This month (July) it will be 20 years since sacks of envelopes containing small samples of poo started arriving at Rugby’s Hospital of St Cross.

Since then, more than 22 million poo samples returned by people in the Midlands and North West region have been logged, analysed and reported as part of the national NHS bowel screening service.

In 2000 the Rugby hub began a pilot programme of testing  and  was one of the very first hubs to go live in the national programme in  July 2006.

In the 20 years since the launch, the Bowel Cancer Screening service has seen lots of changes and goes from strength to strength, improving outcomes for patients where cancers or early signs of cancer are spotted and reducing pressures on colorectal emergency surgery.

The NHS Bowel Cancer Screening programme sends a test kit to those who are eligible and requires them to provide their own small sample of poo, along with the collection date and return by post.

Dr Steve Smith was programme director in 2006. He remembers the original test being quite complicated for people who had to submit three different samples taken over three different days.

“Our biggest challenge was getting people to complete the tests and complete them properly. Around 50% of everyone receiving the original kit returned one compared to 64% today with the new kit, said Steve.

Since 2019 tests have become much more straightforward to complete with just one sample required; the age range of people invited to take part in screening has reduced to 50 from 60 and analysis is much more sensitive and automated.

Steve added, “When we started, samples were analysed by people who were able to spot if poo samples contained anything more than 200 micrograms of blood. Today, automated analysers enable us to identify people  with lower amounts of blood in samples being detected and will pick up early signs and early stages of cancer meaning more people can be treated and have better outcomes.”

Dr Kamaljit Kaur Chatha is the Consultant Clinical Scientist who leads the hub today.

“Ensuring the reliability of the computerised analysers is very important, and each morning the team tests every device against a control for accuracy. This is repeated several times a day so that each of the six analysers can process 200 samples every 40 minutes.

“We are very proud of our team, some of whom have worked here since the service began, and we make sure they are trained in a wide range of the tasks needed for the programme so that they can switch roles regularly.”

Each week the Rugby hub currently processes 27,000 samples. They arrive via Royal Mail in sacks every morning and are opened, logged, analysed and reported on the same day.

The hub also sends out information letters to those eligible for tests as well as notifications of the results of their poo sample and whether further investigations are needed.

It also hosts a helpline which receives between 500 and 600 calls every day with people asking for help around their sample kit or checking their eligibility.

Said Dr Kamaljit Kaur Chatha, “Everyone aged 50 to 74  is now eligible for bowel screening compared to just the 60 to 74 year olds up until two years ago. The more sensitive tests we are now able to carry out with the automated analysers mean that we can prevent more cases of serious illness – screening is a big success for health outcomes.”