The faecal occult blood (FOB) test

Bowel cancers and polyps can sometimes bleed, which is why screening looks for blood in your bowel. Occult blood means blood that is not visible to the eye.

The test doesn’t tell you if you have bowel cancer, or a polyp, but if you have blood in your bowel motions you may be offered further tests to find out the cause of the bleeding. You may have to repeat the FOB test or have an examination of your bowel (a colonoscopy|).

If you are sent an FOB test kit and you aren’t sure whether you should do the test or not, you should call the freephone helpline number, which is on the letter that comes with the test.

You don’t have to take part in the bowel cancer screening programme. If you don’t want to take part you can simply choose not to complete and return the FOB test kit, or you can contact the freephone number on the letter to let the programme know that you don’t want to participate.

After you have received a letter inviting you to take part in the bowel cancer screening programme, you will be sent an FOB test kit and instructions, which you use in the privacy of your own home. In Scotland you'll be sent the letter at the same time as the kit.

The kit includes:

• full instructions
• six cardboard sticks to collect the samples
• an orange and white test card
• a prepaid hygienic envelope to return the samples.

Example of a testing card

There are three parts to the test for three separate bowel motions.

Doing the test

Before collecting each bowel motion it's a good idea to get everything ready. You will need to have two of the supplied cardboard sticks and the orange and white test card. Write the date on the first flap on the test card, then peel back the flap. Underneath you will see two windows – one for each sample of your bowel motion.

Collecting your samples

It’s important that the bowel motion you use to collect your sample from has not been in the toilet bowl, as this can affect the result of the test. You can collect the bowel motion in different ways. You can use a clean disposable plastic container, such as a cleaned margarine or ice cream tub. Alternatively you can collect it on a sheet of newspaper, which you can place across the toilet pan and secure under the rim of the toilet seat. Make sure the newspaper doesn’t touch the water in the toilet.

Once you’ve collected your bowel motion, use one of the cardboard sticks to take a small piece. Spread it thinly over the first window on the test card. Use the second cardboard stick to collect a sample from a different area of your bowel motion. Spread it thinly over the second window.

Once you’ve completed both windows, seal the flap on the test card. Wipe the cardboard sticks with toilet paper, wrap them up and throw them away in an outside bin. Don’t flush them down the toilet.

The second and third samples are collected in the same way, using the two windows under flap two and then flap three. The three samples need to be taken from three different bowel motions, but they don’t have to be collected from three in a row. It's important that all the samples are collected and the kit returned within 14 days of the first sample.

Once you have all three samples you can send the kit to be tested using the prepaid hygienic envelope.

If you have any questions about the sample collection, or if you need a new testing kit to start again, you can ring the freephone helpline number. The number will be printed on the kit instructions.

If you don’t return the testing kit you will be sent a reminder after about four weeks. If you have decided not to participate in the screening programme, you can either ignore the reminder, or contact the helpline to tell them you won’t be sending your kit back.