Bowel cancer - Screening 

Screening for bowel cancer 

Bowel cancer can be present for a long time before any symptoms appear. If it's detected before symptoms appear, it's easier to treat and there's a better chance of surviving the disease.

To detect cases of bowel cancer sooner, the NHS Bowel Cancer Screening Programme was introduced in England in 2006. Men and women aged 60-69 registered with a GP will automatically be sent an invitation for screening through the post every two years.

The screening programme is also being extended in England to those aged 70 to 74. Screening centres in England are rolling out the extension once their two-year screening invites have completed.

Bowel cancer screening is also being carried out in the rest of the UK, but in Scotland people aged 50-74 are invited for screening.

People over 70 can also request a screening kit by calling the freephone helpline 0800 707 6060 (you’ll need your NHS number to hand).

Routine screening isn't offered to people less than 60 years of age, so if you think you may be at an increased risk of bowel cancer and you are not yet eligible for screening, it may help to speak to your GP about your options and what you should be looking out for.

Screening consists of a home testing kit, called an FOBt (faecal occult blood test) kit. The kit arrives through the post when screening is due. The kit is used to collect tiny stool samples on a special card.

The card is then sealed in a special hygienic freepost envelope and sent to a laboratory where it will be checked for traces of blood that may not be visible to the naked eye, but may indicate a problem.

Results

Results are received in writing within two weeks of sending in the test kit. There are three types of result:

  • Normal – when no blood was found in the samples. Screening will be offered again in two years’ time.
  • Unclear – when there were possible traces of blood that could be caused by factors other than cancer, such as haemorrhoids (piles) or stomach ulcers. If you have an unclear result, you will be asked to repeat the test kit up to two more times.
  • Abnormal – when blood was definitely found in the samples. Again, this could be due to something such as piles or bowel polyps. If you have an abnormal result, you will be offered an appointment with a specialist nurse to discuss having an examination of the bowel, called a colonoscopy (see below).

Only half of all bowel cancers are picked up by the screening test. The ones missed by the screening test cause symptoms at a later date. If you develop symptoms after a negative test, try the bowel cancer symptom checker to see whether you need to see your GP.

Colonoscopy

A colonoscopy is an investigation of the lining of the large bowel (colon). A thin, flexible tube with a camera on the end (colonoscope) is passed into your rectum and guided around the bowel.

Only around two in every 100 people completing the FOBt kit will have an abnormal result and will be offered a colonoscopy. Of those who have a colonoscopy, only about one in 10 will have cancer.

New screening test

As well as the FOBt described above, an additional screening test is being rolled out by 2016. This involves inviting people at age 55 to have a one-off flexible sigmoidoscopy test to examine the lower bowel with a camera.

A flexible sigmoidoscopy is a similar test to a colonoscopy, although it cannot be used to see quite as far into the bowel. If the test shows polyps in your bowel, the person will then be offered a full colonoscopy (see above) to investigate further.

Both FOBt and flexible sigmoidoscopy screening tests have been shown to reduce the risk of dying of bowel cancer.

See diagnosing bowel cancer for more information about colonoscopies and sigmoidoscopies.

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Page last reviewed: 02/09/2014

Next review due: 02/09/2016

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The 6 comments posted are personal views. Any information they give has not been checked and may not be accurate.

oho said on 21 September 2014

I am on anticoagulation therapy that includes warfarin as well as insulin. how long should I stay in hospital post colonoscopy

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oathy said on 18 February 2014

My dad is 73 and got the first test in the post few weeks ago. He had a letter today saying they had found tiny traces of blood and sent out another test.
Very worried about this he says he hasn't noticed anything different like bowel movements changing or not feeling like food or seeing blood present when he's been to the loo etc.

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gateway9 said on 17 August 2013

Bowel cancer screening (FOBT) is not a perfect test; my husband had his second clear test in April and was diagnosed with bowel cancer in July after other symptoms sent him to the GP. Please do not ignore any symptoms on the grounds that the test was clear; it is a useful tool and does save lives but is not infallible. At this moment husband recovering from major surgery to treat disease. We have learned that unusual tiredness, changed bowel habit and weight loss may present before the obvious blood loss which sent my husband to GP in June. Cannot fault service and care provided by nhs they have been and are being wonderful.

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Egghead123 said on 05 August 2013

My father had bowel cancer and although I'm 48 and under the starting age for screening can I get screened earlier?
Thanks

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mike diamond said on 23 October 2012

I am 75 years old (do not look or feel like one) but have not yet received an invitation from the NHS
for bowel cancer screening. I assume that I just slipped through the net. In view of having bowel cancer in my family my best action to take is to contact my GP. Anyone in similar situation should do the same.
ps this website is excellent

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SPOCK33 said on 28 June 2011

I was first screened over 2 years ago with a negative result. As I haven't received another test kit I called the helpline to check, to be informed that my file was closed!

It has now been reopened & a kit is on its way. My advice is to make sure that you receive your test kit in good time. It could save your life!

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