NHS cash crisis will delay national bowel screening programme, warns expert

Editorial: Impending or pending? The national bowel cancer screening programme; BMJ Volume 332, p 742

The NHS financial crisis will delay the government's bowel cancer screening programme, which is due to begin this week, warns a senior doctor in this week's BMJ.

The government has said that, from April 2006, it will provide £37.5m to screen men and women aged 60-69 every two years. But this deadline cannot be met, argues Professor Wendy Atkin, because it will take around six months to commission the screening centres, and no funding has yet been provided.

Last week, Cancer Research UK's chief executive, Professor Alex Markham, accused the Department of Health of "unacceptable prevarication" and said he feared the delay will lead to people dying unnecessarily from bowel cancer.

The case for screening is clear, writes Professor Atkin of Cancer Research UK's Colorectal Cancer Unit at St Mark's Hospital, London. Bowel cancer is second only to lung cancer as a cause of cancer deaths in the United Kingdom. In 2004 the number of deaths from bowel cancer (16 148) exceeded the number from breast cancer (12 347) and cervical cancer (1093), diseases for which there are already effective, well run screening programmes. Five year survival rates for bowel cancer, although increasing, remain below 50%.

This programme will be an important opportunity to reverse the low ranking of our bowel cancer survival rates in comparison with the US and several European countries, she says.

There is still time to introduce the programme in 2006, she adds, but doubts about the speed of introducing the programme risks harming the professional goodwill and motivation that have driven service improvements.

"The government's short term financial difficulties should not be permitted to erode national confidence in its commitment to tackling bowel cancer death rates," she concludes.

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