The story of how Scotland came to be the first country in the world to have a bowel screening programme available to the whole population.

The VisitScotland Business Events team spoke to Professor Bob Steele, Clinical Director of the Scottish Colorectal Cancer Screening Programme, co-founder and co-director of the Scottish Cancer Prevention Network and Chair of the Board of Directors of the Scottish Cancer Foundation. In 2016, he was appointed as Independent Chair of the UK National Screening Committee. Professor Steele shares with us his role and inspiration for developing a specialised bowl screening programme and how that programme came to be introduced across Scotland.

We can be justly proud that Scotland has been a pioneer in this life-saving public heath intervention

"When I was a junior surgeon I worked for Professor Sir Pat Forrest in Edinburgh who was the author of the ‘Forrest Report’ that started breast cancer screening in the UK.  I was therefore exposed to screening at an early stage.  At the end of my training, I left Aberdeen to take up my first Consultant post in Nottingham where Professor Jack Hardcastle was running a big trial of screening for bowel cancer.  What impressed me was that, unlike the case in Aberdeen, most patients with bowel cancer in Nottingham had early stage disease which was curable by surgery alone.  This was a direct result of screening and was extremely motivating for a young surgeon.

I therefore decided to focus on bowel cancer and bowel cancer screening in both my clinical and research work, and when I moved to Dundee in 1996 I led a successful bid to host the demonstration pilot of bowel cancer screening that led to the introduction of Bowel Cancer Screening Programmes across the United Kingdom.  When the pilot had been successfully completed, Dundee was chosen as the Bowel Cancer Screening Centre for Scotland and the first screening tests were sent out in March 2000.

Six years later, after careful testing and evaluation, Bowel Cancer Screening was rolled out across the whole of Scotland, and Scotland was the first country in the world to have a Bowel Screening Programme for the whole of the population.  Research and development has continued and the original bowel screening test, which was card based and involved an indirect chemical reaction to detect blood in bowel motion, was replaced by a much more sophisticated immunological test which is more accurate and considerably easier to use. 

This has resulted in a better performing programme which is associated with a much higher uptake across the whole of Scotland.  Bowel cancer screening is not without its challenges, and we need to continually evaluate and develop the programme, but it has been a real success story for NHS Scotland.  We can be justly proud that Scotland has been a pioneer in this life-saving public heath intervention."

With thanks to Professor Bob Steele 

The Centre for Research into Cancer Prevention and Screening (CRiPS)

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