Earlier this year, we supported Lauren Backler to hand in her change.org petition signed by half a million people to the then Secretary of State for Health and Social Care, Jeremy Hunt MP calling for this change in England.
Currently, men and women, aged 60 to 74, are invited for bowel screening and are sent a screening test every two years.
Following a comprehensive review of the evidence, the committee recommends that screening should be offered from aged 50 to 74 using the new and more accurate screening test, the faecal immunochemical test (FIT) at a sensitivity level of 20ug/g. FIT at this level has the potential to detect twice as many cancers and four times as many adenomas.
The sensitivity of FIT to detect blood in poo can be adjusted to be more or less accurate. Adjusting the sensitivity threshold determines the number of people who will be referred for colonoscopy. The lower the threshold, the more sensitive the test is to blood. However, this also means more people who have traces of blood in their poo but who don’t have bowel cancer will be referred for a colonoscopy.
FIT will be rolled out to the current eligible population from this autumn in England before the screening age is lowered. The test is already being used in Scotland from age 50. Wales has committed to roll-out FIT from January 2019 and Northern Ireland has yet to make a public commitment.
Deborah Alsina MBE, Chief Executive of Bowel Cancer UK, said: “We want to see every eligible person in the UK have access to the most effective screening methods. Today’s recommendation to offer FIT from the age of 50 every two years, with the ambition to increase the sensitivity of the test over time to 20 ug/g, is a significant step towards achieving this. We have campaigned strongly for the screening age to be lowered to 50, in line with Scotland and the rest of the world, for some time now, so we are delighted to see this has been recommended in England and Wales.
“What is urgently required now is a clear plan from NHS England and NHS Wales, setting out a sensible but ambitious timeframe for implementation. This must address how current services will cope with introducing FIT, including improving the sensitivity of the test and lowering the screening age when we already know that the biggest constraints to implementing an optimal bowel cancer screening programme are a lack of endoscopy and pathology capacity. That’s why it will be vital to ensure that the NHS has enough staff and resource to deal with the increase in demand this would have on bowel cancer diagnostic services. This will of course save the NHS money over the longer term as an optimal bowel cancer screening programme can both prevent bowel cancer from developing or detect it early when it is cheaper and easier to treat.
“Screening is the best way to diagnose bowel cancer early when it is treatable and curable and the implementation of FIT will provide us with further opportunity to transform survival rates for bowel cancer, currently the UK’s second biggest cancer killer. We must get the delivery of these recommendations right.”