memories of being at home. I’m one
of four, and we played a lot with a
local family who had kids our age –
we were very good friends.
Where isyour favourite
There are so many places to choose
from! I’m torn between the Alps and
the Caribbean...The Alps win, just,
because they’re so beautiful in both
the summer and winter.
playyou, if a moviewas
made aboutyour life?
Julia Roberts without a doubt,
because I love ‘PrettyWoman’! I’m
a bit of a romantic at heart.
Dr Alison Taylor is now offering the
Lister Fertility Clinic service at 31
Old Broad Street – London Bridge
Hospital’s outpatient and diagnostic
centre in the heart of the City. For
further information, or to organise
a consultation, please telephone:
Tel: +44 (0) 20 7234 2009
Colorectal Cancer (CRC) is the second
most common cause of cancer deaths
in developed countries with 35,000 new
cases and 16,000 deaths from CRC in the
UK (2004, CRCUK). Although there have
been significant improvements in prognosis
recently (50% survive 5 years), the UK still
lags behind the USA and most of Western
Europe. One of the main reasons for this
is late presentation, as early-stage tumours
have an excellent prognosis with surgery
alone, but only a minority of cancers are
Tests available for bowel cancer
Faecal occult blood test
The NHS started bowel cancer screening
for the general population in 2006 but
not all areas of the country are currently
covered.The NHS screening programme
uses the faecal occult blood test (FOBt).
After a positive test, the subject is
invited to undergo a colonoscopy.The
evidence for the efficiency of bowel
cancer screening using FOBt comes from
three large randomised controlled trials.
These demonstrated a 15-33% mortality
reduction from CRC because of increased
detection of early stage cancers.The best
result was from the American study, where
a higher proportion of subjects underwent
a colonoscopy.The main disadvantages of
the test, are that it is not very sensitive and
may miss over half of all cancers, especially
if they are not bleeding; it may also not
pick up polyps and may sometimes give a
positive result, even if no cancer is present.
Colonoscopy is regarded as the gold
standard for colonic examination, not
only because it allows complete and
reliable examination of the entire colon,
but also offers the option to remove
polyps or adenomas, thus dramatically
reducing the risk of CRC. It has been
shown to detect advanced polyps or
cancers in 10% of asymptomatic subjects,
aged 50-75. Colonoscopy is used as
a screening test in the USA and some
parts of Western Europe.
CT Colonography (CTC)
This method produces both two-
dimensional and three-dimensional images
or ‘virtual colonoscopy’. Advantages of
CTC include safety, patient tolerability and
the ability to ‘look behind’ mucosal folds.
Recent trials of CTC show similar sensitivity
to optical colonoscopy for detecting polyps.
The main disadvantage of CTC is the
inability to take biopsies or remove polyps,
in this instance an optical colonoscopy is
required. Up to 45% of patients in the NHS
screening programme have been shown
to have polyps or cancer. Also, full bowel
preparation is still required for CTC.
Screening in high risk groups
Some patients have an increased risk of
developing bowel cancer because of a
strong family history or conditions which
predispose them to bowel cancer.These
include those with a past personal or family
history of CRC, those with
inflammatory bowel or endocrine
conditions that are known risk
factors for CRC and those with known
or suspected inherited genetic disorders.
These patients should be offered
surveillance according to current guidelines.
Bowel cancer screening at London
London Bridge Hospital offers bowel
cancer screening using colonoscopy.
London Bridge Hospital
Dr Guy Chung-Faye MRCP PhD
Clinical Lead, SE London Bowel Cancer Screening Centre
Dr John O’Donohue MD FRCP FRCP(I)
Clinical Director, SE London Bowel Cancer Screening Centre
• Colorectal or bowel cancer is the
second most common cause of cancer
deaths in the UK.
• It is preventable and the prognosis is
related to the stage at presentation.
• FOBt has been shown to reduce CRC
• The NHS offers CRC screening with
FOBt for subjects aged 60-69.
• The FOBt may miss half of all cancers.
• Colonoscopy and CTC are more
accurate but are more expensive and
currently not used for population
• London Bridge Hospital can offer
bowel cancer screening using
colonoscopy by accredited specialists
from Bowel Cancer Screening Centres.
For further information,
or to book an appointment,
please contct the GP Liaison
Tel: +44 (0) 20 7234 2009