Bowel cancer and AAA screening

This blog will focus on two other screening programmes that we have within the UK, bowel cancer and AAA screening.

Bowel cancer

Bowel cancer screening if offered to both men and women who are aged 60 to 74. This screening is offered every 2 years. This screening test is fairly different from the others that we’ve mentioned as it is a test that is done at home. People are sent a faecal occult blood test kit with instructions on how to use it in the comfort of their own home, the sample is then sent off and results are sent out 2 weeks after the laboratory have received the completed kit. The test involves sending a small sample of bowel motion on a testing strip off to a laboratory in order to be tested. If this test is found to be abnormal then a colonoscopy is offered to the patient in order to investigate this further.

With the chances of developing bowel cancer being 1 in 20 within the UK, it is a condition that affects many people. It is also a cancer that often doesn’t present with obvious symptoms until later on in the disease. This faecal occult test allows early detection of the condition. Although it doesn’t diagnose bowel cancer it gives an indication to whether further testing needs to be carried out. Often the faecal occult test picks up blood from within the bowel motion however on colonoscopy this is discovered to be due to polyps rather than cancer, which is not a cancerous condition that affects the bowel but can develop into one. Therefore during the colonoscopy stage these can be removed therefore reducing the risk of the individual developing bowel cancer. It is important to be aware that a negative faecal occult test doesn’t necessarily mean that an individual definitely doesn’t have cancer, therefore they should be aware of the signs and symptoms for bowel cancer and inform their GP if they are concerned. These symptoms include fatigue, weight loss, blood seen within their stool, tenesmus (a feeling of need to empty the rectum with little effect).

AAA screening

AAA or abdominal aortic aneurysm is an enlargement in the size of the lumen of a major blood vessel traveling through the abdomen. An aneurysm is classified as an focal dilation of a blood vessel to more than 1.5 times its normal diameter. AAAs are usually asymptomatic and detected incidentally, however the larger the aneurysm the more risk it has of leaking or rupturing which can cause sudden fatalities.

AAA are screened for in males when they turn 65 as males are more at risk of AAAs. The screening test is an ultrasound scan of the abdomen in order to determine the size of the abdominal aorta.

The size of any AAA present is split into the following categories:

- Normal - <3cm – no further action required

- Small AAA – 3-4.4cm – this is unlikely to burst at this stage so no treatment is needed however as the size might increase the individual is invited back every year for another scan in order to check the size. Patients are given advice on stopping smoking, healthy eating and exercise to try and reduce the chances of their AAA from getting bigger.

- Medium AAA – 4.5-5.4cm – again the chances of this bursting are small so no treatment is needed at this stage, however it might get bigger as with the small AAA so individuals are invited for a scan every 3 months to check it’s size.

- Large AAA - >5.5cm – This is at a high risk of bursting if left untreated therefore they are referred to a vascular surgeon in order to discuss treatment options, this can be through an open repair (see image)or an EVAR, endovascular aortic repair.

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