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Introduction Inflammatory bowel disease (IBD) is typically diagnosed in symptomatic patients. However, a small number are diagnosed via Bowel Screening and there is limited published data on this cohort. The aim of this study was to investigate the incidence and outcome of patients diagnosed via the Bowel Screening Program in NHS Tayside.Methods NHS Tayside Data was extracted from the Electronic Cancer Audit Support Environment (ECASE) for the period 2022-2024. ECASE is a national audit tool used to collect data on participants who test positive in the Bowel Screening program. We identified those who proceeded to colonoscopy. Caldicott Guardian approval enabled electronic case note review of all colonoscopy reports, pathology reports and associated clinical letters. Patients were excluded if diagnosed with colorectal cancer, had a previous IBD diagnosis or an incomplete colonoscopy. Incident IBD cases were identified and followed for one year to assess clinical outcomes.Results 3584 patients had a positive qFIT and proceeded to colonoscopy; 30 (0.84%) had a non-specific colitis but 38 (1.1%) incident cases of IBD were identified; median age 58 (50-79), 60.5% were male. 31/38 (82%) reported symptoms. 21 (55.3%) had Ulcerative Colitis (UC) , 10 (26.3%) had Crohns disease (CD), and 7 (18.4%) had IBD-unspecified. Of those with UC, 16 (76.2%) had an E1 phenotype, 1 (4.7%) had an E2 phenotype, and 4 (19.0%) had an E3 phenotype. Of those with CD, 4 (40%) had a L1 phenotype, 3 (30%) an L2 phenotype, and 3 (30%) an L3 phenotype. Almost all patients (33/38) were initiated on treatment after colonoscopy, but only 3 had prednisolone, 3 had budesonide, and one received a biologic. All patients had clinical follow-up, of which 12 (31.6%) had active disease at one year.Conclusions IBD was diagnosed in 1.1% of Bowel Screening colonoscopies with significant clinical implications. Although many patients had mild disease, a considerable proportion had ongoing active disease at one year. Our findings highlight the importance of clear diagnostic pathways and appropriate follow-up for patients with IBD identified through Bowel Screening programs.