Asked by: Feryal Clark (Labour - Enfield North)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if his Department will ensure that the Major Conditions Strategy includes measures in line with the NHS Long Term Plan to increase the number and proportion of bowel cancer patients diagnosed at stage I or stage II by 2028.
Answered by Helen Whately - Minister of State (Department of Health and Social Care)
The Major Conditions Strategy will look at the treatment and prevention of cancer in people of all ages, covering the patient pathway. The strategy will look at a wide range of interventions and enablers to improve outcomes and experience for cancer patients.
This Strategy will draw on previous work on cancer, including over 5,000 submissions provided to the Department as part of our Call for Evidence last year. The summary of responses to the Call for Evidence was published on 17 May 2023. We will continue to work closely with stakeholders, citizens, and the NHS in coming weeks to identify actions for the Strategy that will have the most impact.
Asked by: Patrick Grady (Scottish National Party - Glasgow North)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what recent steps his Department has taken to improve outcomes for bowel cancer patients.
Answered by Helen Whately - Minister of State (Department of Health and Social Care)
NHS England have been working with Cancer Alliances to facilitate the prioritisation and implementation of treatment-focussed recommendations from clinical audits and Getting It Right First Time reports that will make the biggest impact in terms of improving survival outcomes and reducing inequalities. This work was piloted in 2022/23 in lung cancer, and in 2023/24 this work is now expanding to cover three new tumour sites where there is an existing clinical audit: prostate, breast, and bowel.
Asked by: Feryal Clark (Labour - Enfield North)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps his Department is taking to ensure that 75 per cent of bowel cancer patients are diagnosed at stage I or II by 2028.
Answered by Helen Whately - Minister of State (Department of Health and Social Care)
Achieving earlier and faster diagnosis of cancer is a priority for the National Health Service. That is why one of the core ambitions in the NHS Long Term Plan is to diagnose 75% of cancers at stage 1 or 2 by 2028. The latest published data shows this was at 52% between January 2020 to December 2020.
The NHS is improving pathways to get people diagnosed faster once they are referred and is looking into alternative routes into the system, including non-specific symptom (NSS) pathways for patients who do not fit clearly into a single ‘urgent cancer’ referral pathway but who are at risk of being diagnosed with cancer. 103 NSS pathways are currently operational, with more in development.
The NHS bowel cancer screening programme is currently available to everyone aged 60 to 74 years old every two years. Since April 2021, the NHS in England has been gradually reducing the age for bowel screening. The age extension programme began in 2021/22, inviting people aged 56 years old and plans to complete rollout to age 50 years old by 2024/25. This extension was recommended to improve the number of cancers detected and helping to prevent it in some cases.
Asked by: Feryal Clark (Labour - Enfield North)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what proportion of bowel cancer patients were diagnosed at stage I or II in each year since 2010.
Answered by Helen Whately - Minister of State (Department of Health and Social Care)
The following table shows the proportions of staged diagnoses of bowel cancer by diagnosis year from 2013 to 2020 the most recent fully registered diagnosis year.
Year Stage I Stage II Stage III Stage IV
2013 18% 27% 29% 27%
2014 18% 27% 30% 26%
2015 18% 26% 30% 26%
2016 19% 26% 30% 26%
2017 18% 26% 30% 26%
2018 19% 25% 30% 25%
2019 20% 25% 31% 24%
2020 18% 25% 31% 26%
For diagnosis years before 2013, the completeness of staging data of stageable cancers, including bowel cancer, was below 70%. Because of the high level of missing stage data, it is not possible to produce reliable estimates of the stage distribution for the diagnosis years 2010 to 2012.
Asked by: Virendra Sharma (Labour - Ealing, Southall)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether his Department has taken recent steps to implement the recommendation of the UK National Screening Committee to provide faecal-immunochemical test screening for bowel cancer every two years for people aged between 50 and 74.
Answered by Neil O'Brien
The National Health Service is committed to extending the bowel screening programme and have set a timeline for this extension, which is detailed in the table below.
Cohort age at first invitation | Year invitations start |
Age 56 years old | 2021/22 |
Age 58 years old | 2022/23 |
Age 54 years old | 2023/24 |
Age 50 and 52 years old | 2024/25 |
Asked by: Elliot Colburn (Conservative - Carshalton and Wallington)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps his Department is taking to improve early diagnosis of bowel cancer.
Answered by Helen Whately - Minister of State (Department of Health and Social Care)
The National Health Service is improving pathways to get people diagnosed faster once they are referred and is looking into alternative routes into the system, including non-specific symptom (NSS) pathways for patients who do not fit clearly into a single ‘urgent cancer’ referral pathway but who are at risk of being diagnosed with cancer. 103 NSS pathways are currently operational, with more in development.
The NHS bowel cancer screening programme is currently available to everyone aged 60 to 74 years old every two years. Since April 2021, the NHS in England has been gradually reducing the age for bowel screening. The age extension programme began in 2021/22, inviting people aged 56 years old and plans to complete rollout to age 50 years old by 2024/25. This extension was recommended to improve the number of cancers detected and helping to prevent it in some cases.
Asked by: Greg Smith (Conservative - Buckingham)
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 ensure that the Major Conditions Strategy includes policies on bowel cancer patients.
Answered by Helen Whately - Minister of State (Department of Health and Social Care)
The Major Conditions Strategy will draw on previous work on cancer, including over 5,000 submissions provided to the Department as part of our Call for Evidence last year. Many of those submissions will have included feedback on bowel cancer. We will continue to work closely with stakeholders, citizens and the National Health Service in coming weeks to identify actions for the Strategy that will have the most impact.
Asked by: Paula Barker (Labour - Liverpool, Wavertree)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps his Department is taking to help increase the level of uptake for the bowel cancer screening programme.
Answered by Neil O'Brien
In 2019 the Faecal Immunochemical Test (FIT) was rolled out in England for the bowel screening programme. FIT has found to be both more accurate and more acceptable to patients, because of its non-invasive nature.
To increase uptake of screening NHS England ran a ‘help us to help you’ campaign about bowel screening in February and March 2023. The aim of this campaign was to encourage people to take up the offer of bowel cancer screening.
Asked by: Peter Dowd (Labour - Bootle)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what recent progress his Department has made on reducing waiting times for bowel cancer referrals.
Answered by Will Quince
To reduce waiting times, including in bowel cancer referrals, the Government has taken steps by working with NHS England to publish the delivery plan for tackling the COVID-19 backlogs in elective care in February 2022. To deliver this plan, the Government 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 activity.
Diagnostics are crucial part of all cancer pathways. The Government awarded £2.3 billion at the 2021 Spending Review to transform diagnostic services over the next three years. As part of this investment, up to 160 new Community Diagnostic Centres (CDCs) will deliver additional, digitally connected, diagnostic capacity in England, providing patients with a coordinated set of diagnostic checks, including for cancer. To date, there are 92 CDCs currently operational that have delivered over 3 million additional tests since July 2021, including vital cancer checks.
The National Health Service is also continuing to roll-out faecal immunochemical tests (FIT) to support the clinical triage of patients on the lower gastrointestinal cancer pathway, with a clear expectation set out in NHS England’s 2023/24 Operational Planning that at least 80% of Faster Diagnosis Standard for lower gastrointestinal referrals should be accompanied by a FIT result.
Asked by: Alex Sobel (Labour (Co-op) - Leeds North West)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether his Department has plans to fund the use of the medication Avastin on the NHS for the treatment of bowel cancer when alternate medications are not suitable due to gene mutations.
Answered by Will Quince
The National Institute for Health and Care Excellence (NICE) is the independent body responsible for developing evidence-based guidance for the National Health Service on whether new medicines represent a clinically and cost-effective use of resources. NICE’s guidance is based on a thorough assessment of the available evidence and developed through extensive engagement with stakeholders. NICE was unable to recommend bevacizumab (Avastin) as an effective use of NHS resources for the treatment of metastatic colorectal cancer, and it is not routinely funded on the NHS in England.
NICE has been asked to consider updating its appraisals of bevacizumab for colorectal cancer given that there are now multiple biosimilars available, some at significantly lower cost than the price at which bevacizumab was originally assessed. However, NICE must also take into consideration wider considerations regarding the use of bevacizumab in different scenarios that have evolved since the original appraisals. NICE is exploring options and further information on any proposed changes will be made available in due course.