North Wales Assembly Member Mark Isherwood has today called for improvements to bowel cancer screening and GP Referral in Wales.
Speaking in the Member Debate on ‘Bowel Cancer’ in the Chamber this afternoon, Mr Isherwood urged the Welsh Government to optimise bowel cancer screening by using the Faecal Immunochemical Test at the optimal sensitivity threshold, expanding the age range and increasing uptake, and referred to the case of a Wrexham woman who was only diagnosed with bowel cancer after repeated trips to her GP.
Mr Isherwood said:
“This disease is preventable, treatable and even curable. Nine in ten people will survive bowel cancer if diagnosed at the earliest stage.
“Screening is the most effective method of detecting bowel cancer early and plays a key role in improving survival rates.
“Across the UK, bowel cancer screening programmes send everyone aged between 60 – 74 a home test kit, every two years. In Scotland, these are also sent to people in their 50s. Referral by GP is still the route by which most people are diagnosed.
“However, as the symptoms of bowel cancer can be hard to diagnose accurately – and can also be symptoms of other less serious and more common bowel conditions - it can be difficult for GPs to know who to refer and when.
“This can result in delays to patients being able to access diagnostic services and, in some cases, patients having to see their GP more than five times before referral.”
Mr Isherwood referred to the case of Jackie Hill from Wrexham who was diagnosed with bowel cancer after repeated trips to see her GP (See notes below).
He added:
“NICE guidelines for suspected cancer, updated in July 2017, are in place to assist GPs to make these decisions.
“These recommend that the Faecal Immunochemical Test – or FIT - is adopted in primary care to guide referral for suspected bowel cancer in people without rectal bleeding who have unexplained symptoms, but do not meet the criteria for a suspected cancer pathway referral.
“Using FIT in this way could help GPs to better identify, refer the right patients quickly and detect bowel cancer early.
“We need to see this adopted in Wales before 2019, alongside England and Scotland, where it has already been piloted and used in some areas.
“The Annual Cancer report recognises that a poor interface between primary and secondary care is a major cause of delays for cancer patients.
“In response to this, the Welsh Government included recognition and early referral of cancer as part of the Wales GP contract for 2017/18.
“This requires primary care teams to develop strategies to improve recognition and early diagnosis.
“These interventions should support earlier diagnosis of people with cancer who present in primary care and may also potentially lead to a reduction in demand for colonoscopy services.
“Wales must therefore optimise bowel cancer screening by using FIT at the optimal sensitivity threshold, expanding the age range and increasing uptake.”
ENDS
Notes:
*Referring to the case of Jackie Hill from Wrexham who was diagnosed with bowel cancer after repeated trips to see her GP, Mr Isherwood said:
“She said: “my GP examined me but could not detect a lump. I was given laxative and told to go back in the New Year. I went back and told my GP that I was bleeding even more and felt very tired. My blood test came back normal.
“I went back again three months later as the bleeding was very heavy, but I was told there was nothing wrong. Eight months after my first visit, I returned and was referred for the camera to allay my fears, but never once was cancer considered as the blood tests had come back normal and I was told I was too young for cancer.
“At one time my GP even said to me: “And what do you want on this urgent appointment?” I was finally diagnosed with stage 2 cancer.
“I thought, very naively, when I was diagnosed that I would have the tumour removed and then back to normal. Because of the consequences of my treatment, I am constantly worried about going out of the house and many times when I am ready to leave the house I have to go to the toilet. My first thought when I go anywhere is where the toilets are and will they be clean”.