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Although, intuitively, it might be thought that the pathology resulting from screening should be straightforward, being mainly that of polyp diagnosis and the biopsy diagnosis and staging of established adenocarcinoma, in fact experience has shown that there are several areas of considerable difficulty and controversy. In the <jats:styled-content style=\"fixed-case\">UK<\/jats:styled-content> somewhat different programmes, all based on faecal occult blood (<jats:styled-content style=\"fixed-case\">FOB<\/jats:styled-content>) screening, have been developed and each has generated similar pathological conundra. These include the biopsy diagnosis of adenocarcinoma, colorectal serrated pathology, the diagnosis and management of polyp cancers and last, but certainly not least, the phenomenon of the large sigmoid colonic adenomatous polyp with epithelial misplacement\/pseudo\u2010invasion. Polyp cancers provide especially difficult management conundra and discussion of that management within a multidisciplinary team\u2010based management meeting is regarded as essential in the <jats:styled-content style=\"fixed-case\">UK<\/jats:styled-content>. Large adenomatous polyps of the sigmoid colon with epithelial misplacement are selected into <jats:styled-content style=\"fixed-case\">FOB<\/jats:styled-content>\u2010based screening programmes and have provided extraordinary diagnostic challenges. Finally, the quality assurance procedures introduced for screening can ensure a considerable overall improvement in the quality of lower gastrointestinal tract pathological reporting.<\/jats:p>","DOI":"10.1111\/his.12530","type":"journal-article","created":{"date-parts":[[2014,8,14]],"date-time":"2014-08-14T06:53:55Z","timestamp":1407999235000},"page":"66-77","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["The pathology of bowel cancer screening"],"prefix":"10.1111","volume":"66","author":[{"given":"Maurice B","family":"Loughrey","sequence":"first","affiliation":[{"name":"Department of Histopathology Royal Victoria Hospital Belfast UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neil A","family":"Shepherd","sequence":"additional","affiliation":[{"name":"Gloucestershire Cellular Pathology Laboratory Cheltenham General Hospital Cheltenham Gloucestershire UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,1,14]]},"reference":[{"key":"e_1_2_10_2_1","volume-title":"Principles and practice of screening for disease","author":"Wilson JMG","year":"1968"},{"key":"e_1_2_10_3_1","first-page":"591","article-title":"The pre\u2010cancerous changes in the rectum and colon","volume":"46","author":"Lockhart\u2010Mummery JP","year":"1928","journal-title":"Surg. 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