Bowel/colorectal cancer is the second most common cause of cancer deaths in the UK. That’s 48 a day. Free home tests are supplied to everyone aged 50 or over. (You have to request it if over 74.) Yet only 69% of people in Shropshire that receive the test kit use it. I don’t understand why that is the case as it is a really simple test. I thought I’d share details of my test and the consequences in the hope it might encourage more people to take the FIT test and cut the 80 to 90 annual deaths in Shropshire from colon cancer.
Once you are fifty, the FIT testing kit arrives by post. FIT here stands for Faecal Immunochemical Test. It is a simple poo test that checks for tiny traces of blood in your poo to screen for bowel health issues. You just poo on some toilet tissue. Use the cocktail stick provided to grab a tiny sample. Stick that in the tube provided and put the prepaid envelope in the post box.
FIT screening picks up 100 cancers a week. As with all cancers, the earlier it is detected the greater the chances of survival. Younger people are less likely to take the test with just over half (56.2%) of 54-year-olds taking part in screening in 2024-25 UK-wide. That compares to more than 7 in 10 (73.5%) 70 to 74-year-olds. Men are less likely to take the test (62% participation) than women (68%).
My FIT test results in June came back within a week. I had microscopic traces of blood in my poo. Nothing visible by eye. I was told I had a 1 in 10 chance of having colon cancer. That’s not the sort of odds I like and on a few nights, it kept me awake.
I was called in for a colonoscopy. The Royal Shrewsbury Hospital (RSH) invite you to a briefing before the procedure. I asked for a telephone appointment but the nurse I spoke to twice was overly concerned about my mobility problems and my ability to get to the toilet in a hurry. I get around just fine in my flat with grab bars at critical points. I had to go to RSH to demonstrate I could walk with confidence.
Why did I need to show I could get to the loo quickly? It’s a laxative called Plenvu. It is extraordinarily powerful. I’d been on low fibre diet for days beforehand. Mostly soup and mass produced sliced bread which is low in fibre (and totally tasteless). I wore diapers as a precaution for the laxatives. When the colonoscopy was underway I was congratulated on my clean bowel!
I chose to have minimal anaesthetic for the colonoscopy. It meant I could watch the nurses and doctor exploring my insides on the two large screens either side of the bed. It was fascinating. Not as good as Fantastic Voyage (1966) because it didn’t involve Raquel Welch, though we joked about that as they pushed the camera further and further up my bum. This was not comfortable because they needed to inflate the rectum and colon with CO2 to ensure the camera could make progress. It felt like I’d eaten a really bad curry but in the scheme of things it was not that bad. Many people having this procedure chose to have anaesthesia and miss the whole spectacle. I take the view if there is something dangerous up my bum, I want to see it.
Then there was a problem. The camera could not get as far as the appendix because of a twist in my colon. The investigation was halted.
Four polyps (growths) had been identified with the help of AI. The largest was 12mm high and looked like one of the Malvern Hills on the screens. It didn’t look cancerous to the medical staff.
I returned ten days later for a CT Colonoscopy scan of the large bowel. That was quick and straightforward though again I was pumped up with CO2.
The results of the two explorations were sent to a consultant (who I never met or spoke to). He decided the largest polyp had to go. I went to RSH a third time. Normally polyp removal would be during the colonoscopy but they decided not to do that because I was on blood thinners. So I stopped taking those for four days before a flexible sigmoidoscopy, along with some other medication. This time they used enemas not laxatives.
I was earthed and an electrified loop was put over the polyp and tightened. The polyp was sent for a biopsy. A few days later I was told that the polyp was not cancerous. There will be no further checks until my next FIT test in 2028.
Although the procedures were uncomfortable, there were no side effects other than a surfeit of farting. I was immediately eating and drinking and walking with confidence after the procedures. For me, it was two months from FIT test to discharge. Normally, it would be around a month but as I have explained I had complicating factors.
There are many reasons why people don’t take FIT tests. A relatively small number strongly don’t want screening. A much larger number of people are hesitant, embarrassed, mistakenly think they aren’t at risk, forget, procrastinate or encounter practical obstacles.
Some people can’t face taking a sample of poo. Others feel healthy, so think they don’t need a test. The whole purpose of the FIT test is to pick up signs of disease before people feel ill, by which time the cancer may have progressed too far.
Fear of knowing. Fear of medical interventions. A false belief that cancer is a disease of old age. Roughly three quarters of bowel cancers occur in people aged 65 or over but a quarter of cases are below 65. As the graph below shows, bowel cancer rates are higher for men. That reflects a mix of biological and lifestyle risk factors. Men’s lower participation in FIT screening may also contribute.
When bowel cancer has been detected through a FIT test, one study showed that 90% of patients are alive after 5 years. For those that don’t participate in screening, only 61% are alive after 5 years.
The test takes a couple of minutes. Mine found something that could become dangerous fairly quickly. That’s why I am urging everyone to use the FIT test when it drops through the letterbox.