Monday 27 January 2014
The Health and Social Services Department has released a report on the bowel cancer screening service. This is the first comprehensive review of the service to be made available since it was launched as a pilot in October 2011.
Deputy Mark Dorey, Health and Social Services Minister:
"This is a report prepared by HSSD staff for the Board. The Board have not formally considered the report yet but will do so in the very near future. It is therefore unusual to make the report available at this stage. But we consider it necessary given the level of current interest in the bowel cancer screening service and in view of the States Meeting this week."
The report reveals that 1,196 people have been screened for bowel cancer since October 2011. 43 cases of high-risk polyps have been identified, and 46 colonoscopies have been carried out. 3 cancers have been detected. Within the overall figures, 471 people were screened in 2013, from which 13 high-risk polyps were detected. No cancers were detected in 2013.
The report shows that the programme has delivered well in terms of the group of participants who were identified in the original plan in 2011 (a one-off screen of people at the age of 60). It also goes on to outline the process to make changes to the groups of people who will be screened in the future and for the service to move into a full service model from its current pilot-like form.
The review also considered non-clinical aspects of the service. These included support infrastructure, finances, governance and leadership. Issues were identified and reported on. The review reports comments that some of the problems to date could be attributed to its rushed implementation, which was the result of political pressure at that time.
Seven steps are proposed in the review in order to fully establish the bowel cancer screening service in the Health and Social Services Department. It is recommended to the HSSD Board that these steps be approved and that officers of the Department be directed to start the process immediately.
Deputy Mark Dorey said:
"Full credit is due to the hard work and commitment of HSSD and MSG staff in delivering this service. Work has been done in accordance with the business plan agreed by the HSSD Board in 2012 and approved by the Treasury & Resources Department.
There had been no political involvement from the current Board in the service until we had a meeting with MSG in early October 2013 when this review was commissioned. We now have all the facts and figures to help us decide on the future scope of the bowel cancer screening service.
I hope that the detailed information contained in this report allows rational discussion based on fact rather than on some of the unsubstantiated comments that have been made in recent weeks.
We know that screening people born in 1952, 1953 and 1954 was based on sound clinical evidence. In light of the detailed review that is now available it is clear that there are improvements that can be made to the service, including its financial management and leadership. But the Board also has to decide the future scope of the service. This review is the only appropriate way of starting that process and it will be a priority for the Board to consider the recommendations it makes and proposals for the future service."
Bowel cancer screening is a method of identifying people who are at risk of developing bowel cancer, or who have already developed cancer but have not yet presented with symptoms.
According to the recently-published 2013 Channel Islands Cancer Registry Report, bowel cancer is the fourth most common form of cancer in Guernsey, after skin cancer, breast cancer and prostate cancer. On average, between 2007 and 2011, 42 people a year were diagnosed with bowel cancer and 13 people a year died from the disease.
Mortality rates vary significantly depending on how advanced the cancer is when it is detected. The severity of bowel cancer is measured in 'Dukes' stages, from A (least advanced, affecting only part of the bowel wall) to C (most advanced, affecting the whole bowel wall and lymph glands). The five-year survival rates for people in different stages of bowel cancer are as follows:
- Stage A ≈ 90%
- Stage B ≈ 50% to 65%
- Stage C ≈ 15% to 25%
It follows that identifying bowel cancer early can significantly improve a person's chances of survival, as well as potentially reducing treatment costs.