• colonoscopy
• colorectal cancer screening
• colorectal cancer
• COVID-19

Colorectal cancer (CRC) is the third most common malignancy in men and women in England and the second most common cause of cancer-related death. The English bowel cancer screening programme (BCSP) was introduced for those aged 60–69 years in 2006, with rollout complete for 74-year-olds in 2014 and a predicted reduction in CRC mortality of 16% based on the first 2 million tests offered.1 The number of BCSP colonoscopies has increased by nearly a third from 2017 to 2019, and this trend is set to continue. The replacement of the guaiac-based faecal occult blood test by faecal immunochemical test, which requires one rather than three tests, results in around a 7% increase in uptake. Furthermore, the age range for the BCSP is set to increase over the next 4 years to include those aged 50–60 years. The question therefore arises as to how this increased demand will be met.

In Frontline Gastroenterology, Ravindran et al report the results of an important and timely survey of the career intentions of English endoscopists to aid planning of the BCSP workforce.2 In this survey, screening consultants have a median 1 programmed activity dedicated for screening colonoscopy each week, which accounts for 40% of their endoscopy job plan. The survey highlights that retention of screening endoscopists is a looming issue. Screening consultants are older than their non-screening counterparts, and 38% anticipate giving up colonoscopy in the next 2–5 years, the principal reasons being retirement and pension issues. However, others also cited burnout, tiredness and pressure of work. Considering these factors, the authors predict a shortfall of 154 screening …