A NATIONAL bowel cancer screening programme should be established in the State by January 2011, according to a new report which has been presented to Minister for Health Mary Harney.
The report, compiled by an expert group for the board of the National Cancer Screening Service (NCSS) and seen by The Irish Times, states that, when screening is implemented it will "undoubtedly reduce the number of deaths from colorectal cancer in Ireland".
It states that Ireland has a high incidence of colorectal cancer leading to mortality rates that are “amongst the highest in the world”. Approximately 1,900 new cases are diagnosed and around 900 people die from the disease here every year. If bowel cancer screening is implemented as recommended, it will be the first national cancer screening programme to target both men and women.
The expert group, led by Prof Niall O’Higgins, recommends screening men and women aged 55 to 74 every two years. Some 700,000 people would be eligible for the screening programme.
International figures indicate screening could be expected, over time, to reduce deaths by 16 per cent in the population invited for screening. This would be the equivalent, based on current numbers of deaths from colorectal cancer, of saving 144 lives a year. And among those attending for screening deaths could be expected to be cut even more – by as much as 25 per cent.
The expert group’s recommendations were endorsed by specialists from the UK, US and France before their report was sent to Ms Harney by the NCSS last month, seeking her approval to proceed with preparations for the introduction of a screening programme.
While the Health Information and Quality Authority (HIQA) is currently conducting a review of the cost effectiveness of a national bowel cancer screening programme, the NCSS pointed out in its letter to Ms Harney that it was its expectation, based on similar work conducted in other jurisdictions, that a population-based screening programme would be found to be cost-effective.
The board of the NCSS, in outlining the costs of the programme to Ms Harney, said €1 million would be required this year to begin preparatory work and €6 million next year to prepare for its roll-out. After that, it said the capital cost of at least four screening centres would be between €13 million and €14 million, and screening would cost €15 million in the first full year of operation.
The report says around 12,000 patients a year who are screened will require follow-up colonoscopies, an internal examination of the bowel.
“Lengthy waiting lists already exist for colonoscopy procedures in Ireland and increased screening without increased capacity can only be expected to exacerbate this situation,” the NCSS’s chief executive Tony O’Brien states in his letter to Ms Harney, which is contained in the report.
Alternatively, he states, if Ms Harney wished, deficits in current colonoscopy services could be addressed at the same time as this new initiative by developing eight colonoscopy centres.
Recent figures from the National Treatment Purchase Fund indicated public patients can still be waiting up to eight months for a colonoscopy. For those patients with bowel cancer who are left waiting it can be a death sentence, as happened in the case of the late Susie Long.