BowelScreen plans to extend to 59-year-olds

BowelScreen is planning to extend colorectal cancer screening to 59-year-olds in 2022, Clinical Director
Prof Pádraic MacMathuna has informed the Medical Independent.

The extension falls far short of a recommendation in the National Cancer Strategy 2017-2026, which said the HSE should ensure “appropriate” capacity to expand colorectal cancer screening to “all” 55-to-74-year-olds by the end of 2021.

First offered in October 2012, BowelScreen was established to provide screening initially to all eligible men and women aged 60-to-69 and ultimately to the full 55-to-74 age group. No expansion of screening in the identified age range has been implemented to date.

A home faecal immunochemical test (FIT) kit is sent by post every two years to the eligible population who consent to participate.

Those who receive a positive FIT result are referred for screening colonoscopy.

Initially, the screening programme plans to extend age eligibility downwards on a gradual basis. Given the parallel demand for urgent and routine colonoscopies in the symptomatic service, screening expansion is a delicate act.

“We’d like to do it right down to 55 [sooner], but the colonoscopy capacity is the core issue,” said Prof MacMathuna.
The national capacity for endoscopy needs to be increased to meet the requirements of both symptomatic and screened populations, he noted.

BowelScreen is first expanding age eligibility downwards because colon polyp formation generally begins in the 50s; and many individuals reaching 70-plus will already have been invited to participate in BowelScreen.

In BowelScreen’s second screening round from 2016 to 2017, it invited 546,767 eligible people, screened 226,374 clients, performed 6,523 colonoscopies and detected 410 cancers. See news feature, p4-6.