What is bowel cancer screening?

The aim of bowel cancer screening is to find bowel cancer early before it causes any symptoms. When cancer is found at this 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 different types of bowel screening test:

  • The faecal occult blood (FOB) test and the faecal immunochemical test (FIT) look for tiny amounts of blood in your bowel motions.
  • Bowel scope screening and colonoscopy use a flexible tube and camera to look for signs of cancer inside the bowel.

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 is not suitable for everyone. Speak to your GP if you are unsure about whether you should have it.

Bowel cancer screening

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


About bowel cancer screening

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, which is made up of the colon and the rectum. The colon is made up of four parts:

  • ascending colon
  • transverse colon
  • descending colon
  • sigmoid colon.

The small and large bowel
The small and large bowel

View a large version

Read a description of this image


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. There are different bowel screening programmes in each country. These are listed 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 Crohns 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 listed 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.

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


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:

FOB test

These 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.

Bowel scope test

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. The scope can find cancers in the lower part of the bowel. This is where most cancers develop. It also helps prevent bowel cancer by removing polyps before they could turn into cancer.

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

Other tests

Most people have normal results from the FOB test, FIT test and bowel scope screening. But some people 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.

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


Your choice

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.

Back to Bowel screening

The FOB and FIT tests

These tests check for tiny amounts of blood in poo, which can be a sign of polyps or bowel cancer.

Bowel scope screening

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

Colonoscopy

A colonoscopy is a test that looks at the inside of the large bowel.

Virtual colonoscopy

This test is also called a CT colonography. It uses a CT scanner to build a picture of the bowel.

Be bowel aware

It is good to be aware of the symptoms of bowel cancer and ways to reduce your risk.