About bowel cancer screening
This page tells you about screening for bowel cancer. You can find the following information
About bowel cancer screening
Bowel cancer screening aims to find bowel cancer at an early stage in people with no symptoms. Early treatment is more likely to work. Bowel cancer screening can also find polyps. Polyps are not cancers, but may develop into cancers over time. They can easily be removed to reduce your risk of bowel cancer.
Screening in the UK
There are separate bowel cancer screening programmes in England, Wales, Scotland and Northern Ireland.
In England, people aged between 60 and 69 years old are invited for bowel screening every 2 years. This is being extended to include people up to the age of 75. A one-off bowel scoping test is also being introduced for people aged 55. This is to examine the inner lining of the lower part of the bowel. In Northern Ireland men and women aged between 60 and 71 are offered screening. They hope to extend the programme to include people up to 74 from 2014. In Scotland the programme covers people aged between 50 and 74. In Wales, the screening programme invites people aged between 60 and 74 for screening. They aim to start screening from 50 over the next few years.
To get your screening invitations you need to be registered with a GP. Every 2 years, you get a testing kit through the post. It checks for hidden (occult) blood in your poo (stool or faeces). It is called an FOB test (faecal occult blood test). You do the test yourself at home. You smear a small sample of poo onto a piece of treated card. Then you send the card back in a hygienically sealed, prepaid envelope. You get the results through the post about 2 weeks later.
Only 2 out of every 100 people tested (2%) are likely to have a positive result, showing that there is bleeding somewhere in the bowel. This does not mean you have cancer. But it does mean you need further tests. Usually you have an examination of the inner lining of the bowel using a flexible tube with a light and cameral on the end (a colonoscopy). Then a specialist can see inside your bowel and find out what is causing the bleeding.
In England, an extra test is being introduced as part of the NHS bowel cancer screening programme. The test is called bowel scoping or flexible sigmoidoscopy. The doctor uses a flexible short tube to check the inside of the lower bowel. You have this test once, at the age of 55. The FOB test will continue from age 60.
You can view and print the quick guides for all the pages in the About bowel cancer section.
Cancer screening involves testing apparently healthy people for signs that could mean a cancer is developing.
Bowel cancer screening aims to detect bowel cancer at an early stage when treatment is more likely to work. It can also sometimes prevent bowel cancer from developing in the first place.
In the UK bowel screening currently uses Faecal Occult Blood Testing, also called FOBT or FOB. This means looking for hidden traces of blood in poo (stool or faeces).
Testing your poo for blood
Blood in your poo (stools) can be a sign of bowel cancer. You test for this in your own home, using a testing kit.
The kit is a simple way for you to collect small samples of your poo (bowel motions). 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 each kit. You may think that the test sounds a bit embarrassing or unpleasant, but collecting the samples only takes a minute. You get the results of your test in the post within 2 weeks.
Bowel scoping screening uses a thin flexible tube with a tiny camera on the end to look at the inside of the large bowel. It is also called Flexi-Scoping or flexible sigmoidoscopy screening (sometimes shortened to flexisig). This test looks for polyps, which are most likely to grow in the lower bowel. The polyps may develop into cancer if left to grow.
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 carbon dioxide gas into the bowel to open it up so they can see more clearly. They usually remove any polyps they find straightaway, using a thin wire loop passed through the scoping tube.
There are separate bowel screening programmes in England, Wales, Scotland and Northern Ireland. The screening programmes send a bowel cancer testing kit (FOB testing) every 2 years to people eligible to take part. You need to be registered with a GP to get your screening invitations.
In England, men and women aged between 60 and 69 years old take part. This is being extended to include people up to 75. Currently, people aged 70 and over can request a screening kit by contacting the bowel cancer screening helpline on 0800 707 6060.
In England the screening programme is also starting to invite people for a test to look at the inside of the lower bowel and rectum. This is called bowel scope screening. You have this test once, at age 55. The FOBT testing will continue at age 60.
In Northern Ireland, bowel screening with a bowel testing kit (FOB testing) covers men and women between 60 and 71 years old. They hope to extend it to invite people up to 74 from 2014.
In Scotland, bowel screening with a bowel testing kit (FOB testing) covers people between 50 and 74 years old.
In Wales, people aged between 60 and 74 years old are screened with a bowel testing kit (FOB testing). They aim to start screening people from 50 over the next few years.
You usually get the results of your tests 2 weeks later. Most people have a normal result. This doesn't completely rule out cancer. So, it is important to know the symptoms of bowel cancer and see your GP if you have any of them.
Find out about the symptoms of bowel cancer.
An unclear result after an FOBT test
Some people have an unclear result. This means there was a slight suggestion of blood in the sample. If this happens, the programme will send you another kit and ask you to do the test again. This is because the result could have been caused by medical conditions such as piles (haemorrhoids) or a stomach ulcer.
You may have an abnormal result if you eat a lot of red meat, turnips, or horseradish in the 3 days before the test. Or if you have had recent dental work that caused bleeding.
An abnormal result after an FOBT test
In England, out of every 1,000 people who have the test, around 20 (2%) will have an abnormal result. Other medical conditions or some things in your diet can cause an abnormal FOB result so this doesn't necessarily mean that you have cancer. They may ask you to do the test again or you may have an appointment to see a specialist nurse at a bowel screening centre.
Around 16 out of every 20 people with an abnormal result will have an examination of the bowel called a colonoscopy to see whether there is a problem that needs treatment. Of the 16 people
- About 8 will have nothing abnormal found
- About 6 will have polyps
- About 2 will have cancer
You can read our detailed information about colonoscopy.
After bowel scoping
Out of every 300 people who have bowel scope screening, around 285 will have a normal result. This means that no polyps or cancers were found. Around 14 people will have polyps and may need to have further tests such as colonoscopy. Around 1 person has cancer. The screening centre will then let your GP know, who will refer you to a hospital specialist for treatment.
If you have bowel cancer diagnosed at the earliest stage, there is a very good chance that the cancer can be cured. The statistics show that more than 90% of people live for at least 5 years. When it is found late, the chances of survival are much lower.
Bowel cancer screening tests can reduce the risk of bowel cancer developing by finding polyps on the inner lining of the bowel. Polyps develop when cells grow too quickly and form a clump known as a bowel polyp or an adenoma. These are usually benign (non cancerous) but some may contain cancer cells. They may develop into a cancer over a number of years. Polyps found during screening can easily be removed.
We know from research that screening people between 45 and 74 years old with the current FOB test lowers the risk of dying from bowel cancer by around 16%. The bowel cancer screening programme has only been fully up and running since 2010 so it is too early to say exactly how many lives it saves. But experts think that screening will save more than 2000 lives each year by 2025.
The Flexi-Scope trial was led by Cancer Research UK scientists. It showed that bowel scoping helps to prevent bowel cancer. For every 300 people screened, it stops 2 from getting bowel cancer and saves 1 life from bowel cancer.
You can read about the research we are doing into cancer screening on our research into screening and early diagnosis page.
Bowel screening works well in finding cancer but it is not perfect. It doesn't always find cancer when it is there. So some people with bowel cancer will be missed. This is called a false negative result.
Some people will have a false positive result, but this is less common. It means that the tests pick something up even though they don't have bowel cancer. False positive results after FOBT can cause anxiety and lead to further investigations, such as colonoscopy.
People having colonoscopy have a very small risk of bleeding from the bowel, or tearing the wall of the bowel.
Bowel scope screening is usually safe but in rare cases it can damage the bowel. About 1 person in every 3,000 may have serious bleeding caused by bowel scope screening. Sometimes the bowel can be torn but this is even rarer. If that happens, you need surgery straight away to repair the bowel. Most people recover fully.
There is a small chance that some people may be diagnosed and treated for bowel growths that would not have caused them any harm during their lives. This is called over diagnosis.
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.
But 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)
- A strong family history of bowel cancer
- Ulcerative colitis
- Crohn's disease
- Bowel polyps
- A previous bowel cancer
You can read more about screening people at high risk of bowel cancer.
If you would like to find out more about genetic conditions that increase the risk of bowel cancer you can look at our page about inherited genes and specific cancers.
Our CancerStats section has detailed statistical information about bowel screening rates in the UK.
You can find details about the bowel screening programme in different languages on the NHS bowel screening programme website.
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