Asked by: Jim Shannon (Democratic Unionist Party - Strangford)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether her Department has taken recent steps to (a) increase the availability of and (b) support the rollout of new immunotherapy treatments for bowel cancer.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The National Institute for Health and Care Excellence (NICE) is the independent body responsible for developing evidence-based recommendations for the National Health Service in England on whether medicines represent a clinically and cost-effective use of NHS resources. NICE appraises all newly licensed medicines within their licensed indications and the NHS in England is legally required to fund medicines recommended by NICE. Cancer medicines are eligible for funding from the Cancer Drugs Fund from the point of draft NICE guidance.
NICE has already recommended several immunotherapies for bowel cancer, which are now available for the treatment of eligible NHS patients in line with NICE’s recommendations. These include including panitumumab, pembrolizumab, and nivolumab with ipilimumab. NICE is also due to start its appraisal of nivolumab for previously treated metastatic colorectal cancer with high microsatellite instability or mismatch repair deficiency in March 2024.
Asked by: Gregory Campbell (Democratic Unionist Party - East Londonderry)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, when she plans to reduce the minimum age for bowel screening to 50.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
NHS England started the lowering of age for bowel cancer screening in April 2021. The following table shows the rollout plan for the bowel screening, keeping in mind that the timeline may differ slightly from region to region:
Cohort age at first invitation | Year invitations start |
56 years old | 2021/22 |
58 years old | 2022/23 |
54 years old | 2023/24 |
50 and 52 years old | 2024/25 |
Asked by: Henry Smith (Conservative - Crawley)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps she is taking to help increase access to bowel cancer screenings.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
Based on advice from the UK National Screening Committee, the National Health Service is currently extending the age criteria for bowel cancer screening from between 60 and 74 years old so that screening will be available from the age of 50 years old; this is due to be completed by 2024/25. This will increase access for people who would have otherwise not been able to access the service.
Asked by: Gill Furniss (Labour - Sheffield, Brightside and Hillsborough)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, with reference to the national bowel screening programme, when he plans to next review that programme; and whether he has plans to raise the acceptable and achievable bowel screening target thresholds in line with breast screening targets.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The national bowel cancer screening programme in England is currently revising all standards and as a part of this process current thresholds will be reviewed. This review will consider the lowering of the screening age for bowel cancer from 60 to 50 years old.
The process for setting standards involves the meeting of experts as well as meeting with stakeholders and interested parties to ensure the standards are evidence based, acceptable and realistic. Full details on how these standards are set is available at the following link:
https://www.gov.uk/guidance/principles-of-population-screening/screening-standards
Mentions:
1: None I come back to your previous comment about screening, particularly bowel screening. - Speech Link
Asked by: Jim Shannon (Democratic Unionist Party - Strangford)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps her Department is taking to improve the rate of early diagnosis of (a) bowel and (b) bowel-related cancers.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The Department is taking steps to improve the rate of early diagnosis for all cancers, including bowel and bowel-related cancers, and is working jointly with NHS England on implementing the delivery plan, for tackling the COVID-19 related backlogs in elective care. This includes plans to spend more than £8 billion from 2022/23 to 2024/25 to help drive up and protect elective activity, including cancer diagnosis and treatment.
NHS England is working to meet the Faster Diagnosis Standard, which sets a target of 28 days from urgent referral by a general practitioner or screening programme to patients being told that they have cancer, or that cancer is ruled out. To achieve this target NHS England has: streamlined bowel cancer pathways by implementing faecal immunochemical testing triage for patients in primary and secondary care settings on a suspected cancer pathway; implemented non-symptom specific pathways for patients who present with non-specific symptoms, or combinations of non-specific symptoms, that can indicate several different cancers; and has opened community diagnostic centres across England, expanding diagnostic capacity and by prioritising this capacity for cancer services.
In 2023 the NHS England’s Help Us Help You campaign urged people to take up the offer of bowel screening when invited, and the screening offer for the bowel screening programme is being gradually extended from age 60 down to 50 years old by 2025, ensuring more people are screened and potentially diagnosed with bowel cancer at the earliest stage. The National Health Service is also now offering routine preventative bowel cancer screening to thousands of people in England with a genetic condition, Lynch syndrome, that increases their chance of developing bowel cancer and other certain other cancers. This gives the NHS a better chance of finding cancers at a time when they can be more easily and effectively treated.
Mentions:
1: Helen Hayes (Lab - Dulwich and West Norwood) There is an increasing incidence of bowel cancer among younger patients, such as my constituent Emily - Speech Link
Asked by: Rachael Maskell (Labour (Co-op) - York Central)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what estimate she has made of the timeline for meeting cancer screening uptake targets for (a) breast, (b) cervical, (c) bowel and (d) prostate cancer.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The Government is committed to improving uptake in all screening programmes, including for breast, bowel, and cervical screening. There is no national screening programme for prostate cancer. The improvement in cancer screening programmes is not predicated on a specific timeline, but is focusing on targeting specific groups where uptake is low.
NHS England has developed a national improvement plan in collaboration with key stakeholders to improve uptake within the breast screening programme. This plan will encompass a series of evaluative projects, which are expected to report in April 2024
A range of improvements and innovations have been brought in to help improve uptake in the NHS Cervical Screening Programme. For example, appointments are being made available during evenings and weekends, and in some areas cervical screening appointments can be made in any primary care setting, rather than just at one’s own general practice.
In addition, we are also working to test the effectiveness of human papillomavirus infection self-sampling as a primary cervical screening option, with individuals taking their own cervical screening sample. The findings from this evaluation will be used to inform a UK National Screening Committee recommendation, and it is expected that self-sampling could lead to an increase in uptake as it will reduce some of the barriers that prevent people from attending a screening.
Uptake in the NHS Bowel Cancer Screening Programme is currently above the achievable threshold of 60%, between 1 July and 30 September 2023 it was 67.4%, and therefore the focus for this screening programme is on gradually reducing the age of the eligible cohort from 60 years old down to 50 years old, to increase to numbers eligible for this programme.
Asked by: Rachael Maskell (Labour (Co-op) - York Central)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps she is taking to increase the uptake of screening for (a) breast, (b) cervical, (c) bowel and (d) prostate cancer.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The Government is committed to improving uptake in all screening programmes, including for breast, bowel, and cervical screening. There is no national screening programme for prostate cancer. The improvement in cancer screening programmes is not predicated on a specific timeline, but is focusing on targeting specific groups where uptake is low.
NHS England has developed a national improvement plan in collaboration with key stakeholders to improve uptake within the breast screening programme. This plan will encompass a series of evaluative projects, which are expected to report in April 2024
A range of improvements and innovations have been brought in to help improve uptake in the NHS Cervical Screening Programme. For example, appointments are being made available during evenings and weekends, and in some areas cervical screening appointments can be made in any primary care setting, rather than just at one’s own general practice.
In addition, we are also working to test the effectiveness of human papillomavirus infection self-sampling as a primary cervical screening option, with individuals taking their own cervical screening sample. The findings from this evaluation will be used to inform a UK National Screening Committee recommendation, and it is expected that self-sampling could lead to an increase in uptake as it will reduce some of the barriers that prevent people from attending a screening.
Uptake in the NHS Bowel Cancer Screening Programme is currently above the achievable threshold of 60%, between 1 July and 30 September 2023 it was 67.4%, and therefore the focus for this screening programme is on gradually reducing the age of the eligible cohort from 60 years old down to 50 years old, to increase to numbers eligible for this programme.
Asked by: Lennon, Monica (Scottish Labour - Central Scotland)
Question
To ask the Scottish Government what assessment it has made of research published in the Annals of Oncology journal, which reports an expected rise in bowel cancer death rates for adults aged 25 to 49 years in the UK by 26% for men and 39% for women, including (a) what data is available for Scotland, (b) what action it is taking to prevent bowel cancer and (c) how it will improve detection rates in people under the age of 50.
Answered by Gray, Neil - Cabinet Secretary for NHS Recovery, Health and Social Care
(a) There are a number of published data sets available in Scotland that help us understand bowel cancer. These are facilitated by Public Health Scotland and include data on incidence, mortality, staging, waiting times for cancer organised by tumour type.
Cancer Incidence
Public Health Scotland provides an annual update of cancer incidence statistics in Scotland from January 1997 to December 2021. All cancer types are included. Most recent data can be found here
Cancer Mortality
Public Health Scotland provides interpretations of the risk factors that cause cancer and changes in survival for the most common causes of cancer death. Most recent data can be found here
Cancer Staging
Public Health Scotland provides data examining the impact of COVID-19 on cancer staging distributions, with the focus of the report being on the 2022 data in comparison with the most recent pre-pandemic data (2018 and 2019). Most recent data can be found here
Cancer Waiting Times
Public Health Scotland provides quarterly updates of Cancer Waiting Times statistics, reporting two National Standards on how long patients waited for their first cancer treatment. The 62-day standard applies to patients urgently referred with a suspicion of cancer by a primary care clinician/general dental physician, patients referred by one of the national cancer screening programmes, and direct referrals to hospital where the signs and symptoms are consistent with the cancer diagnosed. The 31-day standard applies to all patients, regardless of the route of referral. The most recent data can be found here
(b) The research conducted by Cancer Research UK, published in the Annals of Oncology journal in January 2024, states that bowel cancer can be linked to diet and alcohol intake. The Scottish Government has introduced strong public health interventions to address these risk factors.
The Scottish Government’s Alcohol Framework sets out our priorities for preventing alcohol-related harm and introduced the Minimum Unit Pricing (MUP) to alcohol sales in Scotland. The Scottish Government’s Alcohol Framework, published 20 November 2018, sets out our priorities for preventing alcohol-related harm. It contains 20 actions building on existing measures to change Scotland’s relationship with alcohol, including our world-leading minimum unit pricing policy. The Scottish Government takes a whole population approach to tackling alcohol-related harms, in line with the World Health Organization’s focus on affordability, availability and attractiveness of alcohol.
Prior to the pandemic, the reduction in alcohol sales showed encouraging early signs that the introduction of MUP was having a positive impact. In the 12 months following the introduction of MUP and before the pandemic, there was a 2% decrease in alcohol sales for off premises consumption.
The Scottish Government continue to endorse a healthy balanced diet as represented by the Eatwell Guide . Food Standards Scotland has translated the Eatwell Guide into the Eat Well, Your Way resource. This provides meaningful, practical advice and tips to help people make healthier food and drink choices, whilst acknowledging the social, cultural and environmental influences on food choice.
Our Diet and Healthy Weight Delivery Plan sets out ambitious and wide-ranging action to deliver our vision for a Scotland where everyone eats well and has a healthy weight.
(c) The Scottish Government is committed to detecting cancer as early as possible. A new Detect Cancer Earlier campaign – Be The Early Bird - launched in March 2023, aiming to reduce fear of cancer and empower those with possible symptoms to act early. Following successful independent evaluation, the campaign re-ran in September 2023 to prompt health-seeking behaviour.
The wider Detect Cancer Early Programme works closely with the Scottish Cancer Coalition, including Bowel Cancer UK, to support awareness raising efforts and uses social channels to promote joint content and messages where possible.