Draft health technology assessment of extending BowelScreen to those aged 50 to 54 years

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Bowel cancer (colorectal cancer) refers to cancer that occurs in the lower part of the bowel, that is, the colon and rectum. Bowel cancer is the second most common cancer (excluding non-melanoma skin cancer) in males and the third most common cancer in females, with an average of approximately 2,750 new cases a year. Bowel cancer is the third leading cause of cancer death, accounting for an average of around 1,000 deaths a 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. Bowel cancer typically develops slowly and there may not be any symptoms in the early stages. 

BowelScreen, the National Bowel Screening Programme, commenced in October 2012 with the aim of offering free colorectal cancer screening to people aged 55 to 74 years on a two-yearly cycle. As of April 2025, BowelScreen invites people aged 59 to 70 for screening, and further expansion has been committed to as per the original aim of BowelScreen. Screening involves the use of a faecal immunochemical test (FIT) to detect hidden blood in stool, which is a potential sign of bowel cancer. Participants who receive a positive FIT result are referred for colonoscopy. Depending on the results of the colonoscopy, individuals may return to routine screening, enter a surveillance pathway, or, if cancer is detected, may be referred for treatment. 

Following a request from the National Screening Advisory Committee (NSAC), HIQA undertook a health technology assessment (HTA) of extending the BowelScreen programme to people aged 50 to 54 years. The HTA assessed the clinical effectiveness, safety, cost effectiveness, budget impact, ethical aspects, and organisational considerations associated with extending the BowelScreen programme to people aged 50 to 54 years. A draft report describing the results of this assessment has been published for public consultation.

The aim of this consultation is to obtain feedback from stakeholders with a broad range of experience who could potentially be affected by the expansion of the BowelScreen programme to include those aged 50 to 54. Input from diverse stakeholder groups is essential to ensure that the information provided to support decision-making by the NSAC is comprehensive, balanced and evidence-based.

Interested parties are asked to review the draft report and submit any comments or additional information that may be relevant to the assessment and to decision-making regarding the expansion of BowelScreen to those aged 50 to 54. The consultation period will be open until 15 August 2025. The easiest way to give your feedback is to complete the online consultation form here.

Alternatively, you can fill out a PDF version of the consultation form available below, and e-mail the completed form to consultation@hiqa.ie, or send by post to:

Health Information and Quality Authority,
Public consultation on HTA of extending BowelScreen 
George's Court,
George's Lane,
Smithfield,
Dublin 7,
D07 E98Y.

Following the consultation, the report will be updated based on the feedback received. The final report will then be provided as advice to the NSAC to inform its recommendation to the Minister for Health regarding whether or not the BowelScreen programme should be extended to include those aged 50 to 54. 

The final HTA report and the Statement of Outcomes (a summary of the feedback received and HIQA’s responses to it) will be published on our website.

More details can be found in the following press release.

Online feedback form
Read the protocol here