Bowel cancer screening in England: the first million

In April 2006 the Department of Health in England agreed funding for a national programme of biennial gFOBt screening of 60–69-year-olds. Roll out of the programme started in July 2006 and was complete by January 2010. In this issue of Gut, Logan et al report the uptake and early outcomes of the first million people screened. Almost 2.1 million were invited to participate, and as expected, women had a higher return of tests than men (54.4% vs 49.6%). Of the 1.08 million returning tests 2.5% of men and 1.5% of women had an abnormal test. Seventeen thousand five hundred and eighteen (10 608 M, 6910 F) underwent investigation, with 98% having a colonoscopy as their first investigation. Cancer (n=1772) and higher risk adenomas (n=6543) were found in 11.6% and 43% of men and 7.8% and 29% of women investigated, respectively. Seventy one percent of cancers were ‘early’ (10% polyp cancer, 32% Dukes A, 30% Dukes B; see table 1) and 77% were left-sided (29% rectal, 45% sigmoid) with only 14% being right-sided compared with expected figures of 67% and 24% for left and right side from UK cancer registration. These early data are encouraging and suggest that the intended target of 16% reduction in overall bowel …