Beating bowel cancer could be simpler, quicker and cheaper in the future, says Lesley Dobson

Cancer is a word that frightens most of us. So news of a five-minute, once-in-a-lifetime test that can detect early signs of cancer, and remove them instantly, is a good reason to hang out the banners. Researchers believe that the test could reduce the risk of developing bowel cancer by one third, and save thousands of lives.

In the UK bowel cancer is the third most common cancer, with around one in 20 people developing it during their lives. It is also the UK’s second biggest cancer killer, and particularly affects older people. About nine out of 10 cases of bowel cancer happen to people aged 55 and over. And each year more than 16,000 people die from this disease in the UK.

The good news on bowel cancer comes from research led by Imperial College London, published in The Lancet. The research involved a randomised trial following 170,432 people aged 55 to 64, over an average of 11 years. 40,674 of the participants had one flexible sigmoidoscopy examination (known as the 'Flexi-Scope' test). This involved using a flexible tube with a light, (an endoscope) to examine the large intestine and the rectum.

Growths on the bowel wall, known as polyps, can become cancerous if not treated. The FlexiScope test detects these polyps and removes them, dealing with a relatively small problem before it turns into a life-threatening one.

The results from the study are impressive. The group that had the FlexiScope test had one third fewer cases of bowel cancer. And the number of deaths from bowel cancer in this group was 43% less than in the control group.

Professor Wendy Atkin from the Department of Surgery and Cancer at Imperial College London, who led the research, said: "Our study shows for the first time that we could dramatically reduce the incidence of bowel cancer, and the number of people dying from the disease, by using this one-off test. No other bowel cancer screening technique has ever been shown to prevent the disease. Our results suggest that screening with Flexi-Scope could save thousands of lives."

Professor Max Parmar from the Medical Research Council, which part-funded the study, said: "Most people are unaware that bowel cancer is one of the biggest causes of cancer deaths - only lung cancer tops it. When an MRC-funded study like this generates unprecedented results, it shows the importance of long-term research into the biggest health challenges of the day and also showcases the need for people to volunteer for clinical trials.

"This result would never have been possible without the 170,000 men and women who entered this study and it's fantastic to have a greater proportion of men, who perhaps are not regarded as health conscious as women. As most of the NHS cancer screening tests are for women, Flexi-Scope presents an opportunity for men to enter screening programmes as well."

Harpal Kumar, Cancer Research UK's chief executive, said: "This trial is the first to show the real benefit of flexible sigmoidoscopy in preventing bowel cancer by detecting and removing polyps before they can develop into a cancer. We have a tremendous opportunity to use this procedure to push bowel cancer back down the league table of cancer cases in the UK.

"Cancer Research UK is calling on the next Government to add the test to the existing national bowel screening programme as one of its first priorities. Such a programme, backed by all UK governments, would save thousands of lives and spare tens of thousands of families the anxiety and suffering associated with a cancer diagnosis, whilst also saving the NHS money," he added.

Professor Atkin agrees. "This test is not available at the moment. What we must do is stress the case for the bowel cancer screening programme really urgently, as a priority. The screening needs to be organised so that it’s in a quality assured framework, and so that it’s done safely and equitably. I want everybody in the country to be able to get the best exam.

"We think that the test would be offered in your fifties, because that’s when most people get the polyps that can later lead to cancer. Over 50 is not considered old these days. At that age you have many years of life ahead of you. The marvellous thing about this test it that it would be done in the 50s and it would give long term protection. It won’t give complete protection, because that’s not what screening does.

"We do already have a wonderful bowel cancer screening programme. It’s really important to go for this screening, which is offered every two years, from age 60 to 74, and even after 74, you can request it," says Professor Atkin. "The screening doesn’t prevent bowel cancer, it detects it early and reduces mortality and saves lives that way. The new test aims to save lives by preventing cancer happening in the first place."

The study was funded by the Medical Research Council, the National Institute for Health Research, and Cancer Research UK.