Australian states are currently rolling out colorectal cancer screening as part of the National Bowel Cancer Screening Program. Its success depends on the “physical or psychological harm to those concerned be[ing] less than the chance of benefit”.1 The benefits are clear. Randomised controlled trials show a 16% reduction in colorectal cancer mortality with faecal occult blood testing and colonoscopy of people with a positive faecal occult blood test (FOBT) result.2 In contrast, less attention has been paid to the psychological impact of colorectal cancer screening. Its effective management may also improve screening outcomes.