



(Title Image: Cleveland Clinic Health Essentials)

The Issue

Bowel cancer is one of the most common forms of the disease in both men and women and one of the biggest killers. Since 2008, all people aged 60-74 in Wales have been sent testing kits every 2 years, but only ~55% of those invited actually took park in 2017.

The disease has been brought into sharp contrast at the Senedd since Steffan Lewis AM (Plaid, South Wales East) was diagnosed with late-stage bowel cancer towards the end of 2017 – he wasn’t there yesterday as he’s still undergoing treatment. Age 33, he wouldn’t have been eligible for screening.

Sam Gould – UKIP candidate for the 2016 Assembly election in Caerphilly – died of the disease last year. He was also aged 33.

Some of the most common symptoms of bowel cancer include noticing blood after going to the toilet, sudden unexplained changes in bowel habits (i.e. changing between constipation and diarrhoea), unexplained weight loss, anaemia, abdominal pain or feeling a lump in or around your stomach.

There’s more information here, but it’s important not to self-diagnose (and panic) as it could be the result of a less serious condition – there was a scare in my own family earlier this year that turned out not to be cancer despite almost identical symptoms.

I realise it’s embarrassing and not polite to talk about toilet stuff, but if you’re concerned, see a doctor.

The Motion

The Senedd:

Welcomes Bowel Cancer UK and Beating Bowel Cancer’s recent report highlighting early diagnosis and its ambition to improve survival rates.

Recognises the contribution of bowel cancer patients and healthcare professionals in improving outcomes in the face of increasing demand.

Recognises bowel cancer as the second biggest cancer killer in Wales, the effect early diagnosis has on survival rates and the importance of encouraging the public to take up bowel screening opportunities with uptake rates falling by 1 percent in the last 12 months.

Welcomes the introduction of the simpler and more accurate faecal immunochemical test (FIT) for bowel screening.

Calls on the Welsh Government to deliver a bowel screening programme that can reach its full potential and to address issues around the proposed threshold for FIT introduction, challenges within endoscopy and pathology services to ensure FIT can be introduced and the need to reduce the eligible screening age from 60 to 50.



Key Points

Hefin David AM (Lab, Caerphilly)

For (the motion): There’s progress, but it’s not enough.

Around 2,200 people in Wales are diagnosed with bowel cancer every year, 900 people will die from the disease annually.

His grandfather died of bowel cancer when he was 10 years old, having said he hoped to live long enough to see Hefin attend university.

Deaths from bowel cancer have fallen by 13% across the UK since new treatments and screening were introduced.

Five Welsh health boards are in breach of Welsh Government waiting times – 1,800 patients are waiting more than 8 weeks for a bowel cancer diagnosis.

He’s lobbied in favour of lowering the age eligibility for screening to 50, but was told by an oncologist there were concerns that casting the net too widely and thinly won’t work without the appropriate support in place.

Mark Isherwood AM (Con, North Wales)

For: FIT is the future.

His grandmother died of bowel cancer before he was born.

Scotland sends screening kits to people in their 50s, but people are still more likely to be diagnosed following a GP referral and thorough diagnostic tests like sigmoidoscopy.

FIT is a much better home test because it only needs one sample and better detects the disease in cases where there’s no rectal bleeding.

Dr Dai Lloyd AM (Plaid, South Wales West)

For: The symptoms are common and require careful diagnosis.

If GPs referred everyone showing bowel cancer symptoms to a hospital it’s likely there wouldn’t be room for any other work.

He gave an example of coeliac disease (gluten intolerance) which has similar symptoms to bowel cancer but can be equally serious in its own right.

Caroline Jones AM (UKIP, South Wales West)

For: Expand diagnostic capacity.

Colonoscopy and endoscopy diagnostic capacity needs to be increased otherwise there’s a risk of more cancers being missed.

We need a timetable for lowering the screening age to 50 as 95% of cases are in the over-50s.

Dawn Bowden AM (Lab, Merthyr Tydfil & Rhymney)

For: “Don’t be shy; let’s talk poo”.

People living in the Valleys have a “significantly greater” chance of being diagnosed with bowel cancer than those living in Cardiff and Vale of Glamorgan.

AMs representing the Valleys will be holding events to promote public health screening on May 18th.

Taboos surrounding talking about toilet habits and bowel problems need to be smashed so people will take up screening in greater numbers.

Mandy Jones AM (Ind, North Wales)

For: Screen those with genetic predispositions.

An event on Bowel Cancer held at the Senedd in February this year was a promise made to Sam Gould.

Sam only mentioned the symptoms to a doctor in March 2017; he died that June. His GP thought he was too young to get the disease.

A simple genetic test can detect Lynch syndrome – a genetic predisposition to bowel cancer and other forms of cancer. There’s no screening for it at all in Wales; it costs £200 but the cost of treating advanced bowel cancer is £25,000.

Welsh Government Response

Health Secretary, Vaughan Gething (Lab, Cardiff S. & Penarth)

A new treatment pathway for patients displaying “vague symptoms” of cancer is currently halfway through a two-year trial.

In 2016-17, 280,000 people were screened, 1,600 required a follow-up and 216 people were diagnosed with bowel cancer; it’s a matter of choice for people to take it up, it can’t be forced.

The Welsh Government are looking at ways to introduce testing for Lynch syndrome for new bowel cancer patients.

New recommendations on improving the capacity of colonoscopy services will be discussed in June.

Vote

I doubt anyone was going to vote against a motion like that – which was carried unanimously.