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Costs of bowel Ca screening to soar

Bowel cancer screening will send demand for endoscopy soaring by 69 per cent, with the resulting costs set to far outstrip the allocated cash, a new analysis warns.

Calculations based on the UK colorectal cancer screening pilot suggest as many as 1.9 per cent of patients are likely to require further investigation following faecal occult blood testing, writes Lilian Anekwe.

That equates to about 31,250 new referrals for colonoscopy each year, a team of colorectal cancer specialists warned. Their analysis comes with the programme now rolled out to the first 11 screening centres, with five more due to begin shortly.

Study leader Mr Nicholas Ward, specialist registrar at Colchester General Hospital in Essex, said: 'Capacity for these investigations will be inadequate and the real costs will exceed the funding allocated.'

Writing in the March issue of Colorectal Disease, Mr Ward said testing procedures for bowel cancer screening needed to be refined, as they are being in Scotland with addition of second-line immunological tests.

'Even if prohibitively expensive as an alternative to faecal occult blood, a more refined test might reduce unnecessary referrals if applied second line.'

The researchers said the UK had been allocated £37.5m over two years for the programme, and that this would be dwarfed by the 'real costs' – with testing kits and investigations alone expected to cost £28m.

But the analysis drew harsh criticism from the NHS Bowel Cancer Screening Programme, which said it was 'disappointing to see data interpreted in this way and the programme's success falsely undermined'.

A spokesperson said the programme had been assured by the Government that £60m would be available over three years for screening in England alone.

Dr William Hamilton, Walport clinical lecturer at the University of Bristol and a GP in Exeter, said although much of the data was questionable, the researchers were right that more colonoscopies were needed.

'Whether the Department of Health will do anything about it is another matter,' he added.

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