Staff shortages halt advances that could halve cancer deaths

Britain could halve the number of deaths from bowel cancer by adopting the simple expedient of screening but the health service lacks the capacity to cope, the head of Britain's biggest cancer charity said yesterday.

The scientific case for bowel cancer screening had been proved beyond dispute but more specialist doctors, nurses and new facilities were needed before a national programme could be launched, Professor Alex Markham, the newly appointed chief executive of Cancer Research UK, said. Giving his first press conference before taking up his post next Monday, Professor Markham predicted that the number of people who survived cancer and regained their health would grow to 1.5 million by the end of the decade, a 50 per cent increase, partly because of improvements in screening.

Breast cancer screening is to be extended to include women aged up to 70. Experts believe that this could save an extra 600 lives a year. The introduction of a new liquid-based cytology test for cervical cancer screening would improve detection and cut deaths. A trial is also under way to assess the benefits of prostate cancer screening, which are still uncertain. But the greatest gains are likely to be made in screening for bowel cancer, which is the biggest cause of cancer deaths after lung cancer, with 35,000 cases and 16,000 deaths a year. Professor Markham said scientists from Cancer Research UK had played a leading role in providing the Government with evidence on the effectiveness of bowel cancer screening.

He said: "We think the scientific basis of colorectal screening is indisputable now. However, there is a problem of raising expectations when the clinical services are not able to deliver."

He added: "There is a possibility that a screening programme could very quickly overwhelm current NHS capacity. We don't want to have immediate shock-horror wait-ing list stories. We hope to try to stimulate a positive dialogue with the Government to ensure we get screening in but we don't want it to have unfortunate consequences."

Bowel cancer has a 95 per cent cure rate if caught early, but in more than two thirds of patients it is not detected until it is advanced, when cure rates are as low as 10 per cent. Screening, either by flexible sigmoidoscopy, involving an internal examination of the bowel with a camera on a probe, or by testing for traces of blood in the faeces, could prevent 5,000 cases of the disease a year.

That was the minimum benefit to be expected, Professor Markham said, adding: "We are in a position to halve the death rate over a decade - if the clinical services are provided."

The cost of a national screening programme would be about £50m, to which would be added the cost of treating those identified by the programme. Patients with pre-cancerous polyps - growths from the bowel wall - detected in screening would have them removed, protecting them from the risk of cancer developing.

Professor Markham was speaking as Cancer Research UK published its first audited accounts, which showed that a £26m increase in income was cancelled out by a £26m in its reserves, chiefly because of stock market losses.

Professor Mike Richards, the Government's cancer czar, said screening would be extended where there was clear evidence it would save lives. "Work is under way towards the introduction of a national bowel screening programme," he said.