More people are urgently waiting for bowel cancer tests

Figures published by NHS England today show more people are urgently being referred for key tests that can diagnose bowel cancer – the UK's second biggest cancer killer. This is a good indication that people are speaking to their GP about their bowel health after noticing symptoms or changes.

The figures, for August 2022, show that over 53,000 people who have suspected bowel cancer symptoms were on the urgent 'two-week wait' list for bowel investigations – this is 3,000 higher than the previous month and almost 13,000 higher than this time last year.

Of these people, almost 15,000 people were waiting more than the 14-day target – around 4,000 higher than the previous month and 8,500 higher than this time last year.

The demand for these tests far outweighs the number of appointments available, meaning that if there are more people on the waiting list the longer they have to wait. While most of those waiting won't have bowel cancer, it can be an anxious time so it's important people can be seen quickly to alleviate concerns and if someone does have bowel cancer, early diagnosis is crucial to best possible outcomes.

To help ensure that people with suspected bowel cancer are prioritised for further tests, NHS England wrote to GPs across England last week urging them to ask their patients with potential symptoms of bowel cancer to complete a Quantitative Faecal Immunochemical Test (qFIT) as a way of identifying people that urgently need further tests.

qFIT detects very small, hidden quantities of blood in a stool sample that could mean a person has bowel cancer. The test itself looks identical to the test that people receive as part of the bowel cancer screening programme.

The NHS England guidance to GPs outlined:

• qFIT should be offered to all patients who seek help from their GP for suspected bowel cancer symptoms
• The test will be set at a very sensitive level meaning that it picks up even tiny amounts of blood that may not have been seen by the patient
• Patients who have a positive result from their qFIT should be put onto the urgent referral pathway (the ‘two-week week wait’) for further investigation
• Patients can still be referred for further tests by their GP even if they had a negative qFIT test

Genevieve Edwards, Chief Executive at Bowel Cancer UK, simplifies what this guidance means for people experiencing bowel cancer symptoms: "My message to those worried that they may have bowel cancer, is to ask your GP for a qFIT test.

"Those considered low risk of bowel cancer, like younger people, often face a delayed diagnosis or see their GP several times before being referred for further tests. And when they are referred, it's possible that they may wait a long time for a vital colonoscopy, which may increase their anxiety over a possible bowel cancer diagnosis.

"We hope this guidance will help GPs to better identify and refer the right patients for further testing quickly and could help detect bowel cancer at an earlier stage when it's more treatable and curable. Depending on the patient's result of the qFIT and the doctor's advice, it may also mean that people aren't being referred for a colonoscopy unnecessarily.

"However, the biggest barrier to improving waiting times is the long-standing workforce shortage in endoscopy and pathology services. The new Prime Minister must urgently address this in the upcoming 10-year Cancer Plan to meet the ambition to diagnose 75% of cancers early by 2028."

We were one of 61 stakeholders, including members of the public, charities, primary and secondary care clinicians, who inputted into the development of this guidance when it was first recommended in June 2022 by the Association of Coloproctology of Great Britain and Ireland (ACPGBI) and the British Society of Gastroenterology (BSG).

What this means for patients living in Scotland, Wales and Northern Ireland:

• Scotland: if you have one or more bowel cancer symptoms, please ask your GP for a qFIT
• Wales: you may be offered a qFIT by your GP if you’re eligible within the NG12 guidance
• Northern Ireland: if you have one or more bowel cancer symptoms, please ask your GP for a qFIT
  
  

Here at Bowel Cancer UK we're campaigning and working hard to improve capacity within diagnostic services:

• We, along with over 50 other cancer charities, wrote to the new Secretary of State for Health and Social Care, Therese Coffey MP to urge her to set a date for publication for the awaited new 10-year Cancer Plan, ensuring it's ambitious and fully funded so it delivers for the one in two people who'll get cancer in their lifetime. We also offered her our support as we can provide insight, evidence and experience on bowel cancer diagnosis, treatment and care. We're awaiting her response
• In April, we submitted a comprehensive response into the Department of Health and Social Care's call for evidence to inform a new 10-year Cancer Plan and shared the views of our patient and clinical community. We're awaiting the publication of the new plan which is expected in the Autumn
• We're continuing to meet with key MPs to discuss our new report 'Improving Bowel Cancer Outcomes' which calls for urgent investment in diagnostic workforce and kit to improve capacity within vital cancer services