P295 The results of colorectal cancer screening in patients with cystic fibrosis in Wales

The Cystic Fibrosis Colorectal Cancer Screening Consensus Recommendations reports the median age of onset of colorectal cancer (CRC) in patients with Cystic Fibrosis (PwCF) is 20–30 years younger than the general population and advocates colonoscopy as the screening method of choice. The All Wales Adult Cystic Fibrosis Centre (AWACFC) have developed local guidelines in response. Results of patients who have had CRC screening were reviewed to help inform future investigations. The colonoscopy reports from 2012–2022 of PwCF over 40 years, and post-transplant patients over 30 years were reviewed and examination findings recorded. Patients were referred locally for investigation due to service constraints in the tertiary centre. Out of 68 eligible PwCF over 40 years (non-transplant), 41 patients (60%) were referred for CRC screening. 31 colonoscopies have been recorded in 26 of these patients. 12 patients (46%) were found to have abnormal pathology including polyps, haemorrhoids, colitis and diverticular disease. 1 patient opted for CT colonography that identified a polyp. 4 patients had negative Faecal Immunochemical Testing (FIT) following normal colonoscopies. Of the 21 eligible post-transplant patients, 13 (62%) were offered CRC screening. 12 colonoscopies have been recorded in 9 transplant patients. 5 patients (56%) had polyps on examination. 1 patient had a normal CT Colonography. There were no new cases of colorectal cancer in either group. AWACFC introduced bowel screening protocol based on the Consensus recommendations which incorporated referral pathways to patients’ local hospitals. The Covid-19 pandemic has caused disruption to all waiting lists and therefore some patients are still awaiting investigation. The current evidence is insufficient to support non-invasive tests e.g. FIT and CT colonography for routine CRC screening in PwCF, further research is therefore needed in the CF population.