SCREENING for bowel cancer could save 5,000 lives a year but is held up because the NHS does not have the capacity to treat the patients it would identify, the new head of Britain’s top cancer charity said yesterday.

The potential benefits are huge, saving more than twice as many lives as cervical and breast cancer screening combined, said Professor Alex Markham, who takes over as chief executive of Cancer Research UK next Monday.

“The scientific basis for bowel cancer screening is indisputable,” he said. “The NHS has a good plan, but introducing a screening programme could overwhelm current clinical capacity. If screening was successful it would increase workload dramatically and there is always a danger of raising expectations when the clinical service can’t provide.”

Bowel cancer is one of the most predictable of cancers, proceeding through four distinct stages. But only a tenth of patients are detected in the first stage, when the chances of a cure are very good.

In the second stage, there is a 65 per cent of survival, but only a fifth of cases are detected at this point. Most are found only in the third or fourth stages, when the survival has fallen to 35 and 10 per cent respectively. This makes it clear that early detection is the key, Professor Markham said. At present there are 35,000 new cases a year in Britain, and 16,000 deaths from the disease, which is the second most common cause of cancer deaths.

He said, “without hype”, that 5,000 deaths a year could be saved by screening, which would consist of faecal occult blood sampling and sigmoidoscopy, the internal examination of the lower bowel.

Speaking at Cancer Research UK’s Central London headquarters, Professor Markham said that a national screening programme needed to be carefully co-ordinated to prevent “the immediate shock-horror waiting list story” it might generate. He accepted that screening was invasive and might not appeal to everybody, but said that it was hardly more invasive than cervical screening for women.

He was much less enthusiastic about prostate cancer screening, despite the availability of a simple blood test that would cost no more than about £30 per patient. The problem is that nobody yet knows what to do with a positive result, he said. To try to clarify the position, the charity has promised £1 million to extend an existing trial that compares active monitoring, radiotherapy, or surgery in patients who have prostate cancer.

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