Last reviewed: 7 October 2024
Last reviewed: 7 October 2024
In England, the PCN GP Contract for Early Diagnosis requires PCNs to contribute to improving local uptake of National Cancer Screening Programmes by working with local system partners to agree the PCN contribution to local efforts to improve uptake in bowel cancer screening and follow up on non-responders to invitations.
This must build on any existing actions across the PCN’s Core Network Practices and include at least one specific action to engage a group with low participation locally. Visit our GP contract hub for more information.
NHS England has published guidance to support Integrated Care Boards (ICBs) and their partner NHS trusts to develop their first 5-year joint forward plans (JFPs) with system partners. The guidance requirements may be applied and relevant to improving cancer screening services. For example, ICBs are required to improve quality services and reduce inequalities - which we know exist in bowel cancer screening. Guidance also states that ICBs and partner trust may wish to seek the views of underserved groups (such as inclusion health and vulnerable populations) as part of the duty to reduce inequalities.
The 2024/25 operational planning guidance(PDF) also states that ICBs should commission key services to underpin progress on early diagnosis. This includes working with regional public health commissioners to increase colonoscopy capacity to support the extension of the NHS bowel cancer screening programme to 54-year-olds and patients with Lynch syndrome.
The Scottish Equity in Screening Strategy 2023-2026 also provides an overview of current national projects to support the reduction of screening inequalities, which may be of interest to health professionals in Scotland.
The UK National Screening Committee (NSC) has recommended that screening for bowel cancer should be offered, using the Faecal Immunochemical Test for people aged between 50 and 74, every two years, with a threshold of 20 µg Hb/g. Read our bowel cancer screening at a glance(PDF, 148 KB) resource to see the different screening thresholds that are used across the UK bowel cancer screening programmes.
FIT measures micrograms of human haemoglobin per gram of faeces. The definition of a positive or negative result can be changed by altering the numerical FIT threshold. As a general statement, the lower the threshold, the more sensitive the test will be and the more cases of cancer and adenoma that will be detected and ultimately deaths from bowel cancer averted.
The FIT screening threshold is 80 µg Hb/g in Scotland and Wales, and 120 µg Hb/g in England and Northern Ireland.
There are plans across the UK to reduce the FIT screening threshold in order to detect more bowel cancers early.
England and Wales are extending the bowel cancer screening programme to people aged 50-74 years (from people aged 60-74 years). Using a phased approach, the bowel cancer screening programmes in England and Wales are starting to invite people aged 50-59 to participate. Wales is starting to invite people aged 50 between October 2024 and July 2025.
The rate of progress implementing the extension varies regionally, and GPs can check with their local bowel cancer screening hub or centre to know which age groups are now being invited to participate.
In Northern Ireland, people aged 60-74 are invited for bowel cancer screening. Please note that people aged over 74 years in England and Scotland can request a bowel cancer screening kit.
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