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Bowel screening age range extension

By Dr Alan Smith

The independent Health Information and Quality Authority (HIQA) has recommended that bowel cancer screening in Ireland should in future start 5 years earlier at age 55, and continue 5 years later to age 74.

Currently, men and women aged 60 to 69, are invited for bowel screening. They are sent a home test kit every 2 years to provide stool samples.

However, following a close look at the evidence, the committee said that screening should be offered to people aged 55 to 74, using the faecal immunochemical (FIT) home test kit. 

The evidence shows that screening people at a younger age would enable more bowel cancers to be picked up at an earlier stage, where treatment is likely to be more effective and survival chances improved.

BowelScreen – the National Bowel Screening Programme understands the importance of screening these younger and older age groups. We are planning to begin expanding screening. We are aiming to offer bowel screening to all people aged 55 to 74. This is part of our commitment in Ireland’s National Cancer Strategy. We will keep you informed about our progress.

Why is this important?

Bowel cancer, also known as colon, rectal or colorectal cancer is the second most common invasive cancer diagnosed in men and third most common invasive cancer diagnosed in women in Ireland. 

Every year over 3,000 new cases are reported. The number of these new cases is expected to grow over the next 10 years, due mainly to the fact that more of us are living longer.

It is also the second most common cause of cancer death, with about 1,000 men and women dying each year in Ireland from bowel cancer.

The good news is that we can do something about this. Bowel screening can be an important step in reducing people’s risk of bowel cancer. International evidence shows that screening for bowel cancer in certain age groups is effective at reducing the number of deaths, the number of new cases and the number of families affected. 

Early detection before symptoms develop allows more effective treatment than if diagnosed later when symptoms have already appeared. Screening also allows for the removal of pre-cancerous growths (known as polyps) which can prevent the cancer from actually developing in the first instance. 

The BowelScreen home test (FIT kit) looks for blood not visible to the human eye in your bowel motion (or poo). If the home test is positive for blood then you are invited for a colonoscopy in one of our screening colonoscopy units based in one of 15 units throughout Ireland.

Will we ever screen people aged under 55?

Bowel cancer screening begins at the age of 50 in Scotland, at age 55 or 60 in different parts of England, at age 55 in Northern Ireland and at age 60 in Wales. 

In Ireland, BowelScreen keeps under regular review the evidence for screening younger age groups. In the future, it might be possible that we begin screening people who are younger than 55. It is likely that BowelScreen will apply to Ireland’s National Screening Advisory Committee (NSAC) to screen people of different ages.

Unfortunately, the COVID pandemic did have an impact on BowelScreen. Our screening colonoscopy units had to stop doing colonoscopies  as staff were redeployed to assist with the national effort against the pandemic.

As of 2022 all our screening colonoscopy units are again doing colonoscopies for people whose screening test has shown them to be at risk. But the overall, continuing impact of COVID means that screening invitations are being delayed by approximately a year. This means we will have to expand the programme a little slower than we would like.

The important thing for all people to remember, whether you are eligible for bowel screening or not, is that if you develop any symptoms at any point you should talk to your GP. They will arrange the right follow-up steps for you. 

To read more about bowel screening and steps you can take to reduce your risk of bowel cancer see 

Dr Alan Smith is a specialist in public health medicine with the National Screening Service



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