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Screening aims to detect asymptomatic disease at an early stage when treatment is most likely to be effective. We aim to analyse the symptomatology of screen detected colorectal cancer (CRC) patients in the first year (Sep 2008 - Aug 2009) of screening at the North Staffordshire Bowel Cancer Screening Centre.Four hundred and four patients attended the nurse led screening clinic following positive FOB to complete a standard questionnaire of which 19 declined colonoscopy or any other forms of imaging. 39 patients were diagnosed with CRC during this period and their symptoms analysed from the questionnaire.Relevant symptoms included rectal bleeding 53.84%, change in bowel habits 58.9%, urgency 20.5% and abdominal pain19%. 12.8% had family history of bowel cancer. Only 10.2% of the screen detected CRC patients were asymptomatic.Although CRC screening aims to detect asymptomatic cases, the vast majority of our screen detected patients were symptomatic at the time of screening, and some of them were even eligible to be referred under the UK DOH criteria for high risk symptoms of CRC. Increasing the awareness and improving the knowledge of CRC symptoms in the public mayprompt these patients to seek medical advice even at an earlier stage.