Affluent people are 50 per cent more likely to take part in bowel cancer screening than their deprived counterparts, according to a study published in the British Journal of Cancer (BJC)1.

The Cancer Research UK study, which looked at how many people in the London area returned their home testing kits for bowel cancer, found that only one in three people in the most deprived areas participated.

This compared with one in two people in the wealthiest areas.

The figures are part of the National Awareness and Early Diagnosis Initiative (NAEDI) supplement published in the BJC, which for the first time brings together research underpinning the initiative.

Professor Jane Wardle, lead author from Cancer Research UK’s Health Behaviour Research Centre based at University College London, said: “There’s a real danger that bowel cancer could increasingly become a disease of lower social class if these figures hold true across the UK.

“We know that more than 90 per cent of bowel cancer patients survive if the disease is caught at the earliest stage, compared with around six per cent for cases detected at the latest stage.

“Screening helps to spot early signs of bowel cancer, as well as pre-cancerous growths that don’t cause any symptoms, so it’s important that everyone who receives a testing kit takes part.”

Bowel screening kits – faecal occult blood (FOB) tests – are sent through the post every two years to people aged between 60 and 74 years old2. People take their own stool samples at home and then send the kit back for testing. The results are posted out within two weeks.

Professor Wardle continued: “Our study reveals a worrying pattern, but we don’t know why social class has played such a major role in screening uptake.

“Bowel cancer screening may not be pleasant, but this seems to be less of a deterrent for those who are better off.

“Future research will need to discover what the key barriers are.”

The study monitored the response to the roll out of bowel cancer screening across London in the first 30 months of the programme.

Over 400,000 test kits were sent out. The researchers categorised the addresses to which kits were sent into five groups, based on the neighbourhood characteristics of that postcode area, from the most affluent to the most deprived.

Sara Hiom, director of health information at Cancer Research UK, said: “Some people may be put off by the idea of bowel cancer screening, but it can save lives.

“Cancer Research UK, the NHS and the Department of Health are key players in the National Awareness and Early Diagnosis Initiative (NAEDI), which aims to cut cancer deaths through early diagnosis of the disease. Reducing inequalities in uptake of screening is a crucial part of this.”

Professor Mike Richards, National Cancer Director at the Department of Health, said: “It is now generally accepted that late diagnosis of cancer is a key reason for England having lower cancer survival rates than other comparable countries. This supplement is very important in helping to tackle this problem, as it sets out what is known about the causes of late diagnosis and what can be done to tackle those causes. Through the national screening programmes and NAEDI, the Department of Health, the NHS and key partners such as Cancer Research UK are working to achieve earlier detection and to save lives.”


  1. Von Wagner et al. Inequalities in colorectal cancer screening participation in the first round of the national screening programme in England. British Journal of Cancer (supplement). December 2009


32 per cent of people in the most deprived areas took part in bowel cancer screening compared with 49 per cent in the most affluent areas.

About bowel cancer screening

More than 37,500 people are diagnosed with bowel cancer every year in the UK and about 16,000 people die from bowel cancer each year.

2. The bowel screening programme is being offered to both men and women.

  • In England, people aged 60-69 are screened every 2 years.
  • In Scotland, people aged 50-74 are screened every 2 years.
  • In Wales, people aged 60-69 are screened.
  • In Northern Ireland, the age range for screening is still to be confirmed.

In England, if you are over 70, you can still take part in bowel cancer screening but you won’t automatically receive a kit. You can call freephone 0800 707 60 60 to request a free kit. Scotland has a bowel screening helpline number – 0800 0121 833, as does Wales – 0800 294 3370.

For more information on bowel cancer, click here.


The National Awareness and Early Diagnosis Initiative – NAEDI – was first announced in the Cancer Reform Strategy and is a public sector/third sector partnership led by Mike Richards, National Cancer Director, and Harpal Kumar, chief executive of Cancer Research UK. The role of NAEDI is to co-ordinate and provide support to activities that promote the earlier diagnosis of cancer.

Health Behaviour Research Centre

The Health Behaviour Research Centre is based at University College London and receives funding from Cancer Research UK for research in public attitudes and cancer related health behaviours including cancer screening, diet and smoking. If you would like to participate in future research about your attitudes to cancer you can join the ‘Participant’s Panel’ here.

About the British Journal of Cancer (BJC)

The BJC is owned by Cancer Research UK. Its mission is to encourage communication of the very best cancer research from laboratories and clinics in all countries. Broad coverage, its editorial independence and consistent high standards have made BJC one of the world’s premier general cancer journals.