A Cancer Research UK-funded scheme aims to tackle a waiting list of people at higher risk of developing bowel cancer.
The project, which aims to improve patient access to vital colonoscopies, has launched in the Scottish Borders and, if successful, could change NHS practice across the UK.
The initiative is part of a UK-wide programme from the charity, with additional support from the Bowelbabe Fund for Cancer Research UK, called Test, Evidence, Transition (TET) which aims to accelerate the adoption of best practice in the early diagnosis of bowel cancer.
Cancer waiting times in Scotland are currently amongst the worst on record. In April-June 2024, only 73 per cent of patients who were referred urgently with a suspicion of cancer started treatment within 62 days, with the Borders region performing above the national average at 77.9 per cent. This is still below the 95 per cent standard and nationally is the third worst performance on record since 2012.*
However, patients regarded as being at a higher risk of developing bowel cancer – usually because of pre-existing medical conditions are not covered by this target.
Instead, they are put on ‘surveillance’ lists because they need tests at regular intervals and do not have a current suspicion of cancer based on symptoms.
Stretched resources can mean those with symptoms of suspected cancer take priority, leaving some of those who may have a similar risk, waiting for long periods of time for a colonoscopy with no NHS target in place for them.
To tackle this issue NHS Borders, with the support of Cancer Research UK and research partners at the Universities of Oxford and Cambridge, has developed a new nurse-led surveillance pathway to improve access to colonoscopies.
Dr Jonathan Fletcher, Consultant Physician and NHS Borders Lead Clinician for the project, said: “With the support of Cancer Research UK and the Bowelbabe Fund, we are excited to be overhauling the colonoscopy follow up arrangements for Borders patients with a variety of conditions that increase their risk of colorectal cancer.
“There will be a range of benefits to patients and the endoscopy service that we hope to examine and measure with this initiative.”
A colonoscopy is a type of endoscopy, a non-surgical procedure using a flexible camera to examine the inside of the colon.
In the new pathway in the Borders, patients will receive a new reminder phone call 4-5 days prior to their colonoscopy appointment to reduce missed appointments and carry out a pre-assessment to note any changes in their health.
It will also offer services advising patients on steps they can take to reduce their risk of developing bowel cancer and will improve the use of IT systems to make management of the waiting list more efficient and effective.
Julieann Brennan, Strategic Lead and Board Coordinator for Public Health National Screening Programmes in Scotland, said: “This is an exciting opportunity to work with Cancer Research UK to improve access to our colonoscopy services, particularly for those who may be at higher risk of developing bowel cancer.
“We also want to make improvements in communications with those patients who may be at higher risk.”
TET is a major Cancer Research UK programme which aims to accelerate the adoption of innovation in the health system while reducing inequalities in access to best practice cancer care. Previously, the scheme has focused on reducing waiting times for people with suspected breast and prostate cancer.
Naser Turabi, Director of Evidence and Implementation at Cancer Research UK, said: “There is a relatively less well-known group of people who are at a higher risk of bowel cancer, waiting too long for crucial colonoscopy tests. It has no official target and so can get less attention and resource.
“We are delighted to support this exciting initiative undertaken by NHS Borders who are keen to reduce the wait and improve outcomes for patients in their region.
“If patients in this pilot scheme can be tested at the right frequency, we have a better chance of diagnosing cancer earlier, when treatment is much more likely to be successful. We hope the learning from this work will be adopted elsewhere in Scotland and across the UK.”
TET has received £2m from Cancer Research UK and the Bowelbabe Fund for projects across the UK, with each project delivered by local NHS teams in conjunction with academics to find new ways to improve both patient experience and cancer outcomes.
The Bowelbabe Fund for Cancer Research UK was created to continue the inspiring legacy of Dame Deborah James who was diagnosed with bowel cancer in 2016 at the age of 35.
Launched in the last few weeks of her life and now stewarded by her family, together with Cancer Research UK it works to fund cutting-edge research, raise awareness of signs and symptoms of cancer with the aim of helping more people affected by cancer have more time with the people they love.