Bowel Screening to Begin at 50 in England and Wales

Nicky Broyd

August 10, 2018

Bowel screening is to be brought forward by 10 years to age 50 in England and Wales after ministers accepted the recommendations of the independent expert screening committee.

The current age range is 60-74 with people invited to provide stool samples via postal kits every 2 years.

The new age range will be the same as it already is in Scotland, 50-74, and a new more accurate test will be introduced - the faecal immunochemical test (FIT), which can be undertaken with a home test kit.

The decision was taken to help improve survival rates by detecting cancer earlier, when the treatment outcomes are better.

According to Cancer Research UK, 41,804 new cases of bowel cancer were diagnosed in 2015. There were 16,384 bowel cancer deaths in 2016. With treatment bowel cancer 10 year or longer survival rates are 57%.

The one-off flexible sigmoidoscopy (bowel scope) screening currently available in some areas at 55 will stay in place until the new test reaches that age group.

Spotting More Abnormalities

Director of Screening at Public Health England, Professor Anne Mackie, said: "The risk of bowel cancer rises steeply from around age 50 to 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 FIT screening is due to begin in the autumn, but the age changes will be staggered. Prof Mackie said: "The committee recognises that this change will take time but wants the FIT test to be offered to all aged 60 and over as soon as possible, and options considered for a roll out plan where screening can be offered at 55 and eventually to all aged 50 – ensuring we have the best bowel screening programme possible."
 

Staffing Concerns

Reacting to the announcement, Sara Hiom, director of early diagnosis at Cancer Research UK, said: "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. 

"The biggest challenge facing the Government's plan to start screening at 50 will be finding enough staff to carry out the diagnostic tests, such as colonoscopies, that will be needed as more people are referred following screening. Right now, more than 1 in 10 NHS diagnostic posts are unfilled and thousands more staff will be needed in the future. The staffing crisis must be dealt with urgently through a fully-funded, long-term commitment in the NHS's new plan."

Deborah Alsina, chief executive of Bowel Cancer UK, said: "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."
 

No COPD Screening

In a separate decision, published today in the minutes of the screening committee’s June meeting, it decided against a screening programme for chronic obstructive pulmonary disease (COPD). It cited a lack of clinical evidence and a possible impact on smoking cessation.

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