What is bowel cancer screening?

Bowel screening aims to find bowel cancer early, before symptoms develop. More than 9 out of 10 people (around 90%) survive bowel cancer when it is diagnosed at an early stage.

About bowel cancer

Bowel cancer is the fourth most common cancer in men and in women in the UK. Around 1 in 20 people in the UK (about 5%) will develop it in their lifetime.

Bowel cancer is most common in people in their 60s and 70s. More than 95 out of 100 bowel cancers (over 95%) happen in people over 50.

Most bowel cancers develop in the large bowel.

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. There may be other changes you can make to reduce your risk of bowel cancer.

Who is offered bowel cancer 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. There are different bowel screening programmes in each country (see UK screening programmes below).

Bowel cancer screening is for people who do not have symptoms. If you have any bowel symptoms that continue for three weeks or more, see your GP. Do not wait for a bowel screening invitation.

Bowel screening might not be suitable for certain people. This includes people who:

  • are being treated for bowel cancer
  • have had their large bowel removed
  • are part of a hospital programme that checks for bowel adenomas (polyps)
  • are on a surveillance programme for inflammatory bowel disease such as Crohn’s or ulcerative colitis
  • are waiting for bowel tests 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 (see UK screening programmes below) or your GP for advice.

Screening for people with a higher risk

Some people have a higher risk of developing bowel cancer. People with a higher risk of developing bowel cancer are offered extra bowel screening, usually at their local hospital. This usually starts at a younger age than bowel screening for the general population.

People with a higher risk of developing bowel cancer include people with:

  • a genetic condition that increases their risk of bowel cancer, such as familial adenomatous polyposis (FAP) or Lynch syndrome
  • ulcerative colitis or Crohn’s disease – these can cause inflammation in the bowel
  • a strong family history of bowel cancer – this would mean two or more close family members on the same side of the family with bowel or womb cancer, or one person who was diagnosed at a young age (under 50)
  • polyps in the bowel
  • a previous bowel cancer.

People with a higher risk of developing bowel cancer are usually offered screening with a colonoscopy.

Speak to your doctor if you think you might have a higher risk of developing bowel cancer. They will be able to advise you.

UK screening programmes

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

Your screening test will be sent to the address your GP has for you. So it is important to make sure your GP has the right contact details for you.

  • England

    Currently, if you are aged 60 to 74 you are sent a FOB home screening kit every 2 years. This will change, as the National Screening Committee has recommended that the FOB test is replaced with the FIT test. If you are not sure which test kit you have been sent, call the national screening helpline number below.

    People in England will also be offered a bowel scope screening test at around the age of 55.

    If you are older than 75, you will not automatically be sent a FOB or FIT test. But you can still take part in screening if you choose to. You can call the bowel screening helpline and ask to be sent a test kit.

    For more information about bowel screening in England, call the helpline on 0800 707 6060, Monday to Friday, 9am to 5pm.

  • Scotland

    If you are aged 50 to 74, you will be sent a FIT home screening kit every 2 years.

    If you are older than 75, you will not automatically be sent a FOB or FIT test. But you can still take part in screening if you choose to. You can call the bowel screening helpline and ask to be sent a test kit.

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

    For more information about bowel screening in Scotland, call the helpline on 0800 0121 833, Monday to Friday, 8am to 5pm.

  • Wales

    If you are aged 60 to 74, you will be sent a FOB home screening kit every 2 years. You cannot request a kit if you are 75 or older.

    If you have an unclear result, you may also be sent a FIT test.

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

  • Northern Ireland

    If you are aged 60 to 74, you will be sent a FOB home screening kit every 2 years. You cannot request a kit if you are 75 or older.

    If you have an unclear result, you may also be sent a FIT test. For more information about bowel screening in Northern Ireland, call the helpline on 0800 015 2514, Monday to Friday 9am to 5pm.

Bowel cancer screening tests

The main tests used in bowel cancer screening are:

  • the FOB (faecal occult blood) test
  • the FIT (faecal immunochemical test)
  • the bowel scope test.

FOB and FIT tests

FOB and FIT tests are very similar. They both check for hidden blood in poo, which can be a sign of polyps or bowel cancer. The tests come 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.

The main difference between the two tests is that you only need to send one sample of poo for the FIT test. The FOB test needs three samples to get a complete result.

You should get a letter with the results of your home screening test within 2 weeks. Your GP will also get a letter.

We have more information about FOB and FIT tests.

Bowel scope tests

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

Bowel scope screening uses a tube with a light and a camera to look inside the lower part of the bowel. A bowel scope test can help detect bowel polyps and prevent some bowel cancers. It can also help detect bowel cancers at a very early stage.

You have the test in the hospital as an outpatient.

We have more information about bowel scope tests.

Colonoscopy

A colonoscopy may be done for people who have:

  • an abnormal FOB or FIT test result
  • a second or third unclear FOB test result
  • polyps found during bowel scope screening.

A nurse will usually assess you at your local hospital or screening centre. In some parts of Scotland and Wales, they may assess you over the phone. The nurse may be called a specialist screening practitioner (SSP).

Some people may not be able to have a colonoscopy. This may be because of other health conditions or medications they are taking. They may be offered a virtual colonoscopy.

Getting your results

You should get a letter with the results of your colonoscopy within 3 weeks. Some hospitals may phone you with the results. If you have polyps removed or biopsies taken during your test, the letter will say if you need further tests or a follow-up appointment. Your GP will also get a letter with your results.

Waiting can be an anxious time. You may find it helps to talk to a relative or close friend. Or you can talk to one of our cancer support specialists on 0808 808 00 00.

  • Normal result

    This means no polyps or cancer have been found in your bowel. Or some people may have small polyps that do not need to be removed. Even if you have a normal result, it is important to be aware of bowel cancer symptoms in future.

    After 2 years, you will be invited to take part in bowel cancer screening with a home testing kit again. You will only be invited if you are still within the screening age range for your country.

  • Polyps

    Some people may have polyps that need to be removed. This might be because there are:

    • quite a lot of polyps
    • one or two large polyps.

    Polyps can usually be removed during the colonoscopy. This can help prevent bowel cancer developing. The removed polyps will be sent to a laboratory to be checked by a doctor who specialises in looking at cell and tissue samples (pathologist).

    Depending on the results, you may be invited to keep having bowel cancer screening every 2 years. Or you may have another colonoscopy in the next few years. Polyps may come back after being removed.

  • Other non-cancerous bowel conditions

    Some people may have other changes in their bowel. The most common findings are piles (haemorrhoids) or a bowel condition such as diverticular disease. These conditions may not need treatment if they are not causing symptoms. If this test shows you have a bowel condition, you can ask your GP for information and advice.

  • Cancer 

    Around 1 in 10 people who have a colonoscopy after an abnormal FOB or FIT test result (about 10%) are diagnosed with bowel cancer. If a cancer is found, you will be referred to a cancer specialist for treatment.

    There is a good chance of curing cancer if it is found at its earliest stage. Around 9 out of 10 bowel cancers (about 90%) can be cured if found at an early stage.

Should I take part in bowel screening?

You do not have to take part in the bowel cancer screening programme. It is your choice. You will get a reminder letter if you do not take part. You will also continue to receive an invitation to take part every 2 years, until you are 74. If you do not want to be screened, you can contact the free number on the letter.

It is important to be aware of any changes that could be a sign of bowel cancer, even if you decide not to take part in bowel screening. Go and see your GP if you have any symptoms.

We have listed the main benefits and disadvantages of bowel cancer screening tests. You can use this to help you decide if you want to take part in the FOB test, FIT test and bowel scope screening programmes.

Benefits

  • Bowel cancer screening can detect bowel cancer at its earliest stage, when there is a 9 in 10 (90%) chance of curing it.
  • Bowel screening can prevent some bowel cancers from developing.
  • With regular screening, the number of people who die from bowel cancer is reduced by 16%.

Disadvantages

  • Screening cannot detect all bowel cancers. You should always go to see your doctor if you have any bowel symptoms, even if you had a negative screening result.
  • Not all cancers found during bowel cancer screening can be cured.
  • Rarely, a bowel scope test or a colonoscopy can cause bleeding or a tear in the bowel. If this happens, an operation is needed to repair the bowel.

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