ANALYSIS:A national bowel cancer screening programme for people aged 55 to 74 would be most welcome
WITH COLORECTAL cancer the second most frequently diagnosed cancer in men and women and an average of 925 deaths from colorectal cancer annually, preventing the disease represents a major public health challenge.
So yesterday’s announcements from both the Health Information and Quality Authority (Hiqa) and the National Cancer Screening Service (NCSS) recommending a national bowel cancer screening programme for people aged 55 to 74 years are most welcome. Importantly, it also represents the first time men in the Republic will be offered a comprehensive screening programme for any cancer.
The impact of this on men and their health cannot be underestimated. In general, the male of the species is unused to submitting, on a regular basis, to even slightly invasive medical testing. Getting men (and some women) to place a collecting device in their faecal material may pose some initial challenges.
The test recommended by NCSS experts and the one found to be most cost-effective by Hiqa’s health technology assessment is the faecal immunochemical test (FIT). A test kit will be posted to those eligible for screening. The kit is designed to take as much messiness out of the process as possible. Nonetheless, it does involve placing a device into one’s stool in the toilet bowl; a key challenge for the NCSS will be to devise user-friendly information in order to maximise the uptake of colorectal cancer screening.
The test is based on the detection of hidden blood in the stool. Both pre-cancerous growths (polyps) and bowel cancers bleed, so a confirmed finding of blood is a strong indicator to proceed to the next stage of the screening process – a colonoscopy. FIT is more selective for blood originating from the colon and rectum than the older faecal occult blood test and so is more specific for blood that has originated in the bowel.
Therefore, dietary and drug restrictions are not required with FIT, and this should cut down on the number of false positive results which might otherwise lead to anxiety and unnecessary colonoscopies.
Tallaght consultant gastroenterologist Prof Colm O’Morain said yesterday he had no doubt that FIT was the way to go.
However, the failure of Minister for Health Mary Harney to commit to specific funding is a major disappointment. Asking Hiqa to find “innovative” ways to implement colorectal cancer screening is disingenuous.
Hiqa has already done its job by carrying out a comprehensive assessment of the screening alternatives.