer reviewed journals. No additional data will be requested to meet these objectives.

  • Does the quality of flexible sigmoidoscopy screening affect the future risk of getting bowel cancer and dying from this disease?
  • Does patient experience and procedural factors affect the performance of flexible sigmoidoscopy screening?
  • How safe and acceptable is a once-only flexible sigmoidoscopy?
  • How does having a family history of bowel cancer effect the risk of developing this disease after screening?
  • Can the severity of disease at diagnosis be used to determine the risk of dying from bowel cancer?
  • Among patients identified as higher-risk at their flexible sigmoidoscopy screening, how effective is repeated colonoscopy (examination of the entire bowel) at routine intervals?
  • How commonly does bowel cancer in the upper part of the bowel develop after flexible sigmoidoscopy, and can this be predicted by the number and type of polyp detected at flexible sigmoidoscopy?
  • Does smoking history affect the risk of developing polyps and bowel cancer?
  • Can various medications affect the risk of developing polyps and bowel cancer?
  • Among patients taking part in the UKFSST and also invited to take part in the National Bowel Cancer Screening Programme (BCSP), for which they complete Faecal Occult Blood Tests (FOBTs), how do these two screening tests affect the risk of getting bowel cancer?
  • Can prior flexible sigmoidoscopy affect participation and outcomes of FOBTs in the BCSP?


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