What is bowel cancer screening?

Bowel cancer screening can find bowel cancer before it causes any symptoms. If cancer is found at this early stage, it’s more likely to respond to treatment.

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

The faecal occult blood (FOB) test is the first stage of bowel screening. This test looks for tiny amounts of blood in your bowel motions.

Bowel cancer screening was introduced in the UK after research showed that regular screening can reduce the risk of dying from bowel cancer by 16%. But there are both benefits and disadvantages to bowel screening programmes. Considering these may help you decide whether to have bowel screening.
Screening programmes differ across England, Northern Ireland, Scotland and Wales depending on your age.

Why is screening important?

Bowel cancer screening is important because it can find bowel cancers when they are small, before they cause symptoms. The screening can also detect polyps, which are non-cancerous (benign) growths that may develop into cancer over time. Polyps can easily be removed, which reduces the risk of bowel cancer developing.

Bowel cancer screening was introduced in the UK after studies showed that regular screening can reduce the risk of dying from bowel cancer by 16% (1 in 6).


Screening programmes

Bowel cancer screening programmes vary in England, Scotland, Wales and Northern Ireland:

  • In England, everyone aged 60–69 is currently offered screening every two years. From April 2010 the age limit was extended to include men and women up to their 75th birthday, although it will take a few years for this to happen across the whole of England. Anyone older than this can have bowel screening every two tears by requesting a screening kit using the helpline number 0800 707 60 60.
  • In Scotland, bowel screening is currently offered every two years to people aged 50–74.
  • In Wales, bowel screening is currently offered every two years to people aged 60–74. The age range is gradually being extended to include men and women from the age of 50. It's hoped this will happen across the whole of Wales by 2015.
  • In Northern Ireland, all men and women aged 60–69 are currently offered bowel screening every two years. The upper age limit is gradually being extended to 71.

These bowel screening programmes aim to find bowel cancer at a very early stage, when it has the best chance of being cured.

Screening isn't appropriate for you if you:

  • have had bowel investigations (such as a colonoscopy or barium enema) in the last two years
  • are being treated for bowel cancer
  • have had your large bowel removed
  • are on a bowel polyp surveillance programme
  • are waiting for bowel investigations that have been arranged by your GP.
  • The faecal occult blood (FOB) test is the first stage of bowel screening.

What happens during bowel screening?

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.

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.

About healthtalk.org videos


Benefits and disadvantages of bowel cancer screening

To help you to decide whether to take part in a bowel cancer screening programme, we've listed the main benefits and disadvantages here:

Benefits

  • Bowel cancer screening can detect bowel cancer at its earliest stage, when there is a 90% (9 in 10) chance of curing it.
  • With regular screening, 16% (1 in 6) fewer people die from bowel cancer.
  • Removing polyps which are discovered through screening can reduce the chances of developing bowel cancer.

Disadvantages

  • Bowel cancer screening may not prevent cancer.
  • You may feel embarrassed about collecting samples of your bowel motions.
  • You may get anxious waiting for results.
  • The FOB screening test, like other screening tests, may not always be reliable.
  • A bowel cancer may be missed if it's not bleeding when the FOB test is done.
  • Bowel preparation can be unpleasant in the days before a colonoscopy, CT colonoscopy or barium enema.
  • There are risks associated with having a colonoscopy.
  • Bowel cancer can start to develop in the two years between screening tests.


Bowelscope screening

The NHS in England is planning to introduce a new bowel screening programme. This will use a flexible sigmoidoscopy for all men and women when they reach the age of 55.

This will be called bowelscope screening. Research has shown that a one-off flexible sigmoidoscopy can help to detect bowel polyps and cancers at a very early stage and gives a lasting benefit.

This test will be offered alongside the existing bowel cancer screening programme using the FOB test that will continue from the age of 60 whether a flexible sigmoidoscopy has been done or not.

Flexible sigmoidoscopy is a way of looking inside the bowel using a thin, flexible tube called an endoscope. The endoscope has a tiny light and a camera on the end and allows the nurse or doctor to see the rectum and lower end of the colon (sigmoid colon).

The details of the new screening programme are still being worked out but it is hoped that it will be available throughout England by 2016.


Back to Bowel screening

The bowel

The bowel is part of our digestive system and is made up of the small bowel and the large bowel.

What to do with your FOB test kit

This test checks bowel motions for tiny amount of ‘hidden blood’. It is not a test for cancer, but can indicate whether further tests are needed to examine the bowel.

Getting your FOB test results

Waiting for your FOB test results can be an anxious time. You should get them back within two weeks.

Your feelings about bowel screening

People react differently to their bowel screening results. There is no right or wrong way to feel.

Colonoscopy

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

Virtual colonoscopy (CT colonography, CT enema, CT pneumocolon)

This test uses a CT scanner to create a picture of the bowel.

Barium enema

This is a special x-ray of the large bowel.

Common questions about bowel screening

You may have lots of questions about bowel screening. You can ask your GP if you’re unsure of anything.