by detection and treatment of colorectal malignancies, incidental detection of co-morbid conditions and, potentially (though not yet proven), by increased sensitivity to symptoms leading to greater engagement with health services. With roll-out of national bowel screening programmes close to completion in England, Scotland and Wales (and with implementation plans in place in Northern Ireland), sustained public buy-in will be essential in order for the potential benefits from participation to be realised. While there are undoubtedly limitations to the FOB test and negative outcomes associated with screening, public health and programmatic promotional materials need to present balanced messages providing evidence of the effectiveness of participation in FOB test screening, ideally in response to all scheduled invitations, in reducing risk of dying from this disease. Competing interests None. Provenance and peer review Commissioned; not externally peer reviewed

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