The new bowel cancer screening programme could be missing a quarter of detectable cases because it only targets a limited range of ages of older people, a leading medical editor has claimed.
Dr Ike Iheanacho, editor of the Drugs and Therapeutics Bulletin , which evaluates medical treatments, said people in England were being put at risk of bowel cancer because only those aged 60-69 years are being screened (2006;44). In Scotland, the age band will span from 50 to 74 years, when screening starts next August.
Bowel cancer screening, which started last month in England, using a faecal occult blood test every two years, will be rolled out fully over the next three years.
The cancer kills about 16 000 people a year. But only 8-10% of bowel cancers are currently caught early, when survival rates are as high as 90%.
Dr Iheanacho said, “It is unfair that, depending on where you live, you may miss out on crucial health screening—national screening of the population should mean just that—with the same criteria for all.
“It is also worth noting that if an age cut-off of 69 years (as chosen for England), rather than 74 years, had been used in one of the major bowel cancer screening trials, 25% of detectable cancers would have been missed. It is worrying that the screening programme in England appears so at odds with the evidence from the major population screening trials,” he writes in the September issue.
But Ian Beaumont, spokesman for Bowel Cancer UK, was relieved that the screening programme had happened at all: “Earlier in the year we were disturbed that the screening programme was going to be scrapped because of NHS cutbacks. We campaigned very hard to make sure that it was going to happen.”
People older than 70 will still be able to request a screening kit, he said, although they would not be sent an automatic invitation to do so.
“We know that people of this age are already applying. In Norwich, more than 500 people over 70 [have] applied for the screening kit,” he said.
The decision to limit the scope of the screening programme in England has been a matter of logistics, he said. “The government decided it was best to start gently and build up. They are worried that if they extend the age range too quickly it will place too much demand on the service and personnel. Scotland has a smaller population.”
He thought that the age range would eventually be extended. “We are at the cautiously optimistic stage at the moment,” he said.
A Department of Health spokesperson confirmed that the age group would be reviewed once the programme was fully rolled out.