Thursday, 16 December 2010

UK National Screening Committee (UK NSC) statement on flexible sigmoidoscopy

reposted from:

Flexible sigmoidoscopy  

For immediate release (29 October 2010)

Dr Anne Mackie, UK NSC Director of Programmes, said:

“We welcome the Government’s commitment to invest in new, effective screening methods.  Initial indications suggest that flexible sigmoidoscopy could be a valuable technology and it is important that we research its effectiveness in a timely way.

“Any new screening methodology needs to be rigorously investigated.  Research has been commissioned to model how screening using FS might work in practice as part of the bowel cancer screening programme.  The UK National Screening Committee will investigate these issues in full at its next meeting in November, and final recommendations to Ministers will be made in Spring 2011.”

Professor Julietta Patnick CBE, Director of the NHS Cancer Screening Programmes said:

We’re excited by the coalition’s commitment to introduce flexible sigmoidoscopy for bowel cancer screening if it is recommended by the National Screening Committee. The addition of flexible sigmoidoscopy will allow us to build on the great success of the existing bowel cancer screening programme. If recommended, we will be busy over the next few months developing the processes and QA procedures that will be needed in order to deliver this new service safely and effectively.

Notes to editors

1.  The UK National Screening Committee

The UK National Screening Committee is chaired by the Chief Medical Officer for Scotland and advises Ministers and the NHS in all four UK countries about all aspects of screening policy and supports implementation. Using research evidence, pilot programmes and economic evaluation, it assesses the evidence for programmes against a set of internationally recognised criteria. Assessing programmes in this way is intended to ensure that they do more good than harm at a reasonable cost.

2.  UK NSC research into flexi sig

At its meeting on 16 June the UK NSC received a verbal update on the FS trial and was informed that the results of the trial were very positive.  The Committee welcomed the research, but identified a number of issues that required further investigation.  This additional work will allow the UK NSC to make a full assessment of all the available evidence against its criteria, before making a final decision.

The issues requiring further investigation are: 
  • The need for further modelling to assess the impact of introducing a screening programme for bowel cancer using FS (include taking account of all available international evidence)
  • The age at which the screening would be most effective to screen (the trial participants were between 55 and 64 years)
  • The acceptability and uptake of the test in the general population (the trial population had all indicated before entering the trial that they would take up a screening invitation)
  • The clinical management of people identified as requiring long term surveillance, the size of this group, and the resources involved
  • How it would fit in with the current bowel cancer screening programme.

Modelling work to address these questions is being taken forward by the School for Health and Related Research (ScHARR) at the University of Sheffield, and is due to report in late October, ahead of the next UK NSC meeting in November. 

3. The bowel cancer screening programme

The NHS Bowel Cancer Screening Programme started rolling out in July 2006 and achieved nationwide coverage by 2010.
Programme hubs operate a national call and recall system to send out faecal occult blood (FOB) test kits, analyse samples and despatch results. Each hub is responsible for coordinating the programme in their area and works with up to 20 local screening centres.
The screening centres provide endoscopy services and specialist screening nurse clinics for people receiving an abnormal result. Screening centres are also responsible for referring those requiring treatment to their local hospital multidisciplinary team (MDT).

4. The UK NSC review process

A national screening programme is established only if certain conditions are met. These include having an accurate and acceptable screening test, being able to provide treatment and advice for people who are found to have  a particular condition, and making sure the screening programme does more good than harm to those who are screened.

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