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: 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.
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 help ensure equality in bowel cancer outcomes.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The National Health Service is taking several steps to improve bowel cancer outcomes for patients across England. The NHS is working towards its Long Term Plan’s ambition of diagnosing 75% of all stageable cancers at stage one and two, by 2028. Achieving this will mean that an additional 55,000 people each year will survive their cancer for at least five years after diagnosis. With progress made on reducing waiting times, cancer is being diagnosed at an earlier stage more often, with survival rates improving across almost all types of cancer.
In 2023, NHS England’s Help Us Help You campaign urged people to take up the offer of bowel screening when invited, while gradually extending the screening offer from those aged 60 down to 50 years old, ensuring more people are diagnosed with bowel cancer at the earliest stage.
The NHS 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 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.
Tackling disparities is important in improving all types of cancer outcomes. The Government is committed to its levelling up mission, to narrow the gap in healthy life expectancy by 2030 and increase healthy life expectancy by five years by 2035. Our approach will continue to focus on supporting people to live healthier lives, helping the NHS and social care provide the best treatment and care for patients, and tackling health disparities through national and system interventions such as the NHS’s Core20PLUS5 programme.
The Office for Health Improvement and Disparities was set up to address health inequalities with a range of interventions, including accelerating prevention programmes, reducing digital exclusion, supporting general practice in deprived communities, and improving health literacy.
Asked by: Taiwo Owatemi (Labour - Coventry North West)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps she plans to take to help increase the (a) stock of colonoscopy equipment, (b) number of colonoscopy facilities and (c) number of trained staff; and what other steps she plans to take to increase the use of colonoscopies in detecting bowel cancer.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The Government is not currently planning to take steps to increase the stock of colonoscopy equipment. £2.3 billion was awarded at the Spending Review 2021 to transform diagnostic services over the next three years. Within this funding, NHS England is delivering an expected net increase uplift of 67 endoscopy rooms in acute trusts or in non-community diagnostic centre (CDC) developments. In CDCs, current plans are for 46 sites to be delivering endoscopies from March 2025, of which, 39 will deliver colonoscopies. This will help to support integrated care boards not currently meeting the optimal capacity of 3.5 rooms per 100,000 people over 50 years old, to do so.
NHS England will continue to deliver initiatives to train around 100 clinical endoscopists per annum to be capable of delivering colonoscopies and other gastrointestinal procedures. In addition to this NHS England is also training doctors, such as gastroenterologists, in the same procedures and continuing to develop, implement and improve immersive and rapid colonoscopy training through endoscopy academies.
As of October 2023, there are over 3,200 full-time equivalent doctors working in the specialty of gastroenterology within National Health Service trusts and other core organisations in England. This is over 100, or 4.3%, more than in 2022, over 500, or 20.1%, more than in 2019, and almost 1,400, or 75.2%, more than in 2010.
To improve bowel cancer diagnosis, the NHS has implemented timed cancer pathways for gastro-intestinal (GI) disease. This includes the implementation of Faecal Immunochemical Testing for those with symptoms in the lower GI, to prevent these patients from having unnecessary colonoscopies, freeing up capacity for these procedures and ensuring the most urgent symptomatic patients are seen more quickly.
Asked by: Taiwo Owatemi (Labour - Coventry North West)
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 ensure that people with Lynch Syndrome are (a) informed of their condition and (b) made aware of their increased risk of bowel cancer.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
NHS England, through the NHS Genomic Medicine Service, has launched a national transformation project to ensure more patients with Lynch syndrome are identified and benefit from regular check-ups, earlier interventions, and more targeted treatment, such as combinations of immunotherapy, chemotherapy and surgeries.
People aged between 25 and 75 years old identified as having Lynch Syndrome will be included in the surveillance arm of the National Health Service bowel cancer screening programme, and will be offered a colonoscopy every two years.
The national programme ensures all people diagnosed with bowel and endometrial are offered genomic testing, with a diagnosis for Lynch syndrome not only helping to guide more personalised cancer treatment but enabling their families and relatives to be offered testing too.
Asked by: Kirsten Oswald (Scottish National Party - East Renfrewshire)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how many and what proportion of women who (a) have and (b) do not have multiple sclerosis attended (i) cancer screening appointments, (ii) mammograms and (iii) cervical screening appointments in each of the last five years.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
National Health Service screening programmes do not collect data on an individual’s long-term condition, and therefore no data is available on what proportion of women who have multiple sclerosis, participate in cancer screening programmes.
Under the Equality Act 2010, and the Health and Social Care Act 2012, NHS screening providers have a legal duty to make sure screening services are accessible to everyone, including people with long term conditions, who may have issues with access.
The following table provides data on the percentage of coverage for the three cancer screening programmes, breast, cervical and bowel, within the age groups invited for NHS screenings, in England over the last five years:
| 2016/17 | 2017/18 | 2018/19 | 2019/20 | 2020/21 | 2021/22 |
Breast Screening – ages 50 to 71 years old | 74.9% | 74.6% | 74.2% | 64.2% | 65.3% | 66.4% |
Cervical Screening – ages 25 to 64 years old | 71.4% | 71.9% | 72.2% | 70.2% | 69.9% | 68.7% |
Bowel Screening – ages 60 to 74 years old | 59.2% | 59.5% | 60.5% | 64.3% | 66.1% | 70.3% |
Note: Data for bowel cancer screening is not separated based on sex.
Asked by: Grahame Morris (Labour - Easington)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, which Minister in her Department is responsible for delivery of (a) cancer screening programmes and (b) the NHS public health Section 7A agreement.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
My role as the Minister of State for Health and Secondary Care includes responsibility for major diseases including cancer, and for screening.
In accordance with the NHS Public Health Functions Agreement (made under section 7A of the NHS Act 2006) NHS England is responsible for providing or securing the provision of breast, bowel and cervical screening programmes and other specified public health services.
My Rt. Hon friend, Andrea Leadsom MP, the Parliamentary Under Secretary of State for Public Health, Start for Life and Primary Care, has led ministerial responsibility for arrangements under section 7A.
Asked by: Karin Smyth (Labour - Bristol South)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, with reference to her Department's press release entitled Digital pathology to improve cancer screening and save lives, published on 5 January 2024, what additional training will be given to pathologists working to enable the quick uptake of new technology.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
Following the recommendation from the UK National Screening Committee to support the use of digital pathology in the National Health Service cervical, breast and bowel cancer screening programmes, NHS England are investing in and working with the Royal College of Pathologists in the on-going development of an online Pathology Portal.
This digital learning platform will support trainees and established pathology practitioners in digital pathology to ensure that digital learning materials are available to the multi-professional workforce.
NHS England plans to issue guidance at the end of January 2024 for the three NHS Cancer Screening Programmes, to support local providers of histopathology services who wish to implement digital pathology for the reporting of screening cases.
Asked by: Navendu Mishra (Labour - Stockport)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, pursuant to the Answer of 30 November 2023 to Question 3997 on Incontinence: Health Services, whether her Department plans to engage stakeholders during the course of the National Bladder and Bowel Health Project.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
There have been no formal plans for stakeholder engagement set out at this stage. However, the Department remains open to future engagement with bladder and bowel health stakeholders.
Beyond the project in question, the Department continues to engage with stakeholders including commissioners, providers, and clinicians and also cancer charities on Bowel Cancer screening, including a planned meeting with UK National Screening Committee on bowel cancer screening in January 2024.