Committee recommends upgrades to NHS bowel and cervical screening programmes

The UK National Screening Committee has proposed changes to existing screening programmes for bowel and cervical cancer.

“Now I would urge all the governments of the UK to commit to rolling them out as quickly as possible, as Scotland has already pledged to do with the new bowel screening test FIT” – Sir Harpal Kumar, Cancer Research UK

The announcement, based on independent expert reviews, recommends that an updated test be introduced to the bowel screening programme, and for cervical screening to switch the order of the tests carried out on samples. The switch would see human papillomavirus (HPV) testing as the initial test for cervical screening, with only samples that test positive checked for abnormal cells.

Sir Harpal Kumar, Cancer Research UK’s chief executive, said the announcement was “very important and positive”.

“The UK’s bowel and cervical cancer screening programmes are crucial in reducing cancer deaths, and research shows that the changes to these new tests will make them even more effective.”

The recommendations would see the replacement of the faecal occult blood test (FOBT) – currently used in the NHS Bowel Cancer Screening Programme – with the newer faecal immunochemical test (FIT).

Doing so would provide opportunities to detect and potentially prevent more cancers, according to the recommendations. Scotland had already pledged to adopt the test in February last year.

Both FOBT and FIT detect traces of blood in a person’s stool, which can be a sign of cancer. But FIT is a better test, and can be easier to complete than the current test as participants only need to send a single sample for analysis.

The Committee also recommended using human papillomavirus (HPV) testing before looking for abnormal cells, which is currently the first choice of the NHS Cervical Screening Programme.

Infection with some types of HPV can cause abnormal tissue growth and other changes to cells within the cervix, which can lead to cervical cancer. HPV testing can detect these high risk types of the virus in cells lining a woman’s cervix.

The HPV test is currently used as a secondary measure in some women needing further investigation. But the recommendations point to evidence that screening for HPV first would be a more effective way to identify women at risk of developing cervical cancer, and provide longer protection from the disease so women may not need to be screened as often.

“These changes to the bowel and cervical screening programmes were strongly recommended by the Independent Taskforce behind the new NHS cancer strategy for England which I published in the summer,” added Cancer Research UK’s Sir Harpal Kumar.

“Now I would urge all the governments of the UK to commit to rolling them out as quickly as possible, as Scotland has already pledged to do with the new bowel screening test FIT.”

The Committee’s Dr Anne Mackie said the latest recommendations, based on internationally recognised criteria and a rigorous evidence review and consultation process, would bring about “considerable improvements”.

As part of the UK NSC’s ongoing review process, the recommendations will be looked at again in three years, or earlier if significant new evidence comes to light.

Blog: Fighting FIT – Scotland’s pioneering change to its bowel screening programme

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