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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

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).

» Read more about bowel cancer on NHS Choices

» Read more about bowel cancer on Cancer Research UK

Screening in the UK

Compare how screening is offered across the UK.


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
Medical Research Council
Northern Ireland Cancer Network
Royal College of General Practitioners
Royal College of Nursing
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 Radiologists
Royal College of Surgeons
Royal College of Surgeons of Edinburgh
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.

Related documents

icon Evaluation of the UK Colorectal Cancer Screening Trial May 2003 (PDF document, 1.68MB, 28/03/14)
icon Re-appraisal of the options for colorectal cancer screening using flexible sigmoidoscopy (PDF document, 906KB, 08/04/11)
icon Review of Bowel Cancer against NSC Criteria 2000 (PDF document, 284KB, 26/08/09)

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