What is bowel cancer screening?

The aim of bowel cancer screening is to find bowel cancer before it causes any symptoms. When cancer is found at this early stage, treatment is more effective.

The screening can also detect polyps. These are growths that are not cancerous (benign). But they may develop into cancer over time. Polyps can easily be removed, which reduces the risk of bowel cancer developing.

There are two types of bowel screening test:

  • One type looks for tiny amounts of blood in your bowel motions. The faecal occult blood (FOB) test and the faecal immunochemical test (FIT) do this.
  • The other type uses a flexible tube to look for signs of cancer inside the bowel. Bowel scope screening and colonoscopy do this.

There are benefits and disadvantages to bowel screening. Thinking about these may help you decide whether to have bowel screening.

The age you get your first bowel screening test depends on where in the UK you live. Bowel screening isn’t suitable for everyone. Speak to your GP if you are unsure whether you should have it.

About bowel cancer screening

Bowel cancer screening aims to find bowel cancer early, before symptoms develop. Around 90% of (about 9 out of 10) bowel cancers can be cured if they are found early.

Bowel cancer is the third most common cancer in men and in women in the UK. About 5% of people in the UK (around 1 in 20) will develop it in their lifetime. Bowel cancer is most common in people in their 60s and 70s. Over 95% of bowel cancers (more than 95 out of 100) happen in people over 50. Changes to lifestyle could prevent over half of bowel cancers in the UK.

Most bowel cancers develop in the large bowel, which is made up of the colon and the rectum.

The small and large bowel
The small and large bowel

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Bowel cancer often starts from small non-cancerous growths called polyps. If doctors find polyps in the bowel during screening, they can remove them. This reduces the risk of bowel cancer developing.


Who is offered bowel screening?

If you are registered with a GP, you will be offered your first bowel screening test between the ages of 50 and 60. This depends on which country in the UK you live in, because there are different bowel screening programmes in each country.

Bowel cancer screening is for people who don’t have symptoms. If you have any bowel symptoms, go to see your GP immediately. Don’t wait for a bowel screening invitation.

The national screening programme might not be suitable for certain people. This includes people who:

  • are being treated for bowel cancer
  • have had their large bowel removed
  • are on a bowel adenoma (polyp) surveillance programme
  • are waiting for bowel investigations that have been arranged by their GP.

If you are invited for screening but are not sure you should have it, contact your country’s screening helpline number or your GP for advice.

People with a higher risk of developing bowel cancer

Some people have a higher risk of developing bowel cancer. This can be because several family members have had bowel cancer or they have a medical condition that increases their risk.

People with a high risk of developing bowel cancer are offered extra bowel screening. This usually starts at a younger age than bowel screening for the general population. Speak to your doctor if you think you might have a higher risk of developing bowel cancer. They will be able to advise you.

Our leaflet, 'Are you worried about bowel cancer?', has more information. You can order a free copy by calling our support line on 0808 808 00 00 or visiting be.macmillan.


Your choice

You don’t have to take part in the bowel cancer screening programme. It is your choice. You will get a reminder letter from the programme if you don’t take part. You can contact the free number on the letter to let the programme know that you don’t want to be screened.

I’m a great believer in screening, because I think prevention is better than cure. I think that people should just take advantage of all the things that are available.

David


Bowel cancer screening tests

The two main tests used in bowel cancer screening are the FOB (faecal occult blood) test and the bowel scope test.

FOB test

This test looks for hidden blood in poo, which can be a sign of polyps or bowel cancer. It comes as a home screening kit. You collect a small sample of your poo and send it to a laboratory. It is checked for tiny amounts of blood.

Some people in Scotland may be sent a type of FOB test called the FIT test (faecal immunochemical test).

Bowel scope test

This test is used in England and is being tested in Scotland. It is not part of the bowel screening programme in Wales or Northern Ireland.

Bowel scope screening looks inside the lower part of the bowel, where most cancers develop. It helps prevent bowel cancer by removing polyps before they could turn into cancer. It can also detect cancers in the lower part of the bowel.

You have the test in the hospital as an outpatient. It takes about 15 minutes.

Other tests

Most people have normal results from the FOB test and bowel scope screening. But some have an abnormal result. These people are offered an extra test to look at all of their large bowel. This test is usually a colonoscopy.


UK screening programmes

There are different bowel screening programmes in the four countries in the UK. The screening programmes are based on research done in each country and reflect the different needs of the populations.

England

People between 60–74 years are sent an FOB home screening kit every two years. From 2016, everyone will be offered a bowel scope screening test at around age 55.

You won’t be sent an FOB test kit if you are older than 75. But you can still choose to take part in screening every two years. If you want to opt in, call the bowel cancer screening helpline (see below) to request an FOB test kit each time.

For further information, contact the English bowel screening helpline on 0800 707 6060, Monday–Friday, 9am–5pm.

Scotland

People aged 50–74 are sent an FOB or FIT home screening kit every two years.

If you are older than 75, you can request a home screening kit by calling the bowel screening helpline.

In some parts of Scotland, bowel scope screening is being tested on people around age 60. If it works well, bowel scope screening will be offered to everyone of that age in Scotland.

If you have any questions, contact the Scottish bowel screening helpline on 0800 0121 833, Monday–Friday, 8am–5pm.

Wales

If you are aged 60–74 you will be sent an FOB home screening kit every two years. You cannot request a kit if you are 75 or older.

For more information about bowel screening in Wales, call the helpline on 0800 294 3370, Monday–Friday, 8am–5pm.

Northern Ireland

People aged 60–74 are sent an FOB home screening kit every two years. You cannot request a kit if you are 75 or older.

If you have any questions about bowel screening in Northern Ireland, call the helpline on 0800 015 2514, Monday–Friday, 9am–5pm.

What happens during bowel screening?

In this video, made by healthtalk.org, people affected by cancer share their experiences. They may not be the same as yours, or reflect your situation. Talk to your healthcare team if you have any questions. © University of Oxford

About healthtalk.org videos

What happens during bowel screening?

In this video, made by healthtalk.org, people affected by cancer share their experiences. They may not be the same as yours, or reflect your situation. Talk to your healthcare team if you have any questions. © University of Oxford

About healthtalk.org videos

Back to Bowel screening

The FOB and FIT tests

These tests check poo for tiny amounts of blood. Blood in poo is sometimes a sign of cancer.

Bowel scope screening

This test looks at the lower part of your large bowel. It can help detect cancers at an early stage.

Colonoscopy

A colonoscopy is a way of examining the lining of the bowel from the inside.