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Bowel cancer screening

Dr Roger Henderson
Reviewed by Dr Roger HendersonReviewed on 13.10.2023 | 4 minutes read
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Everyone aged between 60 and 74 is invited automatically for bowel cancer screening. The local health authority will use your age and contact details in the GP records to send you a home test kit, which you send back to check for abnormalities. You’re then sent this kit every 2 years if you live in England.

Bowel cancer is the third most common cancer in the UK. Early detection gives a good chance for treatment to work, and to help prevent the cancer spreading not only through the bowel but also to other parts of the body, which carries a risk of death.

The chance of bowel increases as we get older, and the government is rolling out plans to start screening from 50 years old.

What does screening involve?

The aim is to pick up bowel cancer early, before you have symptoms. The home test kit, called a faecal immunochemical test (FIT) requires you to collect a stool sample and send it off. The kit will have easy-to-follow instructions, but essentially you collect some poo on a stick and put it in a specimen pot, to be sent to the lab in the package provided.

The test picks up microscopic bleeding, which could be from a tumour disrupting normal cells in the gut.

Any screening test needs to be acceptable to the person being tested, and as such, this test is designed to be painless and straightforward, and gives highly accurate results.

And if it seems a little embarrassing, this test is not face to face, you just send the sample away.

What if they find something?

Your result will be sent by post back to you within 2 weeks.

If you have a negative test result, there is nothing else you need to do. You will simply receive another home test kit in 2 years’ time. About 98 out of 100 do not need further tests.

A positive result means that blood was found in your poo. Bleeding can occur from the gut for other reasons, such as haemorrhoids, but a positive result in any screening means that you need further investigations to find out the cause. It does not test for cancer cells but alerts you to the possibility of cancer.

A positive result means you will be referred urgently (and automatically) to a local colorectal team, who will likely offer you a colonoscopy, a small camera that looks at your gut via the back passage.

This account for about 2 out of every 100 people being screened.

What if I have symptoms but I’m not due a screening test?

Bowel cancer is common, so you should be aware of the symptoms and seek an urgent appointment with your doctor if you develop any, even if you have had a recent negative screening test.

Symptoms that point to a problem with your bowel include red blood or a tarry look to the stool, new constipation or diarrhoea, new and persistent tummy pain, a lump in the abdomen or unintentional weight loss.

It’s important to remember that no test is 100% accurate, so get any symptoms checked out.

If you have a family history of bowel cancer or polyps, or you’ve previously had polyps seen on a colonoscopy, discuss this with your doctor as you may warrant testing earlier or more frequently than the screening programme.

The NHS previously offered a one-off colonoscopy to 55 year olds to check for polyps and bowel cancer, but this screening programme has been discontinued.

What if I think I’m high risk for bowel cancer?

If you have a family history of bowel cancer or polyps, discuss this with your GP as you may warrant testing earlier or more frequently than the screening programme.

If you’ve had a colonoscopy previously and they found polyps, you will usually have repeat colonoscopies to check. If you think you should have been followed up, speak to your GP about this.

If you reach the age of 75 or over, and therefore at the end of the screening programme, you will no longer receive home FIT kits automatically. Many people find the screening programme reassuring, so this can be difficult to accept. However, even without symptoms, you can request a kit every 3 years by calling the bowel cancer screening helpline on 0800 707 60 60.

You may have other risk factors for bowel cancer, such as obesity, smoking and excess alcohol. A diet high in processed foods and red meat and low in fibre increases your risk of bowel cancer, so you should try to address these. Maintain a healthy weight, a diet rich in leafy green vegetables and fibre and add in regular exercise, all of which helps to protect against bowel cancer.

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Dr Roger Henderson
Reviewed by Dr Roger Henderson
Reviewed on 13.10.2023
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