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Screening in England, Wales and Northern Ireland

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)

This page is 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 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 will include a change in the age that screening starts and a different testing kit. We will update our information when these changes happen.

In England, men and women between the ages of 60 and 74 years take part. 

In some areas 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. 

People aged over 74, can request a screening kit by contacting the bowel cancer screening programme on 0800 707 6060. 

In Northern Ireland and Wales 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. 

The bowel screening tests

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.

This test is also called the faecal occult blood (FOB) test.

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.

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

Normal 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.

Unclear results 

This means there was a slight suggestion of blood in the sample. If this happens, the programme will send you another testing kit. 

Abnormal results 

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

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

Benefits

Bowel cancer screening saves lives. It aims to prevent and detect cancer at an early stage when treatment is more likely to work.

Risks

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. 

Overdiagnosis 

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.

Information and help

Dangoor sponsorship

About Cancer generously supported by Dangoor Education since 2010.