Screening for bowel cancer with faecal occult blood test (FOBt) kits in the general population is feasible and should be rolled out to a national programme.Overall uptake of screening in Scotland was 50.4% for males, 59.5% for females and 55% overall.Greater number of early stage cancers detected in the population being screened compared to the population that have not been screened (Dukes A: screened population 22.5%, non-screened population 12.6%).Uptake rates influenced by deprivation (Both sexes: least deprived 62.1% compared to most deprived 41.2% by Scottish Index of Multiple Deprivation).UK pilot had a considerable impact on workload in secondary care including increased demand for non-screening colonoscopy services and a substantial impact on pathology services.The impact on primary care was modest.Systematic review indicates that FOBt screening costs approximately £2,000 per Quality Adjusted Life Year and appears relatively cost effective – at this level FOBt screening is well within arbitrary “efficiency” thresholds and commensurate with other population based cancer screening programmes.