Age drop for bowel cancer screening endorsed

Bowel cancer screening should begin from the age of 45 for people at average risk of contracting the disease, according to clinical practice guidelines recently endorsed by the National Health and Medical Research Council (NHMRC).
 
The change is one that Bowel Cancer Australia has long campaigned for but needs to be accepted by the Federal Government before it comes into force.
 
Australians can currently participate in the National Bowel Cancer Screening Program from the age of 50.
 
Under the program, eligible Australians aged 50–74 are sent a free immunochemical faecal occult blood test every two years.
 
If the age for screening does come down, it will bring Australia into line with the United States. In 2021, the American College of Gastroenterology updated its clinical guidelines to recommend that screening start at age 45 for people of average risk, following a similar move by the American Cancer Society.
 
Associate Professor Joel Rhee, Chair of RACGP Specific Interests Cancer and Palliative Care, welcomed the change in the Australian clinical guidelines.

‘This is a positive step and will help strengthen the National Bowel Cancer Screening Program if implemented by the Government,’ he told newsGP.

According to Bowel Cancer Australia, there are around 1716 people diagnosed with bowel cancer under the age of 50 in Australia each year.
 
People aged 40–49 make up 56% of new cases for those aged under 50 as well as 64% of deaths in that age band, the organisation states.
 
Recent research has indicated the rate of bowel cancer is increasing among younger people.
 
However, while clinical guidelines cite modelling that suggests that screening from the age of 40 ‘may be cost-effective’, they say it is not recommended for population screening due to a ‘less favourable benefits-to-burden balance’ compared to screening for those aged 45–74 years.
 
According to the guidelines, people aged 40–44 (previously 45–49) should be able to request screening via their healthcare professional ahead of participating in the screening program.
 
The Department of Health and Aged Care states that bowel cancer can be treated successfully in more than 90% of cases if detected early.
 
The most recent report on the National Bowel Cancer Screening Program indicated that 2.49 million of 6.1 million eligible Australians aged 50–74 (40.9%) took part in the program in 2020–21.
 
Australian Institute of Health and Welfare figures indicate that participation was lowest in very remote areas (25%) and highest in inner-regional areas (43%).
 
GPs can also now bulk order bowel cancer screening kits, a move previously advocated by the RACGP, allowing them to be handed directly to eligible patients during a consultation.
 
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