Call for colorectal cancer screening

[Posted: Wed 17/06/2009 by Joanne McCarthy www.irishhealth.com]

A national colorectal cancer screening programme should be introduced for everyone aged 55 to 74 years, according to a report from the National Cancer Screening Service (NCSS).

Meanwhile, another report published today says such a screening programme could would result in a 14.7% reduction in the incidence and a 36% reduction in the death rate from colorectal cancer.

The NCSS report recommends that a faecal occult blood test (a test which detects blood in the stool) should be offered every two years to screen for colorectal cancer, which is the second most commonly diagnosed cancer in both men and women and the second most common fatal cancer, killing 930 people every year. The report estimates that the test would have a 60% uptake rate out of the 700,000 people eligible for the test.

The NCSS has recommended that as part of a national colorectal cancer screening programme, people with a positive result from the faecal occult blood test should be offered a full colonoscopy.

“Population screening for colorectal cancer has the potential to be one of the most effective public health interventions in the history of the Irish healthcare system,” said Tony O’Brien, CEO of the NCSS.

“We now have a real opportunity to introduce a quality assured programme that is capable of providing huge clinical benefit in a cost effective manner,” he added.

Over the last 15 years the number of cases of colorectal cancer has risen by approximately 20% in both sexes, according to the NCSS. By 2020 the number of new cases of colorectal cancer diagnosed each year in Ireland is projected to increase by 79% in men and 56% in women. The growth is primarily attributable to an increasing and ageing population.

The NCSS recommended that four treatment centres, each with two endoscopy suites, would be initially required to provide 11 to 12,000 colonoscopies per year for national implementation of the screening programme. The centres should be located in association with a designated cancer centre.

Based on the previous experience of the NCSS in the implementation of BreastCheck and CervicalCheck it is estimated that it would take in excess of two years from policy and funding approval to the commencement of screening.

The Health Information and Quality Authority (HIQA) today published a report of the Health Technology Assessment (HTA) of a population-based colorectal cancer screening programme in Ireland.

The Authority’s advice to the Minister in recommending a screening programme based on FIT every two years would result in a 14.7% reduction in the incidence and 36% reduction in mortality from colorectal cancer.

Dr Patricia Harrington, Acting Director of Health Technology Assessment with HIQA, said the results of the HTA clearly show that lives can be saved through the introduction of this screening programme and the associated higher detection rate of colorectal cancer at an early stage. 

The recommended programme would be highly cost-effective, when compared with a policy of no screening," Dr Harrington said. 

"Specifically, a programme based on faecal immunochemical testing (FIT) every two years for people aged 55 to 74 years was found to be the optimal strategy and it would provide the greatest health gain, while remaining highly cost-effective.”

Helath Minister Mary Harney said she had asked HIQA to identify innovative ways of introducing a national programme of colorectal cancer screening in Ireland "within existing resources."

"The introduction of this screening programme is now a priority," the Minister said.

Despite a positive HTA assessment by HIQA last year, the Minister subsequently abandoned plans to introduce a cervical cancer vaccination programme for girls, in order to save €10 million.

See also http://www.hiqa.ie

http://www.ncss.ie