The Government needs to resolve a number of issues to ensure the health service can cope with a national bowel screening programme, a leading Cancer Research UK scientist will tell conference delegates today (Tuesday).
Speaking at the charity's second Senior Researchers' Meeting in Harrogate, Yorkshire, Dr Wendy Atkin will say that a national programme to detect the disease is feasible and can save lives.
But she believes there is an urgent need to address the training and resource requirements of the NHS so the service is not over-stretched and patients do not suffer from delays in diagnosis.
Cancer Research UK scientists have played a leading role in providing the Government with evidence on the effectiveness of bowel cancer screening. A nationwide screening programme is likely to be introduced within the next five years, following evidence on which screening technique will be the best to use.
The two screening options under consideration are the faecal occult blood test (FOBT) followed by colonoscopy and flexible sigmoidoscopy (FS).
Dr Atkin is running the Flexi-Scope trial, funded by the Medical Research Council, NHS R & D and Cancer Research UK, to examine the effectiveness of flexible sigmoidoscopy in detecting early bowel cancer.
Unless there is a drive towards training staff to perform the extra investigations, however, she believes the health service will be over-burdened by a programme that involves either screening method.
She says: "Over the past 15 years dramatic reductions in incidence rates of bowel cancer in the US have been attributed to screening. During this same period in the UK incidence rates have remained unchanged in women and have even increased in men.
"There is now no doubt that screening for bowel cancer can save lives but the Government will have to ensure the NHS is ready for its implementation. Both FS and FOBT will put pressure on an already over-stretched colonoscopy service so it is essential to address this issue now."
"Nurses and non-specialist medical endoscopists as well as gastroenterologists can perform flexible sigmoidoscopy but they are currently in short supply," she adds.
Dr Atkin will say that targets for training should build up an endoscopy capacity for all patients invited for screening and those that present with symptoms to their doctor and are referred for screening.
She believes that as well as training new endoscopists, established endoscopists should be provided with additional training, to meet the rigorous standards required of a screening programme.
In a recent study, a team led by Dr Atkin looked at the performance of endoscopists on the Flexi-Scope trial to see if satisfactory adenoma detection rates were being achieved in all trial centres. Adenomas are precancerous growths.