A study from the University of Washington School of Medicine found patients offered colonoscopy alone were 45% less likely to adhere to screening.

The research suggests more patients may adhere to the NHS bowel cancer screening programme if they were offered a choice of tests. The authors said patient preferences must be taken into account when offering screening.

The NHS Bowel Cancer Screening Programme sends a FOB test to all men and women aged 60-69 every two years.

The DH launched its £8.5m Be Clear On Cancer awareness campaign earlier this year. It is part of a push to boost early detection.

The NHS was told to expect to deliver an extra 15,000 colonoscopies in England during the campaign. Experts have said the NHS may struggle to cope with rising demand.

Researchers said evidence suggests adherence to screening is more important than the specific test used.

In the study, researchers enrolled 997 participants aged 50-79, of whom 58% completed screening.

Just 38% of those offered colonoscopy attended screening. This compared with 67% of those recommended to have FOB testing.

Compliance was highest among those offered a choice between the two, at 69%, though this was not statistically different from the FOB group.

Researchers also found differences in adherence to colorectal cancer screening tests between ethnic groups.

They said reducing barriers to access, such as offering a choice of test, could improve uptake. It follows research from the  University of Oxford last year, which found that patients sent a letter from their GP advising they complete a bowel cancer test kit were more likely to do so.