THE REPUBLIC’S first comprehensive bowel cancer screening programme, carried out by doctors at Tallaght hospital, has had a high detection rate for the disease. The programme’s end-of-year results also confirm the cost-effectiveness of a proposed national screening programme for the second most frequently diagnosed cancer in Ireland.
Welcoming the results of the programme, launched yesterday, the Irish Cancer Society (ICS) said it “unreservedly reinforced” the case for the urgent introduction of a national bowel cancer screening programme.
Such a programme has been recommended to Government by both the National Cancer Screening Service (NCSS) and the Health Information and Quality Authority (HIQA) but has yet to be funded, despite evidence showing it would reduce the incidence of bowel cancer by 36 per cent.
In the first year of the Tallaght Hospital/Trinity College Bowel Cancer Screening Programme, more than 4,000 self-test kits were sent to 50-74 year olds living in the greater Tallaght area. Of 2,540 tests returned to the investigators, 278 were positive.
These people were then invited to have a detailed bowel examination (colonoscopy) in the hospital. Some 50 cancers and pre-cancerous polyps were diagnosed. The programme has funding for one more year.
Lead investigator Prof Colm O’Morain, dean of health sciences at Trinity and consultant gastroenterologist at Tallaght hospital, said the results proved the cost-effectiveness of a national colorectal screening programme.
“The cost could be further substantially reduced by using existing resources, both equipment and personnel, in hospital settings. The colonoscopies in this study were done out-of-hours on Saturdays, using existing hospital facilities,” he said.
The primary screening test recommended by NCSS experts and the one used in the Tallaght study is the faecal immunochemical test (FIT), designed to detect blood in the stool. FIT is more selective for blood originating from the colon and rectum than the older faecal occult blood test (FOB). As dietary and drug restrictions are not required with FIT, it should cut down on the number of false positive results.
The Tallaght study confirms the superiority of the newer screening test: it achieved an 11 per cent detection rate compared with 2 per cent achieved by a UK screening programme using older technology.
The Tallaght researchers were pleased with the response rate from men invited to participate. And, although there was an overall 42 per cent participation rate, Prof O’Morain said this was probably influenced by age and gender and the fact that the screened population came from more deprived areas.
Kathleen O’Meara, head of advocacy and communications, ICS, said, “Ireland has the highest mortality rate for bowel cancer in western Europe and over 50 per cent of patients in Ireland are diagnosed with the most advanced stages.
“This screening programme simply cannot wait until the Government’s finances recover,” she said.
The ICS recently announced details of a funding offer of €1 million to the Government towards the rollout of a national bowel cancer screening programme, for all men and women aged 55-74 years living in the Republic.