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NSC Recommends New Screening Tests

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The UK National Screening Committee (UK NSC) has published a number of recommendations today (15 January 2015) following its meeting on 19 November 2015.

The independent expert committee made 11 recommendations in total, which included improvements to existing screening programmes for Down’s syndrome and other related conditions, cervical cancer, bowel cancer and eye screening for people with diabetes.

Important conclusions from the meeting include:

Introducing faecal immunochemical testing (FIT)

The committee recommended that the faecal immunochemical Test (FIT) should replace the current first test used in the NHS Bowel Cancer Screening Programme. Replacing the current Faecal Occult Blood (FOB) test with FIT provides the opportunity to detect and prevent more cancers and is easier to use.

Introducing non-invasive prenatal testing (NIPT)

The committee recommended that non-invasive prenatal testing (NIPT) be introduced as an additional test into the NHS Fetal Anomaly Screening Programme (FASP) as part of an evaluation. Ongoing monitoring and evaluation will mean that the test is rolled out across England in such a way that the screening programme can be altered if necessary in light of any real life findings. FASP offers screening to women in pregnancy to find out how likely it is that their baby has Down’s syndrome, Edwards’ syndrome, or Patau’s syndrome. The new test is more accurate, meaning that fewer women will need unnecessary diagnostic tests, which can potentially mean a small risk of losing their baby.

Introducing HPV primary screening

Currently the NHS Cervical Screening Programme uses cytology testing to look for abnormal cells that could be the first sign of cancer. Human papillomavirus (HPV) testing is used as a secondary measure in women needing further investigation. Evidence suggests that screening for HPV first will be a more effective way to let women know whether they are at risk of developing cervical cancer.

Changing the frequency of diabetic eye screening appointments

The committee recommended that people with diabetes, at low risk of sight loss, only need to attend eye screening tests every 2 years rather than annually, after evidence showed it was safe to do so. The screening interval for people with a high risk of sight loss should remain yearly as now.

Dr Anne Mackie, Director of Programmes for the UK NSC, said:

The latest recommendations which propose changes to existing screening programmes would bring about considerable improvements. We hope that once implemented, these changes would help identify more people who would benefit from early treatment and in some cases, save lives every year.

All recommendations made by the committee are based on internationally recognised criteria and a rigorous evidence review and consultation process.

At the same meeting, after careful consideration of the evidence, the UK NSC did not recommend introducing screening programmes for the following conditions:

congenital adrenal hyperplasia (CAH) in newborns

glaucoma

hearing loss in older adults

mucopolysaccharidosis type I (MPS I)

neuroblastoma in children

oral cancer

prostate cancer

The UK NSC will review all these recommendations again in 3 years as part of its regular evidence review process or earlier if significant new evidence becomes available.