The National Bowel Cancer Screening Programme: changes and challenges

Abstract

The UK's National Bowel Cancer Screening Programme is approaching its 20th year. The programme aims to improve patient outcomes by identifying bowel cancer at an early stage, and prevent cancer by finding and treating pre-cancerous lesions. There is a tension between the programme's goal—to offer screening to increasing numbers of patients—and the limited endoscopy capacity in a world of finite resources. In the UK, there is an inequity in screening depending on where patients live, which the programme is in the process of addressing. Services in Scotland are currently offered at a younger age, and at a lower threshold (in terms of faecal immunochemical testing) than those offered in England, Wales and Northern Ireland. This article explores difficulties encountered in aiming to achieve optimum screening services and looks at recent developments that seek to increase engagement between eligible participants and the programme.