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High-risk elderly left out of Ca screening

The Government's planned national screening programme for colorectal cancer is set to exclude the age group at highest risk of the disease. Leaders of the pilot screening trials say the failure to check whether it is cost-effective to include people over 69 means the programme will not cover this age group.

An urgent discussion of the age cut-off was held at the latest meeting of the national screening committee.

The over-69s were excluded from the first £5 million

pilot of nearly 300,000 patients because it was modelled on smaller trials that used a cut-off point of 69 years.

The Department of Health has bowed to 'urgent' pressure from the national screening committee and allowed patients over 69 to 'opt in' to the second round of the trials. But experts have warned uptake will be poor as few older

patients even know the pilots exist.

Professor David Weller, who led Scotland's first-round pilot, said it would be impossible to say whether screening older UK patients was cost-

effective.

Professor Weller, professor of general practice at the University of Edinburgh, said cancer tsar Professor Mike Rich-ards still had a 'very open mind' on the issue but predicted the Government would omit the over-69s from the initial roll-out of the national screening campaign. They could be included at a later date, he added.

'My understanding is he and people like Muir Gray [national screening committee programme director] are still scratching their heads and wondering what to do.'

Failure to screen older patients would 'inevitably' miss a substantial number of cancers, he added.

Professor Weller also warn-ed specialist shortages meant GPs would have to counsel patients before the test and follow up 'tens of thousands' found to have polyps when the national programme is launched.

Dr Richard Stevens, chair of the primary care society for gastroenterology, called on the Government to set a clear roll-out timetable.

Dr Stevens, a GP in Oxford, said: 'While it appears there is clear political will to do it, there seems to be a bit of foot dragging.'

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