Overview of UK bowel cancer screening programmes

Eligibility

There are separate bowel screening programmes for each UK nation, which invite the following eligible people to take part in bowel cancer screening by letter every two years:

• England: people aged 50 to 74 years who are registered with a GP.

• Scotland: people aged 50 to 74 years with a CHI (Community Health Index) number.

• Wales: people aged 50 to 74 years who are registered with a GP.

• Northern Ireland: people aged 60 to 74 years who are registered with a GP.

Our bowel cancer screening at a glance guide(PDF, 155 KB) summarises the eligibility criteria and uptake rates of the bowel cancer screening programmes across the UK nations.

Uptake in the UK

Over the past five years, bowel cancer screening uptake has steadily increased across the UK, driven in part by the move to FIT. Uptake rates in 2022 to 2024 ranged between 66% and 71% across the UK nations ¹

²³⁴. To explore bowel cancer screening uptake data by your constituency, visit our local statistics data hub.  For practices in England, you can explore how screening coverage in your ICB or practice compares to predicted levels based on the socio-demographic profile in your area with our local bowel screening tool. 

There are significant inequalities in bowel cancer screening uptake, with variation between UK regions and different demographic groups. Learn more about who’s less likely to take part, the barriers they face, and how these could be addressed on our Supporting access and addressing inequalities page.   

Promoting informed choice

Bowel cancer screening has harms as well as benefits, which is why it is also important to assist people to make an informed decision about whether to take part. Some harms people should be aware of include false positives and negatives, over-reassurance following a normal result, and the risks associated with follow-up investigations – usually a colonoscopy. Our public-facing information on bowel cancer screening includes further guidance on the benefits and harms, to support people with making an informed choice.

The Faecal Immunochemical Test (FIT)

FIT detects and quantifies human haemoglobin (Hb) in stool samples using specific antibodies. The use of specific antibodies reduces false positives that may result from the presence of blood from other sources e.g. ingested through diet. A positive result may indicate gastrointestinal bleeding and typically leads to further investigation, usually via colonoscopy.

Using FIT to manage symptomatic patients 

The FIT is also used to assess the risk of bowel cancer in people with lower gastrointestinal symptoms. The use of the FIT in people with symptoms uses a much lower threshold for a positive result than in the screening programmes. People with symptoms should be tested using a symptomatic FIT regardless of their participation in bowel cancer screening programmes and any results they may have received. See our webpages on the differences between FIT in screening and symptomatic use for more information on how the thresholds and pathways vary for each UK nation.

Safety netting advice

Primary care health professionals will be notified as to whether a person has participated in the bowel cancer screening programme, and if so, whether they had a positive or negative result. Even in patients with a negative screening result, it is important to remain alert to the possibility of bowel cancer. It’s also important to remind people to be aware of key signs and symptoms of bowel cancer, and encourage them to seek medical advice if they notice anything new or unusual, even if they’ve recently taken part in bowel cancer screening and had a negative result. For further information, see our safety netting webpage.

Bowel cancer surveillance for high-risk groups

Bowel cancer surveillance programmes operate separately from the national screening programme, focusing on monitoring individuals at higher risk to support early detection and timely intervention. The British Society of Gastroenterology outlines guidance for the management of hereditary colorectal cancer, which includes:

• People with Lynch syndrome*

• People with polyposis syndromes (conditions where there are more than 10 polyps in the large bowel)

• People with a family history of cancer (see the guidance for further details)

• People with a diagnosis of bowel cancer under the age of 50

There’s also guidance on managing other people who may be eligible for surveillance, including those with Inflammatory Bowel Disease and post-polypectomy or post-colorectal cancer resection. *In England, the NHS Bowel Cancer Screening Programme (BCSP) will invite people with Lynch syndrome to a specialist screening practitioner consultation, followed by a surveillance colonoscopy every two years. If a patient has Lynch syndrome and is not currently invite for surveillance, they should be referred to their clinical genetics team. In Wales, Scotland and Northern Ireland, people diagnosed with Lynch syndrome should be invited for surveillance colonoscopies once every two years by genetic services or secondary care. We encourage primary care professionals to familiarise themselves with surveillance guidelines and eligibility, to support patient awareness and understanding. Our screening for people at high risk of bowel cancer webpage provides more information for patients.

Read more

• Bowel cancer screening home 

• Addressing inequalities in uptake 

• Quality improvements and future optimisation