Overview-Bowel cancer screening
Bowel cancer screening involves having tests to check if you have or are at risk of bowel cancer.
Why it's offered
Bowel cancer is a common type of cancer in both men and women. About 1 in 20 people will get it during their lifetime.
Screening can help detect bowel cancer at an early stage, when it's easier to treat. It can also be used to help check for and remove small growths in the bowel called polyps, which can turn into cancer over time.
Types of screening test
There are 2 types of test used in NHS bowel cancer screening:
- bowel scope screening – a test where a thin, flexible tube with a camera at the end is used to look for and remove any polyps inside your bowel
- home testing kit (the FIT or FOB test) – a kit you use to collect small samples of your poo and post them to a laboratory so they can be checked for tiny amounts of blood (which could be caused by cancer)
If these tests find anything unusual, you might be asked to have further tests to confirm or rule out cancer.
When it's offered
NHS bowel cancer screening is only offered to people aged 55 or over, as this is when you're more likely to get bowel cancer:
- if you're 55, you'll automatically be invited for a one-off bowel scope screening test, if it's available in your area
- if you're 60 to 74, you'll automatically be invited to do a home testing kit every 2 years
- if you're 75 or over, you can ask for a home testing kit every 2 years by calling the free bowel cancer screening helpline on 0800 707 60 60
If you're too young for screening but are worried about a family history of bowel cancer, speak to a GP for advice.
Always see a GP if you have symptoms of bowel cancer at any age – do not wait to have a screening test.
Risks of screening
No screening test is 100% reliable. There's a chance a cancer could be missed, meaning you might be falsely reassured.
There's also a small risk that the bowel scope screening test and some of the tests you might have if screening finds something unusual could damage your bowel, but this is rare.
There are no risks to your health from the home testing kit.
Bowel scope screening-Bowel cancer screening
Bowel scope screening is a new test for people aged 55 where a thin, flexible tube with a camera at the end is used to look inside your bowel.
It's done to look for and remove any small growths called polyps. These could eventually turn into cancer if they're not removed.
The test is also called a flexible sigmoidoscopy or "flexisig".
When it's offered
Bowel scope screening is being rolled out to all men and women in England aged 55. Depending on where you live, it may not be offered in your area yet.
If you're registered with a GP and live in an area where the test is available, you'll automatically be sent an invitation. Call the free bowel cancer screening helpline on 0800 707 60 60 to check if it's available in your area.
It's a one-off test, and you'll only be invited to have it once.
If you decide not to have the test straight away, you can have it at any point up to your 60th birthday. Call the free bowel cancer screening helpline on 0800 707 60 60 to arrange an appointment.
From 60 onwards, you'll be invited to do a bowel cancer screening home test kit every 2 years instead.
What happens
Before your appointment
About 2 weeks before the test:
- you'll be sent a letter about the test, as well as a small plastic pouch containing a liquid to help clear your bowel (an enema) and instructions for how to use it
On the day of the test:
- use the enema about an hour before leaving for your appointment by squeezing the liquid from the pouch into your bottom – it will make you poo very soon after you've used it
The bowel scope test
For the test:
- You may be asked to change into a hospital gown.
- You lie down on a bed on your left side.
- The doctor or nurse gently inserts the camera tube into your bottom.
- Air is pumped down the tube to open up your bowel and make it easier to spot polyps.
- The video from inside your bowel is shown on a screen – you can watch if you want.
- Any polyps are usually removed at the same time and sent to a laboratory to check for cancer.
You're awake during the test.
It's usually painless, although some people find it uncomfortable. If you do have any pain, it usually only lasts a few moments.
Afterwards
The test only takes a few minutes. Your whole appointment may last about 90 minutes.
You can usually go home soon after the test is finished. You do not need to stay in hospital overnight.
Most people can return to their normal activities the same day.
Results
You'll be told straight away if any polyps are found. You'll also be sent a letter explaining your result within 2 weeks.
There are 3 types of result:
Normal result
A normal result means:
- no polyps or cancer were found
- you do not need to do anything
This does not mean you will not ever get bowel cancer. See a GP if you develop symptoms of bowel cancer at any point.
About 95 in 100 people have a normal result.
Polyps found
This means:
- polyps were found and removed during the test, but they were not cancerous
- you might be offered a test called a colonoscopy to check for polyps further up your bowel
- very rarely, you might be offered surgery to remove any polyps left in your bowel
The bowel cancer screening programme has a leaflet on the colonoscopy test.
You can also find out more about what happens during a colonoscopy.
Fewer than 5 in 100 people are asked to have a colonoscopy.
Cancer found
This means:
- polyps were removed during the test, and further tests in a laboratory found they were cancerous
- a doctor or nurse will arrange for you to see a bowel cancer specialist as soon as possible
If cancer is found, it's likely to be at an early stage, so there's a better chance of treatment being successful.
Fewer than 1 in 100 people are found to have cancer.
Risks
Bowel scope screening is very safe. In rare cases, it could damage the bowel and cause serious bleeding that might require surgery.
After going home, see a GP or call 111 straight away if you have:
- severe pain in your tummy or bottom
- blood in your poo that does not go away after 24 hours
More information and advice
You can call the free NHS bowel cancer screening helpline on 0800 707 60 60 for information and advice.
The Bowel Cancer Screening Programme has guides about:
- bowel scope screening test: what it is – in English and other languages
- bowel scope screening: easy guide
Home test-Bowel cancer screening
The bowel cancer screening test for people aged 60 or over is a kit you use at home.
This is used to check for tiny amounts of blood in your poo. It does not diagnose bowel cancer, but it's a simple way to find out if you need further tests.
How to get a screening kit
All men and women aged 60 to 74 who are registered with a GP in England are automatically sent a bowel cancer screening kit every 2 years.
Make sure your GP has your correct address so your kit is posted to the right place.
If you're 75 or over, you can ask for a kit every 2 years by phoning the free bowel cancer screening helpline on 0800 707 60 60.
NHS screening kits are not available for people under 60.
How to use the kit
The main kit used in England is the faecal immunochemical test kit – known as the FIT kit.
Occasionally, some people may use an older kit called the faecal occult blood test kit – or FOB kit. The FOB kit is being gradually phased out.
FIT test
With this kit, you collect 1 sample of poo in a small plastic sample bottle and post it back to a laboratory for testing.
There are instructions with the kit. You can also read the kit instructions online.
Results
Your result should be posted to you within 2 weeks of sending off your kit.
There are 2 types of result.
Normal result
A normal result means:
- no blood was found in your poo sample
- you do not need to do anything
- you'll be invited to do another screening test in 2 years (if you'll still be under 75 by then)
This is not a guarantee that you do not have bowel cancer. See a GP if you get symptoms of bowel cancer at any point.
About 98 in 100 people get a normal result.
Abnormal result
An abnormal result means:
- blood was found in your poo sample
- you do not necessarily have bowel cancer (the blood could be the result of something like piles) but you'll be offered another test called a colonoscopy to check
A colonoscopy is where a thin tube with a camera at the end is inserted into your bottom to look for signs of bowel cancer.
The bowel cancer screening programme also has a leaflet on the colonoscopy test.
About 2 in 100 people get an abnormal result.
More information and advice
Call the free bowel cancer screening helpline on 0800 707 60 60 if:
- your kit has not arrived when you expected it
- you have not had your result after 2 weeks from when you sent off your kit
- you want to know more about screening
- you do not want to be invited for bowel cancer screening
The Bowel Cancer Screening Programme has guides about:
- bowel cancer screening in English and other languages
- bowel cancer screening: an easy guide
FAQs-Bowel cancer screening
What should I do if my home testing kit does not arrive when expected?
If you think you should have received a screening invitation or home testing kit and it has not arrived, call the free bowel cancer screening helpline on 0800 707 60 60.
If you've been screened before, the 2-year gap between invitations starts from when you got your last screening result. This could mean your next invitation is delayed by several months if you had further tests after your last screening.
Will my piles (haemorrhoids) affect the home testing kit?
You can still be screened if you have piles (haemorrhoids), although you're more likely to get an abnormal result.
An abnormal result may be caused by blood from your piles or it could be due to polyps or cancer. If blood is found in your poo sample, you'll be offered another test called a colonoscopy to find the cause.
Can I help someone I care for use the home testing kit?
If you care for someone who needs assistance using the home testing kit, you can help them if they understand the screening process and give you permission.
Speak to a GP for advice if they do not have the capacity to give their consent – for example, if they:
- do not understand the screening process
- are unable to make a decision about being screened
- are unable to communicate their wishes
Their GP will have access to the person's medical records and knowledge of their overall medical health. They can advise you about what may be in the person's best interests.
Should I use the home testing kit if I've had bowel surgery?
You should consider being screened as long as you have a working bowel.
Screening is not helpful only if:
- you've had surgery to remove your bowel
- you have a stoma bag (colostomy bag) to collect your poo – if this is only temporary, it's a good idea to continue with screening once the bag is removed
If you've had bowel surgery and you're not sure if screening is suitable for you, check with a GP or call the free bowel cancer screening helpline on 0800 707 60 60.
Can everybody have bowel scope screening at 55?
Some health problems mean that it might not be possible for you to have bowel scope screening. Call the bowel cancer screening helpline on 0800 707 60 60 if you:
- have had all your large bowel removed or have a stoma bag to collect your poo
- are currently being treated for ulcerative colitis or Crohn's disease in your large bowel
- are waiting for heart surgery or have had heart surgery in the past 3 months
- cannot walk more than 100 yards without resting because of a lung or heart problem
- think you may be too unwell to go for your appointment
Can I have screening for bowel cancer privately?
Bowel cancer screening is available from private healthcare providers but it's not the same as NHS screening.
The NHS programme cares for you through the whole screening process, including any further treatment and care you might need.
With private screening, the care you may need following screening may not be available from the provider.