Warning over bowel screening
The colorectal cancer screening programme to be introduced in England is unlikely to achieve the benefits seen in clinical
trials, an influential review
The Drug and Therapeutics Bulletin warned that England's chosen age range of 60 to 69 was far more restrictive than had been used in trials and was likely to miss a substantial proportion of cancers.
The UK colorectal cancer screening pilot included patients from 50 to 69 and several trials of faecal occult blood testing looked at patients up to 74.
The DTB questioned the Department of Health's decision to so restrict colorectal cancer screening, particularly given that Scotland has decided to include all patients from 50 to 74.
Dr Ike Iheanacho, editor of the DTB, said: 'It is unfair that depending on where you live you may miss out on crucial health screening. National screening should mean just that – with the same criteria for all.
'It is also worth noting that if an age cut-off of 69 years, rather than 74 years, had been used in one of the major bowel cancer screening trials, 25 per cent of detectable cancers would have been missed.
'It is worrying that the screening programme in England appears so at odds with the evidence from the major population screening trials.'
The DTB also questioned the conclusions of an appraisal of screening that suggested biennial testing could cut colorectal cancer mortality by 23.6 per cent. It said a meta-analysis
suggested a 16 per cent reduction, even if screening included everyone from age 40.