The Health Information and Quality Authority (HIQA) has launched a public consultation on its draft health technology assessment (HTA) of extending BowelScreen to those aged 50 to 54 years. 

HIQA was asked by the National Screening Advisory Committee (NSAC) to undertake this assessment. The assessment will provide evidence-based advice to NSAC to support a recommendation on whether or not to extend BowelScreen to those aged 50 to 54.

Bowel cancer (colorectal cancer), refers to cancer that occurs in the colon and rectum. Bowel cancer is the second most common cancer (excluding non-melanoma skin cancer) in men and the third most common cancer in women. In Ireland, bowel cancer is the third leading cause of cancer death. 

Screening involves the use of a faecal immunochemical test (FIT) to detect hidden blood in the stool, which may indicate bowel cancer. People who receive a positive FIT result are referred for colonoscopy. Depending on the results of the colonoscopy, they either return to routine screening, enter a surveillance pathway, or, may be referred for treatment. 

This HTA assesses the clinical effectiveness, safety, cost effectiveness, budget impact, and organisational and ethical considerations associated with extending the BowelScreen programme to those aged 50 to 54. 

Dr Máirín Ryan, HIQA's Deputy CEO and Director of Health Technology Assessment said: “Bowel cancer screening can detect cancer at earlier stages, when there are no symptoms. Cancer found at earlier stages is easier to treat, which can improve outcomes for patients. Bowel cancer is more common in older age groups but screening from the age of 50 is likely to be effective in terms of reducing deaths from colorectal cancer. The risk of harms from screening also appears to be lower in younger age groups. 

Dr Ryan continued: “A commitment is in place to expand screening to people aged 55 to 74. However, the services required for screening are under pressure to meet existing demands. Significant investment and planning would be required to ensure the necessary resources are in place to support a potential future extension of the BowelScreen programme.”

The draft findings of this HTA have now been published and HIQA is seeking feedback from the public on the draft report. A consultation form, which can be completed online or downloaded and filled out, is available at www.hiqa.ie. The deadline for submissions is 5 pm on 15 August 2025.

Following the public consultation, the report will be finalised and submitted as advice to NSAC to inform its recommendation to the Minister for Health. 
Ends.

For further information please contact:
Marty Whelan, Head of Communications and Stakeholder Engagement 085 805 5202 / mwhelan@hiqa.ie

Notes to the editor:

• The Health Information and Quality Authority (HIQA) has today published the following document:
  • Draft health technology assessment of extending BowelScreen to those aged 50 to 54 years.
• The National Screening Advisory Committee (NSAC) was established in 2019 as an independent advisory committee to advise the Minister for Health and Department of Health on all new proposals for population-based screening programmes and revisions to existing programmes. Further information on the NSAC is available here.
• HIQA has been requested by the Department of Health to provide evidence synthesis support and evidence-based advice to the NSAC under an agreed work programme.
• Bowel cancer typically develops slowly. Symptoms are often subtle or absent at the earlier stages of cancer development.
• On average, around 2,750 new bowel cancer cases are diagnosed in Ireland each year. There are around 1,000 bowel cancer-related deaths in Ireland each year.
• Risk factors for bowel cancer include increasing age, male sex, a family or personal history of bowel cancer, personal history of inflammatory bowel disease, sedentary lifestyle, obesity, a diet high in red and processed meats, smoking, and alcohol consumption.
• BowelScreen, the National Bowel Screening Programme, commenced in October 2012 aiming to offer screening to people aged 55 to 74 years on a two-yearly cycle. As of July 2025, BowelScreen invites people aged 59 to 70 for screening, with plans to expand this to the original aim of 55 to 74.
• The faecal immunochemical test (a home test kit) is used as an initial screening test and is typically followed up by a colonoscopy for individuals receiving a positive result.  
• Screening serves to identify people in an apparently healthy population who have asymptomatic disease. Bowel screening is done with the aim of identifying cancer at an early stage, when treatment is most successful.
• Screening for bowel cancer can also help to identify and remove pre-cancerous polyps. Removal of such polyps can prevent the development of cancer altogether.
• Screening may lead to overdiagnosis - the detection of a disease or condition that would never have produced symptoms or problems if undiagnosed. The possible effects of overdiagnosis are important, and include potential psychological impacts, potential treatment-related adverse events, and unnecessary use of resources.