Will the Minister explain why a colonoscopy, as a form of screening for bowel cancer, is not routinely available for patients who are over the age of 74 and at risk of the disease?
Wales, like the rest of the UK, follows the expert advice of the UK National Screening Committee (UK NSC). The UK NSC reviewed its policy on bowel cancer screening in 2018 and continues to recommend that screening should be offered to both men and women up to 74 years of age.
The upper age limit of bowel screening is based on the consideration of the risk of bowel cancer in people aged over 74 with no symptoms of the disease, and the risk to these individuals associated with carrying out screening, particularly from follow-up diagnostic procedures such as colonoscopy. Although serious complications from colonoscopy in the general population are uncommon, perforation of the bowel is one of the potential serious complications of further investigation. This occurs in around 1 in 1,500 procedures. The removal of polyps or tissue samples can cause heavy bleeding which in the general population occurs in about 1 in every 150 colonoscopies. The risk of these complications increases beyond the age of 74.
We know that the incidence of bowel cancer increases with age with 8 out of 10 people diagnosed with bowel cancer being over 60. However, the benefits gained from screening in persons aged 75 and beyond, particularly if they have been screened previously, are small compared to the risks.
The Welsh Government will continue to monitor developments in this area of public health. If new evidence emerges that asymptomatic screening beyond the age of 74 is beneficial, then changes to the upper age limit will be given the appropriate consideration.