Call to lower bowel cancer screening age amid rise in under-50s cases

The minimum age for bowel cancer screenings should be lowered amid soaring rates of under-50 cases, Scotland’s health minister has said.

Public health minister Maree Todd has written to the UK National Screening Committee (UK NSC) asking them to consider reviewing the recommended age threshold for bowel cancer tests amid rising rates in colorectal cancers since 2013.

Bowel cancer is the fourth most common cancer in Scotland, with around 4,000 people diagnosed every year. Crucially, around 44% of these patients are not diagnosed until stages 3 and 4.

The call for a younger screening age comes as Public Health Scotland data reveals a 49% surge in early-onset cases (those under 50 years old) between 2013 and 2023.

Within that age group, the risk rose from six per 100,000 people to nine per 100,000. The increase was most dramatic among women, with cases soaring by 64% compared to a 34% increase in men.

Under current UK NSC recommendations, people aged between 50 and 74 are offered bowel cancer screening every two years.

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.

“Research from Public Health Scotland in September 2025 showed a significant increase in the rate of bowel cancer among those under 50 between 2013 and 2023 in Scotland, and I share the concerns among clinicians, researchers, and public health professionals regarding this upward trend among younger adults.

“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 would support extending bowel screening to younger age groups in order to improve outcomes and achieve public health benefits for the population.”

Genevieve Edwards, Chief Executive of Bowel Cancer UK, said: “It’s right that the Scottish Government wants to keep the evidence on bowel cancer screening in younger adults under review. With bowel cancer rates rising among younger people, it’s important that we continue to explore every opportunity to improve early diagnosis and outcomes.

“Whatever happens with this proposed review, any changes to screening must be based on robust evidence and supported by the NHS having the diagnostic capacity it needs to deliver them safely and effectively. Scotland’s focus must stay on diagnosing bowel cancer earlier and ensuring that everyone receives the right care at the right time.”