Find out about bowel cancer screening programmes in England, Wales and Northern Ireland.
What is screening?
Screening means testing people for early stages of a disease before they have any symptoms.
For screening to be useful the tests:
- need to be reliable at picking up cancers
- need to be simple and quick
- shouldn’t show that someone has cancer when they don’t (false positive results)
- need to not cause any harm
Not all screening tests are helpful and they can have risks.
Who has bowel screening
The screening programmes send a bowel cancer testing kit every 2 years to people eligible to take part. You need to be registered with a GP to receive your screening invitations.
There are separate bowel screening programmes for the different countries in the UK.
In England, men and women between the ages of 60 and 74 years take part.
People aged over 74, can request a screening kit by contacting the bowel cancer screening programme on 0800 707 6060.
The screening programme is also starting to invite people for a bowel scope test to look at the inside of the lower bowel and back passage (rectum). You have this test once, at age 55.
In Wales and Northern Ireland bowel screening with a bowel testing kit covers men and women aged 60 to 74 years old.
Northern Ireland helpline: 0800 015 2514
Wales helpline: 0800 294 3370
In Scotland, bowel screening with a bowel testing kit covers people aged between 50 and 74 years old. If you're over 74, you can ask for a screening test by contacting the helpline on 0800 012 1833.
Bowel screening tests
Bowel cancer screening aims to detect cancer at an early stage when treatment is more likely to work. It can also help to prevent bowel cancer from developing in the first place.
There are 2 bowel cancer screening tests.
Testing for blood in your poo
Blood in your poo (stool or faeces) can be a sign of bowel cancer. You can test for tiny traces of blood that you might not be able to see. You do the test in your own home with a testing kit.
The kit is a simple way for you to collect small samples of your poo. You wipe the sample on a special card, which you then send for testing in a hygienically, sealed, prepaid envelope. There are detailed instructions with the kit.
You may think that the tests sound a bit embarassing, or unpleasant, but collecting the samples doesn't take long.
Voiceover: At the age of 61 Jim is a happy man. Jim’s whistling because he’s just done his bowel cancer screening test.
Oh look, Jim’s just popped a screening kit through Bill’s door. Thanks, Jim.
You see, that kit might just catch the early signs of bowel cancer and save Bill’s life.
The tricky bit with these kits is getting a few samples of your poo onto the test card.
Bill will need to do his business on three separate days and then scoop off a few samples for the doctors to take a look at.
If there’s any blood in it it’s a sign of a number of conditions, one of which could be cancer.
To do it right Bill will need to find a way of collecting his poo without it getting wet. There are lots of different ways.
Perhaps he could cover his hand with a plastic bag or glove and catch it or he could find an old container that fits neatly into the toilet. Just keep looking until you find the right one.
That one, Bill. A perfect fit. And toilet paper, even better. And the next bit was actually quite easy.
Then using one of the sticks from the kit Bill scooped up a bit of poo and smeared it on the test card and then using a different stick one more blob from a different bit of poo for the second sample. A perfect specimen there.
The rest of the poo was flushed away, the sticks went in the bin and that was that. Except of course for the two other numbers.
To get a really good sample he had to repeat the process two more times. In fact he was becoming a bit of an expert by the end. Nice work, Bill!
The kit had to back at the lab for testing within two weeks of the date of his first sample. So it was all done in ten days to allow plenty of time to post it back and he’ll get his results within two weeks.
If there’s blood in the sample it could be a number of things not just the early signs of cancer. A letter will explain the results and what Bill needs to do next.
So if you’re ready, it’s time to get started.
Looking inside your bowel (bowel scope)
Bowel scope screening uses a thin flexible tube with a tiny camera on the end to look at the inside of your large bowel. It is also called Flexi scope or flexible sigmoidoscopy (flexi-sig).
The test looks for polyps. These are most likely to grow in the lower bowel. The polyps might develop into cancer if they grow. It can also find cancers if they have already developed and is likely to pick them up at an early stage.
A specially trained nurse or doctor puts the tube into your back passage and looks at the lower part of the large bowel. The nurse or doctor gently pumps some gas into the bowel to open it up so they can see more clearly. They usually remove the polyps they find straight away, using a thin wire loop passed through the scoping tube.
After bowel screening tests
About 2 weeks after your tests, you will get your results.
Most people have normal results. This doesn't completely rule out cancer. So it is important to know your own body and what is normal for you. See your GP if you have changes that don't go away.
This means there was a slight suggestion of blood in the sample. If this happens, the programme will send you another testing kit.
Around 2 out of every 100 (2%) have an abnormal result.
Most people with an abnormal result do not have cancer. It can be caused by other medical conditions or recent dental work. Or if you've eaten a lot of red meat, turnips or horseradish in the 3 days before the test.
The screening programme may ask you to do the test again. Or you'll have an appointment to see a specialist nurse at a bowel cancer screening centre. The nurse will talk to you about having a test to look at the inside of your large bowel. This is called a colonoscopy.
After bowel scope screening
You'll get the results within 2 weeks.
Most people will have a normal result.
Some people have polyps. The nurse or doctor will usually remove these and send them to a laboratory to be checked. You'll also have a colonoscopy to check the rest of your large bowel.
Around 1 out of 300 people who have bowel scope screening have cancer. The screening centre will let your GP know, who will refer you to a specialist for treatment.
Risks of bowel cancer screening
Bowel cancer screening works well in finding cancer early but it is not perfect.
False positive result
This means that the tests pick up something even though the person doesn't have cancer. This can cause anxiety and lead to further tests.
False negative result
Rarely, screening tests miss a cancer. It is important to know the symptoms of bowel cancer and see your GP if you have any symptoms.
There is a small chance that some people may be diagnosed and treated for bowel growths that would not have caused any harm.
Damage to the bowel wall
Bowel scope screening is usually very safe, but in rare cases it can damage the bowel wall. Around 1 in 3,000 people have serious bleeding. Or the bowel wall may be torn, but this is even rarer. If this happens, you need surgery straight away to repair the bowel.
Screening for people at higher risk
Bowel screening works well at reducing deaths from bowel cancer in people in their 50s, 60s and early 70s. As bowel cancer is rare in younger people, screening them is not useful.
Some people can have regular screening at an earlier age, if they have certain conditions that increase their risk of bowel cancer. These include:
- Familial Adenomatous Polyposis (FAP)
- Hereditary Non Polyposis Colorectal Cancer (HNPCC), also called Lynch syndrome
- A strong family history of bowel cancer
- Ulcerative colitis
- Crohn's disease
- Bowel polyps
- A previous bowel cancer
Be Clear On Cancer
Be Clear On Cancer bowel screening campaign aims to encourage people to do the bowel screening test.