Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, whether his Department is taking steps to introduce an (a) diagnostic protocol for bowel cancer in patients under 50 and (b) a mandatory referral for colonoscopy after two presentations of unresolved rectal bleeding.

The Department is committed to ensuring that people of all ages with symptoms of bowel cancer are diagnosed as quickly as possible. Clinicians should use their judgment in line with National Institute for Health and Care Excellence (NICE) guidance to ensure that every patient receives timely and appropriate investigation for bowel cancer, including patients aged under 50 years old presenting with unresolved rectal bleeding.

Guidance on referral for suspected cancer is developed and maintained by NICE. The guideline NG12 sets out the symptoms which should prompt referral for urgent investigation. For lower gastrointestinal cancer, there are several indications for patients aged under 50 years old which would be expected to result in referral. Further information can be found on the NICE website at the following link:

https://www.nice.org.uk/guidance/ng12/chapter/Recommendations-organised-by-site-of-cancer#lower-gastrointestinal-tract-cancers