Smarter screening to detect bowel cancer
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In October 2025, we announced a £500k commitment to a study aiming to detect more bowel cancers at an earlier stage.
Bowel Star (BOWEL cancer screening STrAtified by Risk) will use new computer algorithms to combine existing screening data about blood levels in poo with new information on personal risk factors such as age, family history and lifestyle.
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Professor David Weller at the University of Edinburgh and Professor Peter Sasieni at Queen Mary University of London are leading the project, collaborating with researchers around the UK. This study involves more than 20,000 people and the team’s aim is to create a new risk-based strategy for bowel cancer screening.
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The NHS currently sends a test kit for blood in poo, called the Faecal Immunochemical Test, or 'FIT', to everyone between the ages of 50 and 74. People whose tests show a blood level above the threshold might receive an invitation for a colonoscopy test, which can help detect cancer. A blood level below the threshold needs no further action. But research has shown that even people with blood levels just below the threshold could be at higher cancer risk. And, we know that age, sex, family history and lifestyle affect a person’s risk of bowel cancer.
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Professor Weller believes a risk-based approach could revolutionise bowel cancer screening. He said, “Our project is exploring risk-based screening to make smarter use of FIT by combining it with personal risk factors. We already know that risk isn’t the same for everyone. For example, older people, men and those with borderline FIT results may need closer monitoring, while people at very low risk could be screened less often. Smarter targeting could find more cancers earlier, reduce unnecessary colonoscopies and ease pressure on the NHS.”
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The study ends in 2029. The evidence it provides should guide policy decisions on bowel cancer screening so that it’s targeted at the right people. This would detect more cancers at an early stage, saving lives and giving people more time with their loved ones.​
