Will the Minister explain why the bowel screening tests end in Wales at 74 years of age, with no option to self-refer thereafter or to continue by opting-in to receiving a test every two years?
Welsh Government policy follows the independent, expert advice of the UK National Screening Committee (UK NSC) which recommends routine asymptomatic bowel screening for men and women between 50 and 74. The advice balances the risks and potential harms as well as benefits of the screening test being offered. For asymptomatic bowel screening above the recommended age group, the additional risks from false positive results and any follow-up investigations outweigh the potential benefits in an older population. At any age, anyone with symptoms of bowel cancer is exhorted to seek prompt advice from their doctor, so that investigation can be offered. This approach offers the appropriate balance of risks, benefits, population equity and efficient use of resources.
The bowel screening programme in Wales currently offers screening to people with no symptoms, aged 51 to 74. Work to reduce the starting age from 60, in line with UK NSC recommendation, has been taking place since October 2021. People aged 51 to 54 have now started to receive bowel screening test kits from October 2023. The test sensitivity has also been increased from a threshold of 150µg of haemoglobin/g of faeces to 120µg. The intention is to expand the age range down to those aged 50 and increase test sensitivity further from October 2024. Our priority is to make asymptomatic population screening available to all those within the recommended age cohort, at the recommended test sensitivity.
At present, there is insufficient evidence for extending the age range beyond the recommended cohort. However, the UK NSC considers any new evidence on behalf of the four UK countries and keeps all its policy positions under regular review when new papers are published. Should the committee recommend asymptomatic bowel screening outside of the current age range, the Welsh Government will consider how this can be implemented in Wales.