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We investigated the incidence of patients who were diagnosed with colorectal cancer, who hadpreviously been investigated via a National BCSP and had, had a negative result. Method: Between Feb 2006 and 2009 1030, patients aged between 60 and 70 were diagnosed with colorectal cancer in Gloucestershire. 240 of the 1030 patients hadpreviously been screened via the BCSP, receiving a negative result. We investigated these 240 patients.Forty two patients (17%) were excluded, of the remaining 198 patients, 59 (25%) had, had a normal faecal occult blood test, and four (2%) having had a normal colonoscopy. 63 (29%) did not respond to the invitation to participate and, 65 patients (27%) had already been diagnosed with colorectal cancerprior to invitation to screening. 26 patients (14%) were staged Dukes A, 114 (57%) were Dukes B, 46 (23%) were Dukes C and 12 (6%) were Dukes D. At 2 years 61% of patients were alive and disease free, 9% were alive with disease recurrence, 8% were awaiting further surgical intervention, 18% were dead, 2% were awaiting further treatment, and 2% were receiving palliative care.A significant number of patients willpresent with advanced colorectal cancer despite having been invited to participate in the BCSP.