Question to the Department of Health and Social Care:

To ask the Secretary of State for Health, what steps the Government is taking to increase early diagnosis of gastro-intestinal cancers.

Improving Outcomes: A Strategy for Cancer (January 2011), is backed by over £750 million over the four years up to 2014-15, including over £450 million to achieve earlier diagnosis of cancer. The £450 million was designed to support direct general practitioner (GP) access to key diagnostic tests including flexible-sigmoidoscopy and colonoscopy to support the diagnosis of bowel cancer. In 2012, the Department published ‘Direct access to diagnostic tests for cancer: best practice referral pathways for general practitioners’ which set out where a direct referral for tests may benefit patients and lead to a faster diagnosis. The earlier diagnosis money is also supporting additional tests and treatment in secondary care and centrally led Be Clear on Cancer (BCOC) campaigns which aim to raise awareness of the symptoms of cancer and get symptomatic patients to present earlier.

The BCOC national Oesophago-Gastric campaign to raise awareness of the main symptoms of these cancers launched on 26 January and will run until 22 February. The campaign uses a wide range of media, including national television and radio advertising, to promote the key message “Having heartburn, most days, for three weeks or more could be a sign of cancer” and “Food sticking when you swallow could be a sign of cancer”.

The campaign is aimed at people over 50, the age group most at risk of developing oesophago-gastric cancers, and their friends and family to raise awareness of the symptoms of persistent heartburn and food sticking and to encourage people with either of these symptoms to visit their GP.

The National Institute for Health and Care Excellence (NICE) is in the process of updating current ‘Referral Guidelines for Suspected Cancer (2005)’ to ensure that these can continue to support GPs to identify patients with suspected cancer symptoms including gastrointestinal symptoms, and urgently refer them as appropriate. NICE’s anticipated publication date for the revised guidelines is May 2015.

We are currently rolling out Bowel Scope Screening (BSS, technical name flexible sigmoidoscopy) to people aged 55 years of age. BSS is an alternative and complementary bowel screening methodology to home testing kits and involves having a thin, bendy tube put a short way into the rectum and lower bowel. The doctor uses the scope to look at the inside wall of the bowel, and remove any small growths (polyps) that are there. Bowel cancers usually develop very slowly from these polyps, known medically as adenomas. By removing them at an early stage it is possible to prevent bowel cancers from developing

We exceeded our target of 30% of BSS centres operational by the end of March 2014 (22 out of 62, 35%), and Public Health England (PHE) is confident of meeting the commitment of having 60% of centres operational by 31 March 2015 (currently 32 are operational, 52%). PHE is also confident of meeting the commitment of 100% (62) centres operational by the end of December 2016.

As at the end of December 2014, 75,322 invitations had been issued and 25,828 BSS procedures had been performed. Uptake stood at approximately 44% and ranged from 38% in the lowest site to 50% in the highest. 1,154 people had been referred to colonoscopy following BSS, with 25 cancers detected and 490 people with high/intermediate risk polyps and 370 people with low risk polyps managed/removed.

On 11 January NHS England announced a new independent cancer taskforce to develop a five-year action plan for cancer services to improve survival rates and save thousands of lives. The taskforce will produce a statement of intent by March 2015, and will aim to publish the new strategy in the summer.