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Bowel Cancer: Screening

Question for Department of Health

UIN 61685, tabled on 25 January 2017

To ask the Secretary of State for Health, what assessment his Department has made of the merits of reducing the age for screening for bowel cancer to people aged 50.

Answered on

2 February 2017

The NHS Bowel Cancer Screening Programme offers bowel cancer screening every two years to men and women aged 60 to 74, using a self-sampling kit, the Faecal Occult Blood (FOB) test. Anyone over the age of 74 can self refer themselves into the screening programme every two years.

The programme initially offered screening to men and women aged 60 to 69 years old because the risk of bowel cancer increases with age, with over 80% of bowel cancers being diagnosed in people who are aged 60 or over. In the bowel cancer screening pilot, conducted in Coventry and Warwickshire and in Scotland in the late 1990s and early 2000s, over three times more cancers were detected in people aged over 60 than under 60, and people in their 60s were most likely to use a testing kit. In addition, there was not enough endoscopy resource to begin at a wider age range. Men and women aged over 70 have always been able to self-refer for screening every two years if they wish. The programme has now been extended to men and women aged up to 74.

In November 2015, the UK National Screening Committee which advises Ministers and the National Health Service in all four countries about all aspects of screening policy, recommended that the Faecal Immunochemical Test (FIT) should replace the currently used FOB test in the NHS Bowel Cancer Screening Programme. Bowel cancer screening using the FIT self-sampling kit will be offered to men and women aged 60 to 74 every two years. Anyone over the age of 74 will still be able to self refer into the NHS Bowel Cancer Screening Programme every two years. FIT is expected to increase screening uptake by around 10% and result in around 200,000 more people a year being tested, potentially saving hundreds of lives. FIT will be implemented from April 2018.

In addition to FOB testing the NHS Bowel Cancer Screening Programme is currently rolling out Bowel Scope Screening (BSS), a one off examination which will play a significant role in preventing bowel cancer. Both men and women will be invited for BSS around the time of their 55th birthday. If people are not screened at 55, they can request BSS up to the age of 59. BSS finds and removes any small bowel growths (polyps) that could eventually turn into cancer.

We believe the biggest impact we can have on saving lives from bowel cancer in England is implementing FIT in 2018 and roll-out of BSS to all men and women aged 55.