Bowel Screening

The pilot and the programme since then

Research in four countries has demonstrated a reduction in death rates in groups of people screened for bowel cancer. This research led the UK government to commission a pilot programme to see whether or not it was feasible to use biennial (every two years) Faecal Occult Blood test screening as a population screening tool for bowel cancer in the UK.

In England the pilot programme started in 2000 in Coventry and north Warwickshire, and was based in Rugby. The pilot programme finished in March 2007 and showed that screening for bowel cancer using the Faecal Occult Blood test was feasible in the NHS. Screening is now offered every two years to men and women registered with a GP aged 60-74 (also see 'What is the NHS Bowel Cancer Screening Programme'). People aged 74 and over can request screening by calling the programme helpline on Freephone 0800 707 60 60.

Some of the people we interviewed about screening had taken part in the English pilot programme. 


She thought the pilot programme was part of a trial.

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She thought the pilot programme was part of a trial.

Age at interview: 62
Sex: Female
Did you enquire at all from anybody how they decide to send it [the invitation to be screened for bowel cancer] to you?

No I just thought, 'Oh you're part of a trial', and that was it, I never queried that, I never even thought about it like than.

It's going to be rolled out to everybody eventually in the whole country.

Well I think it's good, I think it's very good. I often wonder why it's for 60 to 70 age groups, is it 60 to 70 that they sent the trial out?

At the moment yes, it is at the moment.

That surprised me that it was 60 to 70 because I wouldn't have thought it had any respect on age or anything this bowel cancer.

I think it's most common with older people. 


Sir Muir Gray explains that the health professionals running the pilot programme provided an...

Sir Muir Gray explains that the health professionals running the pilot programme provided an...

Would you mind just saying a little bit about the pilot study and why you did one please?

Yes, when you're making decisions in health care you make them on the basis of evidence from research. And there is very good evidence that bowel cancer screening did more good than harm; very good controlled trial done by the Medical Research Council. But the team that did that controlled trial was led by a wonderful person called Jack Hardcastle, and Professor Hardcastle has spent 20 or 30 years of his life doing bowel cancer screening. His team were absolutely focused on it, they did nothing else. Now the problem that faced people like me and Julietta Patnick, the Director of Screening Programmes, was that we have to find a hundred times as many people as were in Jack Hardcastle's team, to cover the whole of England. And we know that those people, at least to start off with, are not going to be so skilled as Jack Hardcastle's team. So what we have to do is to find a part of the country where there is a very good team, and with that team, and we are sure they can deliver a good service that will do more good than harm, we will develop training resources, information systems, patient information, public information, so that when we roll out the programme across the whole of England, ensures that high quality is available across the whole of England. So, I can't, we called it a pilot, and a pilot remember is a ship that negotiates through the shoals of rocks to get you to harbour. It wasn't just a study, it was a pilot journey, we were guided by the pilot, and we are now absolutely clear that we can deliver a good service across the whole of England. So I'm very grateful to the people who ran the pilots, and I can assure the people who were looked after by the pilots, they were not part of a research project, they were working with one of the best services we could find to help us to develop the resources that the rest of England will need.

Sir Muir Gray, is the former Programme Director of the UK National Screening Committee.

In England the screening programme is administered by regional offices, called programme 'hubs'. The hubs send out the invitations to people to take part in screening every two years. They also send out test kits, test results, and arrange appointments with specialist screening practitioners at local screening centres for those with abnormal test results. 

The health professionals working in the local screening centres provide investigations for bowel cancer (such as colonoscopy and bowel scope screening), and any necessary follow-up investigations. If treatment is needed for bowel cancer they refer patients to a named consultant. 

There are 5 regional ‘hubs’ and over 60 screening centres.

The NHS Bowel Cancer Screening Programme started being rolled out in July 2006 and achieved nationwide coverage in 2010.

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Last reviewed May 2016.

Last updated May 2016.

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