Goodyear et al (Gut 2008;57:218–22) clearly show that there has been a decline in the proportion of colorectal cancer patients presenting as emergency admissions between 1999 and 2004. What they conclude is that this trend is a consequence of the Bowel Cancer Screening Pilot which started in their area in September 2000. Unfortunately, an elementary analysis of their data suggests that this is most unlikely to be the explanation.

The aim of bowel cancer screening, to state the obvious, is to detect …