A new study has found that 20,000 cases of bowel cancer have been prevented by England’s screening programme in a decade, as over-50s are set to be offered tests from 2025.
Colorectal cancer is the third most common cancer worldwide. By 2040 there will be 3.2 million new cases per year and 1.6 million deaths per year, according to the World Health Organization. In the UK, nearly 43,000 patients are diagnosed with bowel cancer each year.
Awareness of colorectal cancer has increased, helped by campaigners such as Deborah James, who raised millions of pounds for charity to increase awareness of bowel cancer before dying from the disease in 2022, aged 40.
Most bowel cancer develops from a polyp over a 10- to 15-year period. Symptoms of bowel cancer include blood in stools, changes in toilet habits and abdominal pain.
National screening programmes aim to prevent colorectal cancer by identifying and removing polyps before they become cancerous. The NHS England screening programme was introduced in 2006 to all adults aged 60 to 69, before being expanded in 2010 to everyone aged 60 to 74 years.
In 2025, the age threshold is due to be further lowered to 50. Patients are sent a NHS bowel cancer stool sample kit every two years. If blood is detected in their sample, patients are offered a colonoscopy.
Researchers from the University of Bristol and University Hospitals Bristol and Weston NHS foundation trust used data from the National Cancer Registration and Analysis Service database to examine rates of bowel cancer before and after the screening programme was introduced.
The authors calculated that rates of colorectal cancer in the lowermost portion of the large bowel have decreased by almost 15% since the introduction of the screening programme in 2006. That equates to about 20,000 patients who did not get bowel cancer as a result of screening.
But for cancers of the uppermost part of the colon, the reduction was negligible, the authors found. This is because polyps there are harder to spot and remove in colonoscopy.
David Messenger, consultant colorectal surgeon at Bristol Royal Infirmary and co-author of the report, said the findings showed that there was a case to offer screening to younger adults.
He said: “We know that there has been a dramatic increase in the incidence of bowel cancer in adults aged under 50 years, such that the risk of developing bowel cancer is three times higher among adults born in the mid-1980s compared to those born in the mid-1960s.”
Consideration should therefore be given to lowering the screening age below 50, as is already the case in the US, he added, but would require a cost-benefit analysis of the diagnostic performance of screening versus cancer rates.
Responding to the findings, Dr Lisa Wilde, director of research and external affairs at Bowel Cancer UK, said: “This research reinforces the importance of screening for bowel cancer and shows the potential impact of future improvements to the screening programme to make it more effective.
“Sadly, only one in 10 patients are diagnosed with bowel cancer through the national bowel cancer screening programmes in England and Wales.
“Screening can detect bowel cancer or pre-cancer before symptoms appear, so if you’re invited for screening, please do take part, as it could save your life. And if you’ve lost your kit or thrown it away, you can request a new one by visiting the NHS bowel cancer screening website.”
Dr Claire Knight, senior health information manager at Cancer Research UK, said: “We know that this screening programme saves lives from bowel cancer, and now this large study shows encouraging results that it could also reduce cases among those screened.
“Importantly, the research shows people from more deprived areas, who are at a higher risk of developing bowel cancer, could have the greatest reduction in risk from screening.
Further research over longer periods of time is needed to determine if bowel cancer screening is preventing bowel cancers as well as spotting the disease earlier.”
