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Current UK NSC recommendations > Bowel Cancer

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The UK NSC recommendation on Bowel Cancer screening in adults

Recommendation	Systematic population screening programme recommended
Last review completed	January 2016
Next review due in	2018/19

Key downloads	Recommendation statement Last external review - FIT Economic Evaluation 2015 Last external review - FIT pilot evaluation 2015 Last external review - FIT review summary 2015 Last evidence review summary

The UK NSC recommends a change to the test used in the Bowel Cancer Screening Programmes. The use of Faecal Immunochemical Test as the primary test for bowel cancer should replace guaiac Faecal Occult Blood Test. As colonoscopy capacity grows or screening uptake increases, the UK NSC and programmes should review and recommend alteration of the cut offs to increase the number of cancers detected. Evidence to support continuation or cessation of existing screening programmes should be reviewed regularly. The process for this is currently being revised, which is why this topic does not currently have a review date. The new process will be published in due course. Each programme has an active portfolio of research, evidence and audit to support continual improvement. Find out more about bowel cancer screening in England. The UK NSC recommends a change to the test used in the Bowel Cancer Screening Programmes. The use of Faecal Immunochemical Test as the primary test for bowel cancer should replace guaiac Faecal Occult Blood Test.

Find general information about population health screening.

Why is screening recommended by UK NSC?

FIT is easier to use and can be measured more reliably using a machine rather than the human eye
FIT is sensitive to much smaller amount of blood than gFOBt and therefore can detect cancers more reliably and at an earlier stage
the increased sensitivity enables FIT to detect more pre-cancer lesions (advanced adenomas)
FIT requires a single faecal sample and is more acceptable to invited subjects which markedly increases participation rates
FIT is a cost effective alternative to gFOBt

More about Bowel Cancer

Colorectal cancer – commonly known as colon cancer, or bowel cancer – is any cancer that affects the last section of the digestive system. This usually means the colon (large bowel) or rectum (back passage).

Screening in the UK

Compare how screening is offered across the UK.

Stakeholders

• The Assocation of Coloproctology of Great Britain and Ireland
• Beating Bowel Cancer
• Bowel Cancer UK
• Bowel Cancer Wales
• The British Association for Cancer Research
• British Association of Surgical Oncology
• The British Association of Urological Surgeons
• British Society of Gastroenterology
• Cancer Research UK
• Faculty of Public Health
• Lynn's Bowel Cancer Campaign
• Macmillan
• Medical Research Council
• Royal College of General Practitioners
• Royal College of Pathologists
• Royal College of Physicians
• Royal College of Physicians and Surgeons of Glasgow
• Royal College of Physicians of Edinburgh
• Royal College of Surgeons
• Society and College of Radiographers
• Urostomy Association

The stakeholder groups will be involved when the recommendation is next reviewed. If you think your organisation should be added, please contact us. More information for stakeholders can be found in appendix C of the UK NSC evidence review process.

Recommendation Review History

Bowel cancer screening by Faecal Occult Blood (FOB) testing for men and women aged 50 to 74 was recommended by the UK NSC in July 2003 (the meeting minutes are available and the report on the evaluation of the UK colorectal cancer screening pilot can be downloaded below).

In 2011, the UK NSC agreed that screening for bowel cancer using flexible sigmoidoscopy also meets the UK NSC criteria. This review is available in the key downloads section, below.

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