Population screening for colorectal cancer

Colorectal cancer screening is taking place throughout the UK, utilizing a combination of faecal occult blood testing, and if positive, colonoscopy. Screening aims to reduce mortality through early detection of colorectal cancer in a specifically targeted age range. This article aims to give an overview of the rationale behind colorectal cancer screening, and explain how screening takes place in different parts of the UK.We discuss both the uptake of screening and patients perceptions of the screening process. The reported results to date are discussed in terms of pathological yield at colonoscopy, both of screen-detected cancers and non-neoplastic diagnoses. A clear explanation is given of the criteria to be fulfilled in order to become a colonoscopist in the screening programme.The evolving evidence demonstrates that bowel screening is leading to more colorectal cancers being detected at an earlier stage. The resultant spike in caseload for surgeons and multidisciplinary teams is quantified both in the long and short term. With increased numbers of early detected cancers, more minimally invasive surgical techniques are likely to be utilized. Developments in bowel screening are discussed particularly with regard to one-off flexible sigmoidoscopy and changes to improve the programme in the future.