Our policy on bowel cancer screening

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Bowel screening is the best way to diagnose bowel cancer early. Early diagnosis is crucial - patients diagnosed with bowel cancer at the earliest stage have a better than 90% chance of surviving for five years, whilst for those diagnosed at the latest stage this drops to just 6.6%.

We would like to see the current programme made even more effective by:

  • replacing the currently used Faecal Occult Blood Test (FOBT) with the Faecal Immunochemical Test (FIT)
  • ensuring full roll out of bowel scope as a one-off test in all four nations
  • increasing participation in the bowel cancer screening programme. 

The UK National Screening Committee has recommended that the currently used Faecal Occult Blood Test is replaced with the superior Faecal Immunochemical Test (FIT). The evidence is clear that this is a more effective test and could increase uptake.

Scotland introduced this test in November 2017. England and Wales have committed to introducing this test and we would like to see a similar commitment in Northern Ireland. We expect an annual review of sensitivity to ensure the test can reach its optimum level. We appreciate there may need to be a phased increase in sensitivity once the test has been introduced due to current endoscopy capacity, but we must continue to optimise this test following its introduction.

Cancer Research UK co-funded a trial of bowel scope, a programme which could save thousands of lives a year when fully rolled out. Bowel scope is a one-off screening test which uses flexible sigmoidoscopy to examine the lower two-thirds of the bowel for adenomas or colorectal cancers. It has been recommended by the UK National Screening Committee.

Bowel scope is being rolled out in England. By the end of 2019, everyone in England should be offered bowel scope when they turn 55, in addition to FIT screening at 60. Bowel scope should originally have reached everyone aged 55 by now, it is unlikely that all eligible people will be invited until 2020.  We are disappointed with the slow roll out of this programme and we understand that endoscopy capacity is a limited factor.

Through a pilot programme, some people were invited at age 60 in Scotland in 2014 and 2015. This is great news, but we would like to see commitment for bowel scope to be fully rolled out in Scotland, Wales and Northern Ireland, so that people across the UK can benefit from this breakthrough.

There is considerable variation in participation levels in bowel screening across the country, and the UK average is only around 56%. We call on policymakers in all four nations to set an ambition to increase participation in the bowel screening programme. For example, screening programmes should aim to increase participation by setting an overall ambition to reach 75% uptake by 2020.

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