Beating bowel cancer together

NHS England confirm new screening test to be introduced in England in 2018

Tuesday 21 November 2017

Today, NHS England confirmed plans to introduce a new bowel cancer screening test in 2018, which could detect more cancers earlier. The new Faecal Immunochemical Test (FIT) test is easier to use than the current screening test and more accurate.

FIT works in a similar way to the current screening test by detecting tiny amounts of blood in the poo that could indicate cancer or polyps, (growths that can develop into cancer). However FIT measures blood measures the level of blood in just one gram of poo, whereas the current test only indicates the presence of blood. The ‘sensitivity level’ for the test is the concentration of blood in a poo sample at which people will be referred for prospective colonoscopy.

How sensitive the test is to blood in poo can be adjusted to determine the number of people who should go on for further cancer testing via endoscopy.

We know that the test is more accurate, which means it can detect even more cancers earlier, when the chance of survival is high.

The proposed starting sensitivity threshold is 120ug/g in England, which means an extra 1,500 cancers could be detected and around 8,500 high risk adenomas. The lower the sensitivity threshold, the more cancers can be detected.

A highly sensitive FIT would mean more people are referred for colonoscopy but services are already at breaking point and would not be able to cope with the large amount of additional referrals without a significant increase in diagnostic capacity.

Three months after implementation, NHS England propose to review the programme to assess impact of the sensitivity level on NHS capacity and see if further improvements will be made.

The FIT sensitivity threshold planned within the Bowel Cancer Screening Programme in Wales is 150ug/g and in Scotland, it is 80ug/g.

Scotland have already rolled out FIT into their screening programme. England will be following suit in 2018 and Wales in 2019. Northern Ireland is still yet to approve the new test. No matter which bowel cancer screening test you receive in the post, completing it and returning it could save your life.

Screening aims to detect bowel cancer at an early stage, when treatment has the best chance of working. The test can also find polyps (non-cancerous growths) which might develop into cancer.

Deborah Alsina MBE, Chief Executive of Bowel Cancer UK, says: “The introduction of FIT is a game-changer for bowel cancer. We know that the test is more accurate, which means it can detect even more cancers earlier, when the chance of survival is high.

The lower the sensitivity threshold, the more cancers can be detected.

“However the sensitivity level of 120ug/g is far from optimal given that other countries around the world implement the test at 20 – 45ug/g. If we are a serious about stopping people dying from bowel cancer, we must invest in sufficient workforce capacity to implement this programme. We know the sensitivity level can’t be increased immediately as hospitals are at breaking point but we want to see a clear plan of action to address this in the future.

“The government pledged to train 200 NHS non-medical staff to help ease demand in endoscopy services by 2018, but this is significantly off schedule. The Minister confirmed only 48 people have completed the training programme. This is simply nowhere near enough to cope with the number of referrals that are expected over the next few years.

“On Wednesday the Chancellor has an opportunity  to address this problem by committing the necessary funds to ensure hospitals have sufficient capacity to meet this extra demand, as well as future-proofing the system to allow the sensitivity of FIT to be further increased, which would result in more cancers detected and more lives saved.”

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