title: The first 3 years of national bowel cancer screening at a single UK tertiary centre.
abstract: OBJECTIVE
  St Mark's Bowel Cancer Screening Centre commenced screening in October 2006 as a contributor to the national programme. The first 35 months' experience is reported.
  
  
  METHODS
  Individuals with a positive faecal occult blood test (FOBT) were offered colonoscopy or alternatives if they had significant comorbidity. All screening data were collected prospectively.
  
  
  RESULTS
  Of the 98 815 FOBT kits issued, 42 523 were returned (43% uptake; 20.79% men). In total, 1339/1488 (90%) FOBT-positive participants attended the nurse clinic (57% men). Of these, 1057 had an index colonoscopy, 115 had a computed tomography colonoscopy (CTC) and eight had a flexible sigmoidoscopy. Five hundred and seventeen (44%) procedures were 'normal' (no polyps/cancers). Eighty (6%) individuals had colorectal cancer. The polyp detection rate in index procedures, including colonoscopy, CTC and flexible sigmoidoscopy, was 50%. The adenoma detection rate of all colonoscopies was 62.8%. The median polyp size was 5 (1-80) mm. In total, 1200 colonoscopies were performed by five accredited colonoscopists (96% completion rate). There were 13 (1%) adverse events with < 1 in 500 patients undergoing polypectomy requiring a transfusion. There was one 30-day postsurgical mortality, one perforation and no colonoscopy-related mortality. Almost all 39/40 (97%) patients in the BCS programme felt that the findings were adequately explained compared with 21/32 (64%) elective patients (P < 0.001) within the same unit.
  
  
  CONCLUSIONS
  At this bowel cancer screening single centre, colonoscopy completion rates were high (unadjusted caecal intubation rate of 96%) and complication rates were low. In contrast to other published data, the uptake and cancer-detection rates were lower.
authors.affiliation: Wolfson Unit for Endoscopy, St Mark's Hospital, Harrow, UK.
authors.forename: S
authors.initials: S
authors.lastname: Gupta
authors.forename: B P
authors.initials: BP
authors.lastname: Saunders
authors.forename: C
authors.initials: C
authors.lastname: Fraser
authors.forename: R H
authors.initials: RH
authors.lastname: Kennedy
authors.forename: A
authors.initials: A
authors.lastname: Ignjatovic
authors.forename: S
authors.initials: S
authors.lastname: Sala
authors.forename: S
authors.initials: S
authors.lastname: Marshall
authors.forename: N
authors.initials: N
authors.lastname: Suzuki
authors.forename: M
authors.initials: M
authors.lastname: Vance
authors.forename: S
authors.initials: S
authors.lastname: Thomas-Gibson
mesh_terms: D000236:Adenoma / Q000175:diagnosis* / Q000473:pathology; D000368:Aged; D002983:Clinical Competence; D003111:Colonic Polyps / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D003113:Colonoscopy / Q000009:adverse effects / Q000706:statistics & numerical data*; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D009313:National Health Programs / Q000706:statistics & numerical data; D009780:Occult Blood; D017060:Patient Satisfaction; D012812:Sigmoidoscopy / Q000706:statistics & numerical data; D014057:Tomography, X-Ray Computed; D006113:United Kingdom