Bowel cancer screening

Bowel cancer screening uptake is increasing, unlike the other cancer screening programmes, likely due to the introduction of the more acceptable FIT test in 2018-19 leading to an initial 3% increase in uptake, both nationally and locally, which seems to be continuing, Figure 1. Compounding this is the recommendation to extend the screening population to include those aged 50-59 and the impact this is predicted to have on the system, Table 3. North Tyneside has proportionately more 50 – 74 year olds than other parts of the North East, and England, which adds further local demand to the screening programme. Due to these systematic changes, the demand for the screening programme will continue to increase.

Since the introduction of the screening programme in 2006, the age standardised incidence rate of bowel cancer has decreased by 6%. This reduction tentatively illustrates the effectiveness of the screening programme to not only diagnose bowel cancer early, but to also prevent bowel cancer by the removal of incidental findings such as polyps.

As the screening population is extended to 50–59-year-olds, the volume of people going through the programme will increase with varying projected impact on the programme and a potential increase in the number of people requiring secondary care follow up may increase, even if the positivity rate remains at 2% or even reduces. The projected positivity rate is not currently publicly available. It will be critical for the regional screening and immunisations teams to work closely with regional Hubs and bowel screening services within secondary care to ensure capacity is built into the system as the age extension continues.

As modifiable risk factors for bowel cancer continue to be more common in deprived communities it is critical that specific targeted work is done jointly to address these modifiable risk factors and increase screening simultaneously. Therefore, increasing uptake in these communities is critical to reducing health inequalities.