Private bowel cancer checks 'less accurate than NHS tests'

Thousands of bowel tumours are missed every year due to ‘unacceptable’ test failures as it emerges private checks are ‘less accurate’ than those carried out on the NHS, new study suggests

• UK researchers looked at more than 120,000 individuals having a colonoscopy 
• Some 9,317 cancers developed six months to three years after colonoscopies
• Known as post-colonoscopy colorectal cancers, said to be ‘largely avoidable’  

Private screenings for bowel cancer miss or fail to prevent more than double the proportion of cases as NHS programmes, a study suggests.

UK researchers looked at more than 120,000 individuals having a colonoscopy, the main test for colorectal cancer, in England between 2005 and 2013 and later diagnosed with the disease.

Some 9,317 cancers developed six months to three years after colonoscopies which had given patients the all-clear.

Figures released by medical journal The Lancet claim that an NHS bowel cancer test fails to detect about one third of abnormal growths and potentially fatal tumours

These are known as post-colonoscopy colorectal cancers – or PCCRCs – which are said to be ‘largely avoidable’.

The overall PCCRCs rate, looking at both the NHS and private providers, declined from 9 per cent in 2005 to 6.5 per cent in 2013. But, while the trend is continuing downward, the study led by the University of Leeds identified ‘substantial variation’ between providers.

Some 3.6 per cent of cancers (593) were diagnosed between six months to three years after a procedure within the NHS Bowel Cancer Screening Programme, compared with 7.4 per cent (9,130) overall in the NHS and 9.3 per cent (187) diagnosed after a false negative colonoscopy performed by an independent provider.

But, while the trend is continuing downward, the study led by the University of Leeds (pictured) identified ‘substantial variation’ between providers

The latter are increasingly being used to meet the rising demand on the NHS, which carries out more than 650,000 colonoscopies a year. The authors believe it is likely that high-risk patients are being seen by the BCSP while those with a lower risk are passed to the independent sector.

They said it is reasonable to assume that the high quality of colonoscopies in the BCSP contributes to its reduced rates.

The differences may also be linked to training and accreditation processes.

The authors say the variation needs to be minimised to increase early diagnosis.

If the overall rates were brought down to the rates achieved in the NHS, more than 3,900 cases of colorectal cancer would have been prevented or diagnosed earlier, the researchers estimate.

They conclude in the BMJ: ‘Quality improvement initiatives are needed to address this variation in rates.’

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