§ Mr. Lansley
To ask the Secretary of State for Health (1) what steps he will take to tackle increases in workload for NHS staff working in(a) pathology, (b) radiology, (c) oncology and (d) surgery arising from the bowel cancer screening programme; 
(2) what plans his Department has to introduce a targeted and tailored national recruitment programme to increase participation in social groups in whom colonoscopy uptake is particularly low; 
(3) what estimate he has made of the cost to the NHS of introducing the national bowel cancer screening programme; 
(4) what type of diagnostic test will be used in the national bowel cancer screening programme; and if he will make a statement; 
(5) when the national bowel cancer screening programme will become fully operational; and if he will make a statement; 
(6) what plans he has to change the (a) lower and (b) upper age limit for bowel cancer screening. 
§ Miss Melanie Johnson
The methodology for a national bowel cancer screening programme is not clear cut. Following the publication of the results of a pilot using faecal occult blood (FOB) testing in May 2003, and early signs of the potential of flexible sigmoidoscopy, the Government re-affirmed their commitment to introducing bowel screening and to improving symptomatic services. The Department is addressing these difficult issues with the assistance of key stakeholders from the voluntary sector, patient and professional groups, and the national health service through the NHS bowel cancer programme and the bowel cancer advisory group.
The first phase of the pilot study of FOB testing showed that the performance of the original research can be replicated in a routine NHS setting. We have commissioned a second phase of the pilot at a cost of £1 million per annum to enable us to monitor the acceptability and effectiveness of repeat screening and to try and investigate service improvements, including 1179W encouraging hard to reach social groups to accept their screening invitations. We are also considering a potential pilot of screening using flexible sigmoidoscopy.
NHS cancer screening programmes have commissioned a formal options appraisal of bowel cancer screening from the School of Health and Related Research in Sheffield. The options appraisal is due to report in the autumn, and will consider all the issues associated with bowel cancer screening, including the age range at which men and women will be invited for screening.
In addition, as part of the NHS bowel cancer programme, we are investing in the expansion, training and modernisation of the bowel cancer workforce, streamlining services for patients with bowel cancer symptoms, and considering communications issues for the general public and health professionals.
In order to gather evidence on screening methodology and to ensure symptomatic services are expanded and modernised to take on the extra work required, it is unlikely that a national screening programme will start before 2006–07. It is currently estimated that a national bowel cancer screening programme will cost around £80 million a year to run.