In a significant advancement for cancer detection, NHS England is set to improve the accuracy of its faecal immunochemical test (FIT), which identifies bowel cancer by detecting blood in stool samples. This initiative aims to enhance the sensitivity of the test, ultimately leading to earlier diagnoses and saving countless lives.
Enhanced Test Sensitivity
Under the new plan, the threshold for blood detection in stool samples will be lowered from 120 micrograms per gram to 80 micrograms by 2028. This adjustment aligns England’s testing standards with those already established in Scotland and Wales. According to Professor Peter Johnson, the national clinical director for cancer at NHS England, this change represents a crucial advancement in bowel cancer detection. He stated, “This is a major step forward in bowel cancer detection and will help save hundreds more lives from this devastating disease.”
By implementing a lower threshold, the NHS aims to create a more effective early warning system for bowel cancer, allowing for earlier identification and treatment of the disease, often before symptoms manifest.
The Impact of Bowel Cancer
Bowel cancer is the second leading cause of cancer-related deaths in the UK, with approximately 44,100 diagnoses made each year. Tragically, the disease claims around 17,400 lives annually. Risk factors include a diet high in processed meats, obesity, and excessive alcohol consumption, with Cancer Research UK indicating that over half of bowel cancer cases—54%—are preventable.
Once fully executed, the new threshold is projected to reduce late-stage diagnoses and fatalities by around 6%. Furthermore, NHS estimates suggest that this proactive approach could save the health service £32 million annually.
Increased Detection and Screening
The updated testing protocol is expected to result in an additional 600 bowel cancer diagnoses each year, marking an 11% increase from the current 5,320 cases detected annually. The NHS will also need to conduct 35% more colonoscopies, which are recommended for patients identified as at risk following the FIT test.
The FIT test has been part of the NHS’s bowel cancer screening programme since 2019, allowing eligible individuals to complete the test at home and return it by post for laboratory analysis. In 2024, eligibility was extended to include those aged 50 to 53, resulting in nearly 7 million kits being sent out that year. Of those, 68% were returned, leading to the identification of 5,320 cancers. An additional 1.2 million people are now eligible due to the expanded age criteria.
Genevieve Edwards, the chief executive of Bowel Cancer UK, expressed her enthusiasm for the lowered threshold, calling it “great news for people living in England.” She noted that this change signifies a pivotal moment in the country’s approach to bowel cancer screening.
Addressing Late Diagnoses
Despite these improvements, a recent report from Bowel Cancer UK highlighted that 25% of bowel cancer cases are only diagnosed when patients present at Accident and Emergency due to severe symptoms. This underscores the critical need for enhanced screening measures and public awareness campaigns to encourage timely participation in screening programmes.
Why it Matters
The NHS’s commitment to improving bowel cancer screening through enhanced test sensitivity is a vital step toward reducing mortality rates associated with this prevalent disease. By identifying cancers earlier and increasing the number of diagnoses, the initiative not only saves lives but also alleviates the financial burden on the healthcare system. As awareness of risk factors and the importance of screening grows, it is crucial for individuals to take proactive steps in managing their health, ultimately leading to a healthier population and a reduction in preventable cancer cases.
