Bowel cancer screening aims to check for bowel cancer or abnormalities that could lead to bowel cancer. The screening tests include:
- testing for blood in your poo
- looking inside your bowel using a scope (flexible sigmoidoscopy)
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 or abnormalities that could lead to cancer
- overall must do more good than harm to people taking part
- must be something that people are willing to do
Screening tests are not perfect and have some risks. The screening programme should also be good value for money for the NHS.
Who can have 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.
There will be some changes to the bowel screening programme in England, Northern Ireland and Wales in the next few months. These include a change in the age that screening starts and a different testing kit. We will continue to update this information when the changes happen.
In England, men and women between the ages of 60 and 74 years take part.
The bowel cancer screening programme in England uses a test called faecal occult blood (FOB). But Public Health England has committed to introducing a new test called faecal immunochemical test (FIT) in 2019.
In some areas, the screening programme also invites 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.
People aged over 74, can request a screening kit by contacting the bowel cancer screening programme on 0800 707 6060.
In Wales, the bowel cancer screening programme covers men and women aged 60 to 74 years old.
The bowel cancer screening programme in Wales currently uses the faecal occult blood (FOB) test. But this will be gradually replaced by a new test called faecal immunochemical test (FIT) in 2019.
Wales helpline: 0800 294 3370
In Scotland, bowel screening with a faecal immunochemical test (FIT) 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.
In Northern Ireland, bowel screening with the faecal occult blood (FOB) test covers men and women aged 60 to 74 years old.
Northern Ireland helpline: 0800 015 2514
The bowel screening tests
There are 3 bowel cancer screening tests.
Testing for blood in your poo - faecal occult blood (FOB) test
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.
Your GP practice will post the test to you, to do in your own home. 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 test sounds unpleasant, but it 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.
Testing for blood in your poo - faecal immunochemical test (FIT)
FIT is the name of a new bowel cancer screening test. The test looks for tiny traces of blood in the sample of poo (stool or faeces) which can be a sign of bowel cancer. It is easier to use than the FOB test because you only need to collect one sample.
The FIT test will gradually replace the FOB test in 2019.
Looking inside your bowel
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. They are most likely to grow in the lower bowel. The polyps might develop into cancer.
It can also find cancers and is likely to pick them up at an early stage.
A specially trained health care professional (endoscopist) puts the tube into your back passage and looks at the lower part of the large bowel. They gently pump some gas into your 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.
What happens after bowel screening tests?
About 2 weeks after your tests, you will get your results.
After testing for blood in your poo
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. This is only relevant for the FOB test.
Most people with an abnormal result do not have cancer. It can be caused by other medical conditions or recent dental work. 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.
Around 2 out of every 100 people (2%) who do the FOB test have an abnormal result.
After bowel scope screening
Most people will have a normal result.
Some people have polyps. The endoscopist 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.
Risks and benefits of bowel cancer screening
Bowel cancer screening saves lives. It aims to prevent and detect cancer at an early stage when treatment is more likely to work.
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.
Be Clear On Cancer
Be Clear On Cancer bowel screening campaign aims to encourage people to do the bowel screening test.