Bowel Cancer Screening Age

Caroline Ansell Excerpts

Tuesday 8th March 2016 Westminster Hall

[Caroline Ansell (Eastbourne) (Con)]

I beg to move,

That this House has considered bowel cancer screening age.

Bowel cancer is second only to lung cancer for the number of lives it takes. Across the country, 165,457 people have signed a petition to bring down the bowel cancer screening age in the UK in a bid to hit this devastating disease.

[Margaret Ferrier (Rutherglen and Hamilton West) (SNP)]

It is extremely unfortunate that bowel cancer— screening is available only in England, Wales and Northern Ireland from the age of 60. Would the hon. Lady’s welcome the Scottish Government’s approach of screening people from the age of 50 being taken up across the rest of the UK? That would surely give many individuals an early diagnosis and a higher chance of survival.

[Caroline Ansell]

I thank the hon. Lady for her intervention. I recognise that earlier screening in Scotland and would certainly welcome it.

The petition that I mentioned has been well supported; in fact, it has had 500 new signatories this very day. The originator of the petition, Lauren Backler, has travelled from Eastbourne to be with us today in Westminster. May I at this point pay tribute to her courage and endeavour? For anyone hearing the news that they or a loved one have been diagnosed with bowel cancer, it will be simply earth-shattering, as Lauren knows. She writes:

“On 2nd December 2014, my Mum Fiona Backler was diagnosed with bowel cancer, at Eastbourne DGH’s”—

Eastbourne District General Hospital’s—

“Accident and Emergency and was told a few days later that the cancer was terminal. She started palliative chemotherapy within a week, but despite us being told that potentially she could have up to 2 years to live, she passed away on 28th March 2015, just under 4 months after diagnosis and a week after her 56th birthday. Before she was diagnosed, she had been back and forth to her GP with vague symptoms, and had even had an endoscopy about a year and a half beforehand, which she had been told was all clear. When she was diagnosed, her consultant told us that the cancer had possibly been missed at that stage.

Bowel cancer screening can often pick up abnormalities in people who have no symptoms at all, and so I believe that if the screening age was lowered to 50 it would give thousands of people a fighting chance of beating the disease.”

[Rebecca Pow (Taunton Deane) (Con)]

My hon. Friend knows that I have come to the debate for personal reasons. My husband was diagnosed with bowel cancer in December 2014, when we were right in the middle of fighting the campaign, and it was I who spotted the unusual signs and dragged him to the GP, where, like many men, he would never have gone, or at least not for a very long time. Ironically, he received a letter some months later saying, “Come for the screening,” when he would have been 55. Had he had that letter at 50, the polyps would have been recognised and removed and they would, potentially, not have turned into cancer. As it was, he did have cancer, and we had to go through that earth-shattering experience that the poor lady whom my hon. Friend talks about has also been through. I sympathise with her, and I urge support for my hon. Friend’s motion. We need to continue to explain why the matter is so important.

--- Later in debate ---

[Caroline Ansell]

I thank my hon. Friend for her moving contribution. Personal testimony highlights just why earlier intervention is vital—it can be life-saving.

[Glyn Davies (Montgomeryshire) (Con)]

My hon. Friend makes reference to personal experience. I would not be here today without an early diagnosis of the bowel cancer I suffered. I had an operation that left me with a stoma, and I am living proof that someone can make a 100% recovery and even become a Member of Parliament, if they work hard.

I hope my hon. Friend agrees that one of the big benefits of screening is not only the identification of blood as a possible sign of bowel cancer, but the raising of awareness. The truth is that it came as a huge shock to me, and I imagine that it comes as a huge shock to people who think they are invulnerable and do not believe that they could possibly be suffering from bowel cancer.

[Caroline Ansell]

My hon. Friend makes an apposite point, and I hope that, in a small way, this debate, underpinned as it is by personal testimony, plays a part in raising awareness. As I said at the beginning of my speech, the disease takes the second highest number of lives of all cancers.

[Julian Knight (Solihull) (Con)]

I congratulate my hon. Friend on securing this important debate. As someone who lost both of his grandfathers to bowel cancer, I think that early diagnosis is absolutely key. However, it is not just a case of screening at a specific age; it is about spotting the signs. I have friends who have developed this dreadful disease in their 30s. It is all about spotting the key signs. One of those friends went on, after recovery, to carry the Olympic torch and is now a champion for young people with bowel cancer. Will my hon. Friend go on to talk about spotting the signs and not just about screening?

[Caroline Ansell]

My hon. Friend makes a very worthy point. He brings glad tidings, too, that bowel cancer can be beaten and that those who have suffered from this terrible condition can go on to lead rich and fulfilling lives—which, in some cases, bring them to Parliament.

[Mr Andrew Smith (Oxford East) (Lab)]

The hon. Lady is being very generous in giving way. I commend her excellent speech, the petitioners and her remarks about her brave constituent. With the national rate of screening at 58%—it is only slightly higher in Oxfordshire—does she agree that, as well as raising awareness and pushing for an earlier age of screening, which I fully endorse, still more needs to be done to increase take-up, notwithstanding the adverts and the reminder letters that are already sent?

[Caroline Ansell]

The right hon. Gentleman is right in identifying that as a key way to move forward. In fact, screening uptake has not really moved in more than a decade, so we do need to be in the business of raising awareness of the condition, its symptoms and the opportunities for screening, at whatever age it is set.

[Chris Davies (Brecon and Radnorshire) (Con)]

While we are on the personal stories, cancer—bowel cancer in particular—touches all families. I sadly lost my sister this time last year through it and my father is in a hospice at the moment for that exact reason. I am someone who is going through the investigative treatment, just as the husband of my hon. Friend the Member for Taunton Deane (Rebecca Pow) did, and everything is fine so far. As uncomfortable as it is, it is particularly difficult for men to be brave enough to go out and have the investigative actions take place. I am 48, so reducing the age would not necessarily have covered me. My sister, sadly, was 50 when she passed away. But bringing the age down will certainly give other people a chance, and that is the most important thing. I congratulate my hon. Friend on bringing the debate forward.

[Caroline Ansell]

I thank my hon. Friend for his contribution.

[Kevin Foster (Torbay) (Con)]

I welcome the fact that my hon. Friend has secured this debate. My mother was diagnosed with bowel cancer at 56 and, ironically, my father, who was 60 at the time, had received the screening kit five months previously. Does my hon. Friend agree that that shows the need to review the age at which people are screened?

[Caroline Ansell]

I agree, and I hope we can put that need forward today. I know that the Minister and her Department are working hard in this area and that they are all the time seeking to secure better outcomes. I hope that they might just revisit the screening age as part of that.

It has been really moving to hear from right hon. and hon. Members about their own experiences and about the losses they have suffered. Lauren is here today, having lost her mum. What a terrible tragedy that is. It feels especially poignant that we are here so soon after celebrating mother’s day.

With today’s advances in life expectancy, 56—the age at which Lauren’s mother died— is incredibly young, yet if Lauren’s mother had lived in Scotland, she would have been screened three times before the age at which she was diagnosed, increasing the chances of early detection and therefore survival. Learning that must have been a bitter blow. England has, however, led in this area. In 2006, we became the first home nation and one of the first countries in the world to offer routine screening for bowel cancer, with the faecal occult blood test, or FOBT, being sent every two years to those aged 60 to 69—later extended to 74. However, a year later Scotland implemented the same screening, with the crucial difference that it would begin from the age of 50.

The national screening committee, which ran FOBT pilots in the early 2000s, felt that 50 was the right age at which to begin to screen. It noted a lower take-up of the test in 50 to 60-year-olds compared with those over the age of 60, but recommended that the Government take measures to address that. However, when deciding on final implementation it was recognised that, due to a shortage of endoscopy equipment and with substantially higher incidence rates over the age of 60, screening would begin with that age group. It is conceded that more than 80% of those diagnosed with bowel cancer are over the age of 60.

A University of Sheffield study recommended that offering both bowel scope screening and the FOBT from the age of 60 would maximise survival rates and have the important trade-off of being cost-effective. Yet the same study also found that the FOBT would substantially lower the number of deaths by as much as 23% if it was run for 50 to 69-year-olds, whereas running it from the age of 60 only would reduce the number of deaths by only 14%. It is hard to talk about percentages but, just to bring the debate back to the personal level, that significant 9% would have included Lauren’s mum, and perhaps other people we know.

We know that there is a clear upward incidence of bowel cancer over the age of 50. The rate of bowel cancer roughly triples between one’s 40s and one’s 50s, before doubling again in one’s 60s. We all should be aware of the signs and take precautions in our diet and lifestyle to prevent and detect bowel cancer—and, yes, perhaps we ought to shed the very British attitude that we must keep calm and carry on, and seek out our GP. More must be done to improve screening uptake rates. Bowel cancer screening rates remain disappointingly low nationwide, having barely moved above those achieved in the pilot 16 years ago.

[Rebecca Pow]

Spotting the signs is absolutely crucial, and we have had some great receptions in Parliament about just that point with the bowel cancer organisations, but I want to put a positive spin on things. Let us not be negative. If we spot bowel cancer early, which is exactly what my hon. Friend is talking about, it is fully possible to recover. It is one of the ones that has a positive outcome. We have got some great medical teams in this country, and I think we should praise them. In particular, I praise the team at Musgrove Park hospital. It has one of the best support teams in this area. I know Lauren has had a terrible time, but for other people there is an awful lot of positivity, which is why my hon. Friend secured the debate.

[Caroline Ansell]

Indeed, there is a lot of positivity. Lauren brings that positivity: she wants not only to reduce the screening ages, but to advance awareness of bowel cancer across the piece. I know that she is particularly concerned about those who are at risk and are already carrying the condition in their 20s and their 30s. So much more needs to be done, and that includes us talking about our symptoms and taking that forward. As we have heard, there is a good prognosis if we can strike out for that early intervention.

[Sir David Amess (Southend West) (Con)]

On that positive note, my mother had a scare at 90. She ended up with a colostomy and she is shortly to be 104. There are good outcomes. Does my hon. Friend share my disappointment that the national average for take-up is 58%? In Southend, it is 52%. Our excellent Minister will be keen to ensure that there is a much higher take-up rate.

[Caroline Ansell]

Indeed. I am looking forward to hearing more from the Minister about the excellent work the Government are doing. I know that they have plans and prospects for hitting that low take-up. I fear that that low take-up might be a very British sort of thing, and we need to break through that if we are to strive to see the same survival rates as some of our European counterparts.

On early diagnosis, those diagnosed with stage 1 bowel cancer have a 97% chance of survival, which is hugely positive. That compares with a chance of survival of just 7% when the cancer is more advanced. Early diagnosis not only provides patients with a much better chance of survival, but would cost the NHS far less, saving an estimated £34 million according to the charity Beating Bowel Cancer. That is because treatment for the earlier stages of cancer is often less intensive and invasive than treatment for more advanced diseases.

Sadly we also know that we are lagging behind other countries on survival rates. A 2013 study for the London School of Hygiene and Tropical Medicine, which was part-funded by the European Commission, found that in Britain we diagnose bowel cancer later than other countries, while our survival rate overall for bowel cancer was only 51.8%. That is lower than the European average of 57% and lower than Germany’s survival rate of 62%. That is not where we want to be. I am looking forward to hearing from the Minister about her Department’s sterling work, but my question today is: could the age of screening be revisited? Is there scope to further personalise and target testing in those younger years?

[Mr Philip Hollobone (in the Chair)]

For the Minister’s benefit, the debate will conclude at 4.57 pm.