ANALYSIS:International studies have long concluded that bowel cancer screening can save lives, writes EITHNE DONNELLAN.
‘ABUNDANT EVIDENCE from all around the globe indicates that deaths from colorectal cancer, a common and potentially fatal condition in men and women, can be prevented by high-quality screening.”
Those are the words of Prof Niall O’Higgins, chairperson of the National Cancer Screening Service’s (NCSS) expert advisory group on colorectal cancer screening, in his foreword to a new report. The study looks at the potential benefits of introducing a bowel cancer screening programme in the Republic.
The expert group is unequivocal. Screening should be introduced here – and fast. They say a national bowel cancer screening programme should be established by January 1st, 2011, allowing this year and next for the necessary preparations for its roll-out.
Why do they come to this conclusion? Well, basically, because screening would save lives by picking up cancers at a stage when they could be cured. It would also pick up pre-cancerous cells before they became cancerous, reducing the incidence of people getting bowel cancer and thus saving on costly cancer treatments in the long run. Screening, the expert group points out, would detect 1,134 cancers a year and over 4,500 polyps would also be found during subsequent colonoscopy examinations. The removal of these lesions has been shown to reduce the risk of developing colorectal cancer.
Bowel cancer is the second most commonly diagnosed cancer among Irish men and women, and the second most common cause of cancer deaths in the State. Over 1,000 men and over 800 women here are diagnosed with bowel cancer each year and 500 men and 400 women die from the disease on an annual basis. Hundreds, according to the expert group’s report, go through expensive treatment each year that places “a huge burden on health budgets”. Action, therefore, needs to be taken.
Other countries have already seen the benefits of screening. The UK government plans to have a screening programme in place for all those aged between 60 and 69 in England by 2010, Scotland is currently screening those aged between 50 and 74, Wales has begun screening those aged 60 to 69 and Northern Ireland aims to begin screening by the end of this year.
National population-based screening programmes also exist in Finland, France, Italy and Poland, while regional screening programmes are in place in several other European countries.
While the Irish Cancer Society had been calling for bowel cancer screening to begin at age 50, the expert group’s report says that as the incidence of colorectal cancer is relatively low before the age of 50 and increases with age, the initial target age group for the screening programme should be between 55 and 74 years.
Whether or not the expert group’s recommendation that screening be introduced here is adopted by the Government will, in the end, come down not to how many lives will be saved each year, but to money.
We have already seen Minister for Health Mary Harney postpone the introduction of a national cervical cancer vaccination programme, even though it would save lives, because she said the country couldn’t afford it. However, at a meeting of the Oireachtas health committee late last year, Ms Harney hinted that she supported the introduction of bowel cancer screening and indicated the €1 million required by the NCSS to prepare for its roll-out would be provided this year. But when the NCSS was asked this week if the money had been provided, a spokeswoman said the NCSS doesn’t yet know its budget for 2009 so it couldn’t confirm whether or not the €1 million promised for colorectal screening had been provided.
The Government will now be prioritising many projects as it aims to cut costs. If it gets its priorities right, funding will be provided for a national bowel cancer screening programme. In the overall scheme of things it’s a pretty cheap intervention, serving both men and women. It would be cheaper, for example, than the national cervical cancer screening programme introduced last September – that is costing upwards of €35 million a year – and would save more lives.