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Northern Ireland to introduce HPV for boys and new bowel cancer screening test

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Two measures designed to reduce the incidence of cancer have been announced today by the Department of Health in Northern Ireland.

Boys aged 12-13 in Northern Ireland are to be offered a vaccine to protect them against human papillomavirus (HPV) related cancers.

“This is an effective vaccine against a particularly harmful virus”

Michael McBride

In addition, the faecal immunochemical test (FIT) will replace the faecal occult blood (FOB) test as the primary screening method in the Bowel Cancer Screening Programme in Northern Ireland.

From September this year, the department said the HPV vaccine would be offered to all boys in year nine at school. An HPV vaccination programme for girls was introduced across the UK in 2008.

Extending the programme to adolescent boys is based on advice from the Joint Committee of Vaccination and Immunisation, the expert panel that advises the four UK health departments.

The governments in England and Scotland announced a similar extension of the HPV vaccine to boys in July last year, followed by ministers in Wales in August.

The HPV vaccine currently used in the UK offers protection from four HPV types including those that are responsible for about 70% of cervical cancers

Uptake for the girls’ HPV immunisation programme in Northern Ireland has achieved high levels over the last 10 years – with almost 90% of girls completing the full course of doses.

At present two doses of the vaccine, given six months apart, are required to achieve adequate protection against the main types of HPV.

The annual costs of the introduction of HPV vaccination for boys in Northern Ireland is estimated at just under £750,000.

“Both decisions have been under active consideration for some time and can now be made”

Richard Pengelly

Commenting on the announcement, Northern Ireland’s chief medical officer Dr Michael McBride said: “This is an effective vaccine against a particularly harmful virus.

“We can now look forward to a future where we can be even more confident that we will reduce cervical cancer and other HPV related cancers that affect both men and women,” he added.

Meanwhile, the new FIT bowel screening test will be introduced to the Bowel Cancer Screening Programme from early 2020.

The department said evidence had shown there was increased patient acceptability of the FIT screening test and increased uptake of screening would “mean even more lives can be saved”.

It noted that every year in Northern Ireland there were around 1,100 new cases of bowel cancer, with over 400 deaths.

FIT is sensitive to a much lower concentrations of blood than FOB and can, therefore, detect cancers much more reliably and at an earlier stage, and also more pre-cancer lesions.

The new test requires a single faecal sample, whereas FOB requires three, and is more acceptable to those invited to screening, highlighted the department.

It added that pilot studies of FIT testing carried out in England and Scotland reported markedly increased uptake rates in both pilots, and across all deprivation quintiles.

Currently, uptake in Northern Ireland is lower in more deprived groups and, therefore, the more deprived groups could gain the greatest benefit from the introduction of FIT.

The FIT was introduced in Scotland in 2017, in England during last year and in Wales from the start of this year.

Replacing FOB testing with FIT in Northern Ireland will require an additional investment of £300,000 in 2019-20, increasing to just over £1m per annum from 2020-21, said the department.

Richard Pengelly, permanent secretary at Northern Ireland’s Department of Health, said: “I am very pleased to be able to announce both these decisions today.

“The evidence is clear in both cases that very significant health protection benefits can be achieved for our citizens,” he said.

“Both decisions have been under active consideration for some time and can now be made, following confirmation of the department’s budget allocation for this year,” he added.

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