Bowel Cancer Screening Programme Review – Screening to Start Earlier at Age 50:
Following a comprehensive review of the evidence, the UK National Screening Committee (UK NSC), an independent committee of screening experts, has recommended that bowel cancer screening begin 10 years earlier than it used to and should be offered from age 50 to 74 using the new and more accurate screening test, the faecal immunochemical test (FIT) at a sensitivity level of 20ug/g. Currently bowel cancer screening is offered every 2 years to men and women aged 60 to 74. People older than this can ask for a screening kit every 2 years by calling the free helpline on 0800 707 60 60. Using the kit, you collect small samples of your poo and post them to a lab which then checks them for tiny amounts of blood, which could be caused by cancer.
The UK National Screening Committee (UK NSC) makes recommendations to government ministers in the 4 UK countries on all aspects of population screening. It ensures that screening provides more benefit than harm, at a reasonable cost to the NHS. Their recommendations are based on internationally recognised criteria and an evidence based review process.
Evidence showed that screening people at a younger age would allow more bowel cancers to be picked up at an earlier stage. Currently, men and women in England are first invited for screening at the age of 60 and sent a home testing kit. The change brings England in line with Scotland where bowel screening is already automatically offered from age 50. Cancer Research UK said it was delighted by the government’s decision to lower the age bowel screening starts.
An additional one-off test called bowel scope screening was introduced in England for men and women in their 56th year in 2018.
In August 2018, UK government ministers agreed that in the future bowel cancer screening in England will start at the age of 50. PHE and the NHS are looking at how this can best be achieved.
Bowel cancer is a general term for cancer that begins in the large bowel. Depending on where it starts, bowel cancer is sometimes called colon or rectal cancer.
Faecal immunochemical test
The current home test kits are being improved. In the future, the plan is to send a more accurate test to everyone from the age of 50. A new test kit called ‘the faecal immunochemical test’ (FIT) was introduced in England in June 2019. This kit is now sent with all invitations for bowel cancer screening. People eligible for bowel cancer screening get an invitation letter, along with an information leafletexplaining screening and its possible benefits and risks. About a week later, the programme sends a FIT kit with instructions on how to use it at home. Results are sent out 2 weeks after the laboratory receives the completed kit. The screening programme offers individuals with an abnormal screening result a colonoscopy. This test involves a thin, flexible tube with a camera being inserted into the bowel to look for polyps which can turn cancerous.
Guaiac faecal occult blood test
The ‘guaiac faecal occult blood test’ (gFOBT) kit was phased out during 2019 and replaced by the FIT kit.
Bowel scope test
Bowel scope screening (also called a flexible sigmoidoscopy or ‘flexisig’) is an additional test for people in their 56th year. Bowel scope screening is being introduced by the NHS, but is not yet available everywhere.
Those who have an abnormal result after screening will be offered a colonoscopy.
The risk of bowel cancer rises steeply from around age 50-54 and rates are significantly higher among males than females. Starting screening 10 years earlier at 50 will help spot more abnormalities at an early stage that could develop into bowel cancer if not detected. The change would take time to implement but the new ‘FIT’ bowel screening test which is being rolled out is a much more convenient, user friendly and reliable test and the NHS and PHE say that this is a real opportunity to reshape our bowel screening programme and potentially detect the stages of bowel cancer much earlier.
Bowel Cancer Statistics and Risks
- Bowel cancer is the fourth most common cancer in the UK.
- 42,000 people diagnosed every year.
- More than 16,000 people die from the cancer annually in the UK.
- People are 14 times more likely to survive bowel cancer if it’s found early.
- Public information about bowel cancer screening is available on the NHS website.
- Members can also call the free bowel cancer screening helpline on 0800 707 60 60.
Symptoms of Bowel Cancer
- Bleeding from your bottom and/or blood in your poo.
- A persistent and unexplained change in bowel habit.
- Unexplained weight loss.
- Extreme tiredness for no obvious reason.
- A pain or lump in your tummy.
Cancer Research UK stated that this will mean more cancers can be spotted earlier, saving lives. When bowel cancer is diagnosed at an early stage, 9 in 10 people survive but when it is detected in the late stages, survival falls to 1 in 10. One of the biggest challenges is finding enough staff to carry out diagnostic tests, such as colonoscopies, which more people will need when screening is extended.Bowel cancer screening is one of 11 NHS national population screening programmes now available in the UK.
Attachment: NHS Bowel Cancer Screening Information Leaflet
National Health, Safety & Environment Officer