Abstract

Colorectal cancer screening is now rolled out across the United Kingdom and is currently based on guaiac faecal occult blood testing as the primary screening test. A matched cohort study from Scotland has demonstrated a mortality reduction that is in keeping with the results of the population based randomised studies conducted in England and Denmark. However, interval cancer rates are high and appear to increase, at least between Rounds 1 and Rounds 3 of a biennial screening programme. In addition, there is little evidence that faecal occult blood test screening at the analytical sensitivity utilised in the United Kingdom has any effect on colorectal cancer incidence. The two developments that are currently being evaluated within the UK Screening Programme are flexible sigmoidoscopy and faecal immunochemical testing and it is likely that the introduction of either or both of these modalities will significantly enhance the effectiveness of the screening programme.