Government screening programs can stop at 74 - but we don't.

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The Australian Institute of Health and Welfare reports that the highest incidence of bowel cancer is in people over the age of 80. It’s a similar story in the UK, where 43% of all new bowel cancer cases are in over-75s. 

Given those figures, why does Colorectal Screening (CRC), such as the National Bowel Screening Program, stop at 74? Surely it would make more sense to keep going. 

Population screening programs are about numbers

Screening programs are run on a population level. They’re about maximising the benefits and minimising the risks for the greatest number of people within a defined age range. 

Those benefits include the chance for early detection of bowel conditions when they’re often more treatable. 

A successful CRC screening program relies on evidence, participation and reviewing population-based results  to determine that the benefits outweigh the risks. An age limit is one of the key pieces of evidence that ensures the benefits continually outweigh the risks in any population screening program.  

So why do population screening programs stop at 74?

A decision to offer bowel screening to patients aged 50-74 isn’t arbitrary. It’s based on a careful review of the evidence regarding the condition, the test and the follow-up diagnostic procedures to determine an age range that maximises benefits and minimises risks – not for one individual patient but for the whole age group.

Bowel disease can be  slow growing. It can take years for cells to turn into polyps and for some of those polyps to eventually grow into cancer. Screening above the age of 74 may, statistically, be of less benefit simply because we’re mortal and not all polyps are cancerous. 

Then there’s the question of what happens after a positive test. In the case of bowel screening, a positive screening test is usually followed by a colonoscopy. That’s an invasive procedure usually carried out under general anaesthetic. The risk of complications from the procedure or the anaesthesia increase significantly with age and may outweigh the benefit of screening. 

Again, though, those decisions are made at a population level based on the average patient. 

And you may not be the average patient. 

What are your options if you’re an older person? 

A systematic review of studies into bowel cancer screening for over-75s concluded that screening people aged 75-85 should be done on a case-by-case basis. That means stopping population-based screening by 75 but leaving it open for health-care professionals to offer screening to older patients who may benefit or request a non-invasive bowel health check.

Why? Because, in individual cases, the benefits of early detection may still outweigh the risks. Personalised healthcare decisions like this are extremely important because you’re not a statistic. You’re not average. Your decisions should be based on your situation, not on population-level statistics.

Here at ColoVantage Home, we understand that when you turn 76 it isn’t the end, and that the benefits of completing bowel screening may still outweigh the risks associated. 

The newly released National Health and Medical Research Council “population Screening recommendations” suggest individuals aged 75-85, who have had a discussion with their health care professional could consider completing a Bowel Screening Test, such as the ColoVantage Home test. 

So, while you may no longer be eligible for the national screening program,  with ColoVantageⓇ Home, you can order your own test, take it at home and post it to us to analyse. 

Within a short time, you’ll receive your results, giving you either peace of mind or vital information you and your health care professional can act on to protect your health. Both are worth having. 

 

Disclaimer

*All information is general and is not intended to be a substitute for professional medical advice.  Always follow directions for use.

References

 

  •  Cancer Council Australia Colorectal Cancer Screening Working Party. Clinical practice guidelines for the prevention, early detection and management of colorectal cancer: Population screening. Summary of Recommendations. September 2023. Sydney: Cancer Council Australia.
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