On 12 July 2026, the Scottish Government announced that Public Health Minister Maree Todd had asked the UK National Screening Committee (UK NSC) to consider reviewing the recommended age for bowel cancer screening. The request fulfils a pledge set out in the SNP’s paper outlining the first 100 days of a new SNP government and follows a significant rise in colorectal cancer cases among people under the age of 50 in Scotland. At present, screening in Scotland is offered to those aged 50-74.
According to The Herald, Ms Todd said:
“We have already committed that, if the UK NSC does not agree to a review, we will establish a pilot in Scotland to trial bowel cancer screening in younger people.”
She added:
“Earlier detection of bowel cancer is strongly associated with improved outcomes, and I would welcome a review by the UK NSC to determine whether the evidence supports extending bowel screening to younger age groups in order to improve outcomes and deliver wider public health benefits.”
Scotland’s current bowel screening programme
Bowel screening in Scotland uses the faecal immunochemical test (FIT), which is completed at home.
The FIT test involves collecting a stool sample and returning it to the Scottish Bowel Screening Centre in a pre-paid envelope. Results are usually issued by letter within two weeks of returning the test.
If blood is detected above the screening threshold, the individual is referred to their local colorectal cancer service for further assessment, which may include a colonoscopy.
Currently, everyone in Scotland who has a Community Health Index (CHI) number and is aged 50 to 74 is routinely invited to complete a bowel screening test every two years. Individuals aged 75 and over are not automatically invited but they can request a bowel home screening test kit every two years.
Bowel screening ages across the UK
Screening policy is determined separately by ministers in each UK nation and is based on the independent, evidence-based advice of the UK NSC. This means that screening programmes can differ across the UK. The following table summarises the current screening policy for each part of the UK.
Health officials in Northern Ireland are actively considering lowering the bowel cancer screening age to age 50.
Increase in bowel cancer cases in Scotland among people under 50
The latest cancer incidence data from Public Health Scotland showed a marked increase in bowel cancer cases among people under the age of 50.
Between 2013 and 2023, the incidence rate of colorectal cancer for under 50-year-olds increased by 49% (rising from 6 cases per 100,000 people to 9 cases per 100,000). The increase was greater among females, with rates rising by 64%, compared with 34% among men.
Research is currently underway to better understand why this is happening.
Risk factors of bowel cancer
Doctors don’t know the exact causes of bowel cancer, but there are risk factors that can increase an individual’s chance of developing it.
Risk factors include:
- age
- dietary factors (eating a lot of red and processed meat and not eating enough fibre)
- lifestyle factors (drinking alcohol, smoking tobacco and low physical activity)
- being overweight
- having an inflammatory bowel condition or Type 2 diabetes
- a family history of bowel cancer.
Pros and cons of screening programmes
Population screening programmes offer substantial public health benefits, but they can also carry risks and result in unintended consequences.
When making screening recommendations the UK NSC considers all available scientific evidence and determines whether it is likely to provide more benefit than harm to the population as whole. The UK NSC has produced a short video explaining the advantages and disadvantages of population screening.
Potential benefits and risks of extending screening
Screening can detect cancers at an earlier stage, when treatment is generally more effective and outcomes are better. Bowel cancer screening can also identify certain bowel polyps before they develop into cancer.
However, no screening test is completely accurate. All screening programmes carry the possibility of false positive and false negative results.
A false positive result may lead to unnecessary worry and anxiety and could result in additional investigations for someone who does not have cancer. A false negative result may provide reassurance when cancer is actually present, potentially delaying diagnosis.
There is also a risk of overdiagnosis, where screening identifies abnormalities that would never have caused symptoms or harm during a person’s lifetime, potentially leading to unnecessary treatment.
Whether or not someone is eligible for bowel screening, it is important to be aware of the symptoms of bowel cancer. Anyone experiencing symptoms should contact their GP without delay.
Julia Hurst, Enquiries Officer, SPICe
Featured image credit: Picipedia under Creative Commons licence