Bowel cancer is no longer a condition that only affects older people.
The Marie Keating Foundation’s #NoRegrets campaign, launched as part of Bowel Cancer Awareness Month, has played a key role in advocating for earlier bowel cancer screening in Ireland. In collaboration with patient advocacy group Bowel Cancer Ireland, the Foundation has consistently called on the Government to lower the national bowel screening age from 59 to 50, based on the alarming rise in early-onset bowel cancer.
The Foundation outlined that:
•1 in 5 people diagnosed with bowel cancer in Ireland is under 60
•1 in 10 is under 50
•Incidence of bowel cancer in those under 50 has nearly doubled over the past 25 years

Public consultation The Health Information and Quality Authority (HIQA) is holding a public consultation to give people an opportunity to provide feedback on the health technology assessment (HTA) of extending BowelScreen to those aged 50 to 54.
HIQA will then carefully assess all feedback received and, where appropriate, incorporate it into the report. The final HTA and a statement of outcomes report (a summary of the consultation responses) will be published on HIQA’s website once the HTA has been completed.
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 closing date for the public consultation is 5pm on Friday, 15 August 2025.

Background:
The draft HTA outlines the trends outlined above:
•CRC incidence is increasing in people under 55, making early screening critical.
•Among those aged 50 to 54, approximately 140 cases of CRC are diagnosed each year.
•67% of which are detected at advanced stages (Stage III or IV).
•CRC cases are projected to double by 2045, driven by population growth and ageing (Chapters 3, 5, 10).

These statistics show a clear and growing need to intervene earlier and screening from age 50 is a necessary public health response.

Clinical Benefits: Early Detection Saves Lives

The draft HTA shows:
•5-year survival is 97% for Stage I, compared to just 14% at Stage IV.
•Screen-detected cancers are diagnosed earlier, significantly improving survival outcomes.
•Repeated FIT screening improves effectiveness over time.
•Screening also reduces CRC incidence by identifying and removing pre-cancerous lesions (Section 5, 9, 10).

This is not just a matter of cost—it is about saving lives.

Alignment with International Best Practice
The draft HTA outlines that:
•Most international guidelines recommend screening from age 50.
•The European Council recommends FIT-based screening from ages 50–74. (Section, 2, 4, 10)

Ireland risks lagging behind in the early detection of early onset bowel cancer unless it aligns with these international standards.

Economic and Organisational Viability

The draft HTA makes clear:
•Screening from age 50 – 74 is likely cost-effective compared to screening 55 -74, based on a willingness-to-pay threshold of €20,000 per QALY gained.
•Over 10 years, implementation would cost between €45–€66 million.
•Earlier diagnosis reduces high-cost, late-stage treatment and improves population health. (Section 5, 6, 10)

Additionally:
•Long-term cost savings are achieved through reduced symptomatic presentations and fewer advanced cases.
•Incremental rollout such as one-yearly or two-yearly expansions would help manage initial resource requirements effectively. (Section 7, 8, 10)

Public Demand and Patient Perspective
At the Marie Keating Foundation, we witness every day the devastating consequences of delayed cancer diagnoses on individuals and their families.
Behind every statistic are real people—real lives, real families, real futures.

The rise is early onset CRC is something the MKF has seen mirrored within its Positive Living support group for those living with stage 4 or metastatic cancers. We have seen a significant increase in the number of participants under 50 with a late-stage CRC diagnosis. Since Covid, the Foundation has supported a number of members with metastatic CRC, all under the age of 50, of which sadly five have died in the past two years. There is strong public demand for earlier access to screening—and the medical evidence firmly backs this call. Alongside fellow cancer charities, advocacy organisations, healthcare professionals and patients, we have consistently urged that screening should begin at age 50.

The benefits to both patients and the wider population are clear. Every year of inaction leaves more people at risk of preventable, late-stage bowel cancer. Delaying this change is no longer acceptable.

Recommendations and Request for Action
We strongly urge HIQA to recommend to the Minister for Health and the National Screening Service that:
•BowelScreen be expanded to include 50–54-year-olds without delay
•A phased rollout begin, with a timeline clearly communicated
•Additional capacity-building investment be prioritised to support expansion
•Public awareness campaigns are aligned with rollout to maximise uptake and equity

The epidemiological data, clinical benefits, international standards and cost-effectiveness evidence are clear and compelling. Every year of delay risks more preventable deaths.

1. For Use by Other Groups
   We encourage fellow advocacy organisations, patients and concerned individuals to:
   •Submit feedback before 15 August 2025 HERE
   •Reference findings from the HTA as outlined above to strengthen submissions

Together, we can make a real difference in protecting people at risk of bowel cancer in Ireland.