Bowel Cancer: Screening

For screening programmes, the Government is guided by the independent scientific advice of the UK National Screening Committee (UK NSC). It is only where the offer to screen provides more good than harm that a screening programme is recommended. The UK NSC makes its recommendations based on internationally recognised criteria and a rigorous evidence review and consultation process.

The UK NSC considers all of the latest scientific evidence when reviewing the case for screening for different conditions. As the policy is based on the benefits and harms to whole populations, the screening decisions are based on the effect on the whole population, rather than individual circumstances. Where there is a lack of evidence, the committee cannot be confident that screening would benefit the population as a whole. In these circumstances, the proportionate approach is to screen within the range that has evidence to back the policy.

The National Health Service bowel screening programme in England was recently extended from people aged 60 to 74 years old to people aged 50 to 74 years old. This aligns with the evidence of where the screening programme can do the most good with the least harm caused. Harm can include increased anxiety, misdiagnosis, over diagnosis, where unnecessary and invasive follow up tests are offered, or unnecessary treatment.

The UK NSC is awaiting the results of the AgeX trial which is looking at extending the upper and lower age thresholds for breast screening.

The UK NSC keeps these age brackets under review. The committee recognises that screening programmes are not static and that, over time, they may need to change to be more effective.

In both bowel screening and breast screening, individuals can request to continue to receive testing beyond the upper age threshold.