Bowel Screening
Posting the sample for the bowel cancer screening test
This section describes people’s experiences with the faecal occult blood test (FOBT), which requires multiple samples to be collected. The faecal immunochemical test (FIT) kit is now used for bowel screening in the UK, which only requires 1 sample to be collected and for the sample to ideally be sent within 24 hours of collection.
With the FOBT kit, storing samples was necessary, but with the FIT kit, the sample should not be stored, but should be sent in the post as soon as possible (within 24 hours) after collection.
Storing samples with the FOBT kit
The people we spoke with who took part in bowel cancer screening using the faecal occult blood test (FOBT) kit described their experiences storing their samples before sending them off in the post.
For the FOBT kit, stool samples (faeces) were collected from 3 separate motions. Samples could be taken from 3 motions in a row or on 3 different days, which did not have to be consecutive. All the samples were required to be collected within 14 days.
After taking the first sample, the FOBT test kit then had to be stored somewhere while waiting for the next sample to be collected. The kit couldn't be left in a warm place or in direct sunlight.
Most people kept their test kit in the bathroom, in a cabinet, a drawer, or in a plastic bag or plastic box.
He kept his test kit in a little container on a bathroom shelf out of direct sunlight and away from liquids.
He kept his test kit in a little container on a bathroom shelf out of direct sunlight and away from liquids.
Where did you store it between the different times that you had to use the test kit?
I kept it on the bathroom shelf in a little container, so that it was away from everything you know. But I suppose really you could either keep it in your bathroom cabinet, somewhere convenient you know, somewhere where it's not liable to be contaminated by any liquids or direct sunlight.
She thought the sample might smell, and kept the test kit in a plastic box.
She thought the sample might smell, and kept the test kit in a plastic box.
What was your biggest concern, were you worried about storing it?
I was worried about storing it, I was thinking well if I did one say Monday and I didn't go again till Wednesday or Thursday where would I keep it, is it going to smell? And then I just, I just kept it in a little plastic box personally, I put it in a plastic box and kept it in the bathroom until I did it, till I did the three and I was able to post them off.
One man kept his FOBT kit beside his toothpaste so that he would be reminded to collect another sample the next day. Someone else kept the kit in an empty bath and another person kept hers on a cold tile.
One woman was worried that her flat was too warm, so she kept her test kit in her 'bogy hole', a cool cupboard where she kept her brooms.
Sending the completed bowel screening test sample through the post
After all the samples have been collected, people are asked to put the test kit into a provided hygenic prepaid envelope and sent it through the post.
Most people we spoke with seemed to be happy about this process, but a few people said they were concerned about sending their sample through the post.
Some people said they were worried about hygiene, felt embarrassed or anxious about the idea of putting faeces in the post, or were worried that the envelope might be opened. However, the information that arrives with the test kit makes it clear that the envelope meets postal regulations and is both hygenic and safe to send.
He was worried about contamination and thought the test kits should be sealed more effectively.
He was worried about contamination and thought the test kits should be sealed more effectively.
I thought that without having some form of seal over it, it was a little bit dodgy and I thought it was risky to send a toilet sample through the post, not in a sealed container. I did think that the sampling wallet with the little stick down windows could have been more secure from a health contamination point of view.
Perhaps there could be a peel off label or something to seal the window down securely rather than a little tuck in flap. It doesn't strike me as being good hygiene.
Did that worry you at the time?
From the point of view of general health and the fact there must be thousands of these things going through the post, yes, because bacteria have no regard to a piece of paper and sticky tape over the end. It should be sealed more effectively than it is I think, bearing in mind that the laboratory technician has to open it, but there could be some method of sealing it down a bit more securely I think.
She didn't like the idea of sending samples through the post.
She didn't like the idea of sending samples through the post.
How did you feel about putting it in the post?
Well, I mean it was no problem, I just put in the post, and then I thought, 'Oh I wonder if the postmen know what they are handling? Perhaps they don't'.
How did you feel about that?
Not very nice really is it?
Could that have deterred you from doing it do you think?
It could, Oh well I don't know. I think it perhaps would have been better if it could have been taken to a clinic or a doctor's, and they [the test kits] could have been sent off in bulk.
Initially he thought it might be unlawful to put faeces in the post, but soon saw that the envelope was very secure.
Initially he thought it might be unlawful to put faeces in the post, but soon saw that the envelope was very secure.
How did you feel about putting it in the post?
Well, initially I thought I'm sure there must be some law against putting this kind of thing in the post. Then I thought, 'Well don't be foolish, it's obviously done the best way it can.' But because the sample is clearly secured, not only within itself, but it then goes into an envelope which is the most secure envelope I've ever come across, there was no way that anybody anywhere could've known what was inside there. I mean when they said they were going to send me a kit, I don't know why, I was thinking of a cardboard box. But its not, it's just an envelope sized thing. It's as simple as that, its goes in an envelope, not even A5 size, much smaller than that, flat. Nobody would know, or have the faintest idea what was in there.
We have not yet been able to interview anyone who has experienced sample collection with the FIT kit. If you have had this type of testing and you would like us to include your story on this website, please email us at hexi@phc.ox.ac.uk for more information.
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