What happens next

The results of the FOB test can be either:

  • Negative
  • That is, no blood present. This is the result for around 98 in 100 people. Routine screening will then be offered to you every two years until you reach the age when screening stops.
  • Unclear
  • This is the result for around 2 in 100 people. This means that you will be asked to take a FIT test.  This gives a more detailed clarification of the FOB test results.
  • Positive
  • That is, blood is found to be present. This is the result for around 2 in 100 people. You will then be referred to a Specialist Screening Practitioner (SSP) for further investigation which is usually a colonoscopy. A colonoscopy is a test in which a long, thin, flexible telescope (a colonoscope) is passed through your rectum into your colon (large bowel) in order for the whole of your colon and rectum to be looked at in detail.

Colonoscopy

What happens at the appointment with the Specialist Practitioner?

If you have a positive test result, you will be offered an appointment with a Specialist Screening Practitioner.  The Specialist Screening Practitioner will discuss your screening result with you and explain what further tests can be done.  The most common test is called a colonoscopy. You will be given the opportunity to ask questions or raise any concerns you may have. The assessment is to ensure you are fit enough to have a colonoscopy.

The assessment should take no more than 45 minutes.

The Specialist Screening Practitioner will explain the colonoscopy procedure with you and give you written information to take away.

If you cannot attend this assessment, it is important you contact the free phone helpline on 0800 015 2514 as soon as possible to arrange a more suitable date and time.

What is a Colonoscopy?

A colonoscopy uses a very small camera on the end of a thin tube to let the doctor or nurse look for any polyps or signs of cancer inside your bowel.  A thin flexible tube called a colonoscope is passed into your back passage while you are under sedation, and guided round your bowel.  A colonoscopy is the most effective way to diagnose bowel cancer.  A colonoscopy can also detect bowel polyps.  Polyps are not cancer, but can sometimes change into cancer over a number of years.  Polyps can be removed (usually during the colonoscospy), thereby reducing your risk of developing bowel cancer in the future.

What if the Colonoscopy shows I need further treatment?

If you need further treatment you will be sent to whichever specialist is right for you.  For example, if polyps are removed at colonoscopy, you may be called back for a repeat colonoscopy in one to three years time. The Specialist Screening Practitioner will be able to answer any questions or discuss any concerns you may have when you come along for your assessment.

Removal of Polyps at the Colonoscopy

Figure 1: A pedunculated polyp

Figure 2: Snare for removal of polyp

Figure 3: Site of polyp after removal from colon

Procedure — The medical term for removing polyps is polypectomy. Most polypectomies can be performed through a colonoscope. Small polyps can be removed with an instrument that is inserted through the colonoscope and snips off small pieces of tissue. Larger polyps are usually removed by placing a noose, or snare, around the polyp base and burning through it with electric cautery.  The cautery also helps to stop bleeding after the polyp is removed.

Polyp removal is not painful because the lining of the colon does not have the ability to feel pain. In addition, a sedative medication is given before the colonoscopy to prevent pain caused by stretching of the colon. Rarely, a polyp will be too large to remove during colonoscopy, which means that a surgical procedure will be needed at a later time.

 (Pictures courtesy of: Dr Mike at the Colonoscopy Chronicles - http://colonoscopychronicles.blogspot.co.uk/)