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  1. S J Goodyear
  1. Mr S J Goodyear, Department of Surgery, University Hospitals Coventry and Warwickshire NHS Trust, Clifford Bridge Road, Coventry CV2 2DX, UK; drgoodyear{at}hotmail.com

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Professor Logan suggests that our findings (Gut 2008;57:218–22) are unlikely to arise from the Bowel Cancer Screening Pilot (BCSP) in Coventry and north Warwickshire. However, the stability of the total admission rate for colorectal cancer (CRC) at UHCW NHS Trust following the roll-out of the BCSP in Coventry and north Warwickshire is unsurprising. Incidence rates for CRC have remained stable for 15 years1 and there is no evidence of a significant change in the population demographics for this region.2 Screeening using the faecal occult blood test (FOBT) is intended to diagnose (early) asymptomatic CRC. Therefore, upon implementation of screening it is reasonable to anticipate a short-term increase in detection as a result of reduced lead-time in the screened 50–69-year-old cohort, in addition to those diagnosed by conventional routes. This could potentially correspond to the reported increase in total CRC admissions in 2002 (round 1 of screening concluded in SY3; table 1). However, once screening …

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