Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what assessment he has made of the potential impact of the NHS England pilot of reducing the faecal immunochemical test threshold for the Bowel Cancer Screening Programme from 120µg/g to 80µg/g on his policies on the wider roll-out of that threshold.

NHS England is assessing the potential impact of reducing the faecal immunochemical test (FIT) threshold for the Bowel Cancer Screening Programme from 120µg/g to 80µg/g. This is an ongoing assessment which includes evaluating and learning from early adopter sites, undertaking activity modelling, and reviewing the modelling carried out by the School of Health and Related Research which was commissioned by the UK National Screening Committee. Alongside multi-disciplinary regional planning, this will support the planning for the wider roll-out of the threshold reduction.

Activity modelling shows that the wider roll-out is likely to increase demand on specialist screening practitioners and colonoscopy services by approximately 35%. The expectation is that the reduced threshold will increase polyp detection, thereby preventing bowel cancer and also diagnosing more bowel cancers earlier.

To support the early adopters and plans for reducing the threshold across all bowel cancer screening sites, there is ongoing endoscopy transformation, of symptomatic pathways, which aims to release colonoscopy capacity through a number of routes. These include:

• the use of FIT as a clinical triage tool in accordance with National Institute for Health and Care Excellence guidance;
• the use of alternative imaging modalities such as Colon Capsule Endoscopy and Computed Tomography Colonography; and
• the use of other pre diagnostic tools such as capsule sponge testing.