Improved Bowel Cancer Screening Set to Detect 600 More Cases Annually

NHS England has announced an enhanced screening programme for bowel cancer, which is projected to identify an additional 600 cases annually. This initiative, set to launch next month, aims to lower the detection threshold for its home-screening kit, thereby increasing the number of adults eligible for further investigation.

The current faecal immunochemical test (FIT) is available to individuals aged 50 and over. It detects blood in stool samples, with a threshold that triggers further testing currently set at 120 micrograms of haemoglobin per gram of faeces. Under the new guidelines, this threshold will be reduced to 80 micrograms, aligning with practices in Scotland and Wales. However, Northern Ireland will maintain the higher threshold.

NHS England anticipates that this change will lead to a 35 percent increase in colonoscopies, translating to approximately 34,000 additional procedures each year. As a result, the detection of high-risk polyps—precursors to bowel cancer—is expected to rise by about 2,000 cases.

Currently, around 2 percent of individuals who take the FIT require further investigation. This figure is expected to increase to 3 percent following the implementation of the new threshold, resulting in an 11 percent rise in early detections. The initiative is projected to reduce late-stage bowel cancer diagnoses and fatalities by about 6 percent, potentially saving the NHS approximately £32 million annually, as bowel cancer currently claims around 17,400 lives each year.

Impact on Early Detection

The changes come in the wake of tragic stories, such as that of BBC broadcaster Dame Deborah James, who died from bowel cancer in 2022 at the age of 40. She had established the charity bowelbabe.org to raise funds for cancer research, highlighting the importance of early detection.

Peter Johnson, a representative of NHS England, emphasized the significance of the new testing threshold. He stated, “Testing at a lower threshold will provide a better early-warning system for bowel cancer, helping us to spot and treat cancers earlier, often picking up problems before symptoms appear.” This proactive approach could allow for the removal of harmful polyps before they develop into cancer.

Genevieve Edwards, Chief Executive of Bowel Cancer UK, remarked, “Increasing the sensitivity of the test means more cancers will be prevented and found earlier, saving more lives from the UK’s fourth most common cancer.” This sentiment is echoed by Michelle Mitchell, Chief Executive of Cancer Research UK, who noted, “Bowel cancer is the second biggest cause of cancer death in England, so it’s crucial that progress like this continues.”

Future Steps in Cancer Care

The UK National Screening Committee (NSC) has recommended an optimal threshold for further testing set at 20 micrograms of haemoglobin. However, due to the increased demand this would place on NHS services, including colonoscopy and pathology, the NSC has advised a gradual move towards this ideal threshold.

To further enhance the uptake of the screening programme, NHS England plans to introduce digital alerts informing individuals that their testing kits are in the mail. This initiative aligns with the upcoming National Cancer Plan, which sets out the government’s vision for transforming cancer care by 2035.

As the screening programme evolves, the emphasis remains on encouraging individuals to consult their general practitioners if they notice any unusual symptoms. Early detection can significantly improve outcomes, making awareness and proactive health checks critical in the fight against bowel cancer.