Delay introducing new screening test

Bowel Cancer UK, which is raising awareness of the importance of screening during Bowel Cancer Awareness Month in April, is issuing a strong warning that lives are being lost because of delays in introducing a new screening test to England, Wales and Northern Ireland. 

The simpler and more accurate bowel cancer screening test has yet to be approved by the Government or Welsh or Northern Ireland assemblies, despite a recommendation from the UK National Screening Committee (UKNSC) over three months ago.

The charity is highlighting that the UKNSC recommended in January that the Faecal Immunochemical Test (FIT) be adopted by the screening programmes, replacing the current guaiac Faecal Occult Blood Test (gFOBT). The new test would come at a welcome time as uptake rates for bowel cancer screening are shockingly low with huge variations across the UK.

England

In many areas of England uptake rates fall well short of the 58 per cent average, in some cases it is as low as 33 per cent. Forty four per cent of CCGs in England are below the national average with seven out of ten of the worst areas in England being in London.

Wales

In Wales the situation is particularly poor, with a national average uptake rate of 50 per cent compared to 58 per cent in England and Scotland. None of the Welsh Health Boards achieve the screening uptake target of 60 per cent for Wales.

Northern Ireland

In Northern Ireland FIT is used currently for repeat test which require further investigation but is not used for the initial screening test.

Whilst we wait for a decision, lives are being lost, claims Deborah Alsina, Chief Executive of Bowel Cancer UK. “The best way to improve screening uptake is the introduction of FIT. The test has been proven to be more accurate and easier for people to complete. However the government and the two assemblies have still not approved the UKNSC’s recommendation three months after it was published.”

“Bowel cancer screening saves lives so we must ensure more people complete and return the test when they receive it in the post. Screening can detect bowel cancer at an early stage in people with no symptoms, when it is easier to treat.”

“Scotland has already moved to implement FIT in their screening programme and now England, Wales and Northern Ireland are lagging behind. People’s lives should not be put at risk in this way.”

FIT is now used in population screening around the world including Italy, The Netherlands, France, Ireland, New Zealand, Australia, Spain and Japan and a pilot in England proved extremely successful with up to a 10% increase rate in participation.

Stephen Halloran, Emeritus Professor, University of Surrey and international expert on FIT was one of the researchers who carried out the pilot said: “Our study demonstrated that FIT could increase the detection of bowel cancer with a significant two fold increase in detection of cancers and a fourfold increase in advanced adenomas. We also showed that FIT is one of the most effective ways of increasing screening uptake among people we know are less likely to take the current test – those with limited health literacy, people in lower socioeconomic groups, men and some ethnic minority communities.”

Bowel cancer is the second biggest cancer killer in the UK with 16,200 people dying from the disease every year. However bowel cancer is treatable and curable especially if diagnosed early. Nearly everyone diagnosed at the earliest stage will survive bowel cancer. However this drops significantly as the disease develops. A third of people (34 per cent) in England who are diagnosed with bowel cancer through screening are diagnosed at stage 1, the earliest and most treatable stage, compared to only six per cent of those who are diagnosed through emergency admission to hospital.

Bowel Cancer UK also carried out a nationwide survey which demonstrated high awareness of the screening programme, with at least nine out of ten (99 per cent in Scotland, 88 per cent in Wales, 95 per cent in Northern Ireland and 93 per cent in England) people questioned of screening age saying they are aware of it.

The poll also showed that people understood the benefits of taking part. Around nine of out ten (92 per cent in Scotland, 86 per cent in Wales, 91 per cent in Northern Ireland and England) knew that regularly taking part in screening is likely to reduce your chances of dying from bowel cancer and over three quarters of people questioned (89 per cent in Scotland, 77 per cent in Wales, 76 per cent in Northern Ireland, 82 per cent in England) said that even if you do not have symptoms and feel well you should still take part.

Deborah Alsina added: “While it’s good news that there is such high awareness of the screening programmes among those eligible and they know why they should do it, far too many people are not completing the test. We must change this and the introduction of FIT is part of the solution.”

Download the findings of our UK national screening survey

Download the England screening uptake rates

Download the Wales screening uptake rates

Download the Northern Ireland screening uptake rates

Find out more about screening

"Taking part in the NHS bowel cancer screening programme may have saved my life." Read a patients blog about screening