These days, healthy 55-year-olds all over the country are invited to an examination – so-called bowel screening. Around 70,000 women and men receive a small package in the post with equipment that can provide vital answers. But midway through the introduction of the mass screening for bowel cancer, there are many who do not use the offer. SAMPLING EQUIPMENT IN THE POST: Section chief Roald Torp at Innlandet Hospital shows the sampling equipment. When the bowel screening program is fully operational, up to 200,000 stool samples will be analyzed annually. – No doubt Lars Baukhol (55) feels healthy and has an active lifestyle. Therefore, he has no reason to believe that the stool test will reveal disease. At the same time, he has experienced losing a good friend. The friend was in good physical shape and still only in his 40s. Nevertheless, he got bowel cancer. That makes Baukhol think a little extra. – I must admit that I have thought about it for many years. A BIT INCONVENIENT: Lars Baukhol has pondered how the stool test should be carried out in practice. But in the package is a detailed user manual. – This is understandable, smiles Lars Baukhol. Photo: Alexander Nordby / news How is the screening carried out? Illustration: Bowel screening program / Cancer register The national program was launched in August 2022. According to Puljevis, the country’s 55-year-olds are invited to take part in the survey. Men and women are offered screening with a test for blood in the faeces every two years for 10 years. Each individual takes a stool sample at home which they will send for analysis at the laboratory at Akershus University Hospital. If more than a certain amount of blood is detected in the stool, you will be offered a colonoscopy. Colonoscopy is an examination of the colon. With the help of a swab with a small camera, you look for diseases or ulcers in the intestine. It is also possible to take samples, remove polyps and treat bleeding. The examination usually lasts between 15 and 45 minutes. It is possible to get relaxing and/or pain-relieving medication. Source: Bowel screening center at Innlandet Hospital – Should have been everyone That’s what Kristina Bergersen (29) says, who lost her mother to breast cancer when Bergersen was 24. Bowel screening is the third mass screening for cancer. There are already national screening programs for breast cancer and cervical cancer. The 29-year-old’s mother was diagnosed with breast cancer after screening when she was 54. By then the cancer was advanced. Now she encourages everyone who is offered a mass examination to get tested. – A test like this can change your whole life. Bergersen has often thought about the years her mother could have had if the cancer had been detected earlier. And on the highlights she has missed. – It was very hard for her to know that she wasn’t going to be there for the big things. REMEMBERS THE MOTHER: Kristina has created a “family corner” in the living room. There she has family photos, her mother’s teddy bears and her glasses. Photo: Astrid Gerdts / news Diffuse symptoms In 2021, 4,500 people were diagnosed with colon and rectal cancer. Bowel cancer is the second most frequent form of cancer for both men and women. If bowel cancer is detected early, it is easier to treat, and figures from the Cancer Registry show that 95% of patients survive in these cases. Kristin Randel, head of the Bowel Screening Section in the Cancer Registry, says that bowel cancer can cause diffuse symptoms at the start, and the symptoms can resemble other harmless conditions. – At the same time, we know that many people do not get symptoms until it is quite far advanced, and it is precisely those who we want to catch with a screening programme, she says. When will the bowel screening offer come to you? Symptoms of bowel cancer Bowel cancer or colorectal cancer is a collective term for cancer of the colon and rectum. Changed stool patterns such as alternating slow/loose stools are common in colon cancer. In rectal cancer, loose stools and a strong urge to defecate are a symptom when the tumor has reached a certain size. Feeling that the bowel is not emptying properly when defecating is caused by the tumor taking up space and it can feel as if there is still faeces left in the bowel. Air in the bowel, a feeling of being bloated can be caused by the bowel becoming clogged. Abdominal pain can occur if a tumor blocks the intestinal passage so that faeces and air have difficulty passing. Approximately 20 per cent of all colon/rectal cancers start with acute pain and bowel loops (ileus). Blood in the stool can appear as visible red blood if the tumor is in the lower part of the intestine or as black stool if the tumor is in the upper part of the intestine. If you have blood in the rectum, in the toilet bowl or on the paper, you should have this checked by your doctor, even if it is only small amounts. Weight loss comes from the fact that appetite often becomes poor due to the problems described above. This may be a sign that the disease has progressed. Anemia (low blood percentage and/or low iron stores) comes from the fact that the tumor has often bled into the intestine over time. The symptoms of bowel cancer vary depending on where the tumor is located. The area where the tumor is located can also be tender, and the tumor itself can sometimes be felt. The symptoms above can be signs of other conditions and not necessarily cancer. The advice on Helsenorge.no is that you should contact a doctor if the symptoms last for more than three weeks. Source: Helsenorge.no Presupposes that it is used Bowel screening is carried out by the participants taking a stool sample at home, which is sent for analysis. Only in this way will it be revealed whether otherwise healthy people should be called in for further examination. And only in that way will the program be effective. However, Kristin Randel, who leads the bowel screening program, is not disappointed by the participation. – We have to let time pass before we can actually say something about the proportion that participates. At the same time, she does not hide that the Norwegian Cancer Registry hopes more people will join. PROGRAM LEADER: Kristin Randel explains that the goal is for everyone to get enough information to make the right choice for themselves. – There are some who are already in a follow-up program with a colonoscopy, and then you do not need to participate. There are also some who have a serious illness, in which case we recommend that you discuss it with your GP before deciding whether or not to participate. Photo: Astrid Gerdts / news In an experiment from 2012, there was 60% participation for the group that was offered screening with a test for blood in the faeces. – We hope to get similar figures in a national programme, and ideally a little higher, says Randel. Regardless of whether one chooses to submit a sample or not, Randel hopes that the program will draw attention to bowel cancer. – We focus on simultaneously informing people about bowel cancer and the symptoms of bowel cancer. It can also contribute to not waiting too long. INFORMATION: Before the package of test equipment arrives in the post, you will receive an information letter about the program. If you do not want trial equipment sent, you can let us know. Lars Baukhol will participate both to contribute to increased knowledge about the disease and to get answers for his own part. Photo: Alexander Nordby / news Own screening center Each health institution has its own screening center for follow-up of those who need further examination. There, the program participants are offered a colonoscopy. The doctor will then look for any polyps that could develop into cancer. Innlandet Hospital opened its new screening center at Hamar Hospital last week. Section chief in the medical department, Roald Torp, is one of those who will perform colonoscopies in the new centre. – We examine the colon thoroughly, and we can remove large and small polyps. If there are larger tumors, surgery must be planned. NEW SCREENING CENTER AT HAMAR: Roald Torp shows off the new examination room. He believes it is important to create an atmosphere that makes people relax. – Those who come are often stressed and have some discomfort along the way, and we then offer sedatives and painkillers. Photo: Astrid Gerdts / news Why introduce bowel screening? Illustration: Bowel screening program / Cancer register Reducing the incidence of bowel cancer: Finding precursors to cancer Reducing mortality from bowel cancer: Finding cancer at an earlier stage More gentle treatment Source: Bowel screening program
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Midway through the introduction of bowel screening, only a little over half participate – news Innlandet – Local news, TV and radio
