Bowel screening phone calls to 60 year olds and non-responders
May 2014
Bowel screening health promotion over the phone
Introduction
Check that you are speaking to the right person
Do you have a few minutes to spare to discuss health screening offered by the practice?
Have you recently received an invitation and a bowel screening test kit in the post?
If no, explain that you will give them a number to call at the end of the conversation to get a replacement kit
(for 60 year olds, if they have not received their invitation by 6 weeks after their 60th birthday)
If yes: have you already completed the kit and returned it?
If yes: check that they received a result within 2 weeks of posting their kit, and thank them for participating
If they have not completed the kit, offer the following information:
Brief explanation of bowel cancer
Your doctor/the practice is very supportive of bowel screening and we are encouraging all our patients over
the age of 60 to take part in screening
Bowel cancer is the third most common cancer in the UK
It affects both men and women - and the chances of developing bowel cancer increase with age. Most
people who get bowel cancer are older than 60.
Bowel cancer occurs when abnormal cells in the bowel multiply out of control to form a lump called a
tumour. The tumour cells can spread to other parts of the body if not treated early.
The good news is that bowel cancer is very treatable if found early. More than 9 out of 10 people with
bowel cancer that is found early will still be alive after 10 years.
Bowel screening
Bowel cancer screening aims to find bowel cancer early, when it is treatable. A common symptom of
bowel cancer is blood in your poo (faeces, stool). Sometimes this blood can be difficult to see.
The NHS has developed a home screening kit for everyone aged between 60 and 74 years old, to look
for tiny amounts of hidden blood
The test can also pick up changes in cells in the bowel that might become cancer over time. These
changes are called polyps - and are very common.
Polyps cause tiny (invisible) amounts of blood in poo. If a polyp is found, it can be removed and so
prevent cancer developing.
A positive result or any bleeding when you go to the toilet doesn’t mean bowel cancer - or even polyps.
There could be other reasons such as piles. But it’s best to get it checked out.
We know that the test kit can seem a bit strange or even daunting. All over the world millions of people
have done this test at home and I can help by explaining the test procedure
Ask if they have the kit and the leaflet which shows how to do the test.
Use the test kit instruction leaflet to talk through the test process.
If the patient remains uncertain about the process, invite them to the practice for a face to face discussion.
Bowel screening phone calls to 60 year olds and non-responders
May 2014
Provide the opportunity to ask questions and remind them that they can make an appointment to see their
doctor if they are worried about any symptoms that might be bowel cancer.
See your doctor straight away if you have any symptoms that might be bowel cancer
 a change in bowel habit (looser poo for 3 weeks or more)
 blood in your poo
 a lump in your tummy
 unexplained pain in your tummy
 unexplained weight loss
Other questions:
1. Where is the bowel? And what does it do?
The large bowel is a long pipe in the digestive system just below the tummy. It absorbs water and nutrients
from food, and passes waste out of the body as poo.
2. Why is it so important to spot bowel cancer early?
Most bowel cancers that remain in the bowel don’t kill if they’re treated at an early stage. But if cells are
given time to spread to other parts of the body the chance of survival reduces significantly. That’s why
spotting cancer early saves lives. More than 9 out of 10 people with bowel cancer that’s found early will
survive.
3. Why should I be screened for bowel cancer?
Screening tests help to detect bowel cancer early, even before you could notice symptoms. The risk of
bowel cancer increases with age, and that’s why people aged 60 to 74 are sent a screening kit every two
years. People over 75 can request a screening kit by calling 0800 707 60 60.
4. I have piles (haemorrhoids); does this mean blood in my poo won’t be caused by bowel cancer?
People with haemorrhoids are as likely to get bowel cancer as anyone else - and should definitely take part
in screening. If you see blood in your poo – even if you have haemorrhoids – always check with your GP.
5. Can I reduce my chances of getting bowel cancer?
Yes. Bowel cancer is a very common type of cancer and over half of cases are caused by risks that you
can control including
 a diet high in red or processed meats
 being overweight: leaner people are less likely to develop bowel cancer than obese people
 being inactive
 high alcohol intake
 smoking
Apart from screening, these are things you can do to reduce the chance of bowel cancer.
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Eat less red and processed meat (sausages, smoked meat) and less dairy foods
Eat more fibre (at least 5 vegetables and pieces of fruit a day)
Maintain a healthy weight and waist size
Be more physically active
If you drink alcohol, stick to no more than 2 units a day for a woman and 3 units a day for a man, ideally
on no more than 4 days in a week
Stop smoking
Find out more at www.nhs.uk by searching for ‘bowel cancer’.
6. My parent/sibling had bowel cancer. What should I do?
A family history of bowel cancer (a close relative) puts you at much greater risk of developing the disease
so it’s very important to follow the advice above and to take part in screening. If you are worried about
symptoms (see above) see your doctor straight away.
Bowel screening phone calls to 60 year olds and non-responders
May 2014
Reasons for not doing the screening
1) Why do I need to be screened? I have no symptoms or family history.
Screening saves lives, the earlier the problem is detected, the more likely people are to lead long and
healthy lives. Anyone can get bowel cancer and screening can prevent it developing and save your life.
2) I have already done the test kit
(i) if recently, ask if they have any other questions, thank them and terminate the call.
(ii) if under 60, and they say that they had the test some time ago, inform person that they wouldn’t have
been asked to do a screening test before they were 60 in this country. It may have been a diagnostic test,
or have been offered in another country. If so, it’s a good idea to join the screening programme now.
(iii) if over 60: apologise that their doctor’s record shows that they did not successfully complete a kit last
time they were invited. Did s/he receive a result? Was s/he asked to repeat the test because it was not
clear the first time, or hadn’t been completed exactly as required? If yes, proceed as below. If the person is
sure that they have previously completed a kit, ask if they have any other questions and terminate the call.
3) It’s far too messy and unhygenic: Everything is provided for you and it’s free and is done at home,
there is no pain or need to get undressed. It’s just part of a natural human process. People who have
participated have felt it important to go through a bit of inconvenience if it means saving their lives.
Wash your hands well, as you normally would when you have finished the test, and you will be safe.
4) My friend did it and he/she had a bad experience: find out what the experience was, address
accordingly emphasising that most people rarely have such experiences (if it’s related to
colonoscopy/repeat testing).
If it’s a personal issue, experiences are different for everyone; an explanation of the kit will enable you
to become more confident about how to complete the test kit and learn about how to reduce your risk.
Most people who do the test once, do so again each time they are invited.
How to get a replacement kit
Freephone 0800 707 60 60
You can ask to speak to someone in your own language