About bowel cancer screening
This page tells you about screening for bowel cancer. You can find information about
About bowel cancer screening
Screening means looking for early signs of a particular disease in people who do not have symptoms.
Screening in the UK
In England men and women aged between 60 and 69 years old are screened every two years. They have a faecal occult blood (FOB) test. This test checks for hidden (occult) blood in your stool (faeces). You can do the test yourself at home.
The national bowel screening programme in Scotland screens men and women aged between 50 and 74 years. A similar scheme started in Wales in 2008. There are plans for a scheme to start in Northern Ireland in 2010.
If you are offered screening you get a testing kit through the post. You smear a small sample of stool onto a piece of treated card and send the card back in a hygienically sealed, prepaid envelope. The results come by post too. Only 2 out of every 100 people tested are likely to have a positive result. A positive FOB test does not mean you have cancer, but does mean you should have further tests - usually a colonoscopy so that a specialist can see inside your bowel and find what is causing the bleeding.
You can view and print the quick guides for all the pages in the About bowel cancer section.
Screening means looking for early signs of a particular disease in healthy people who do not have symptoms. Research has looked at two main ways of screening for bowel cancer
In the UK, more than 37,500 people are diagnosed each year with colon cancer or rectal cancer. Bowel cancer screening programmes for both men and women are being introduced throughout the UK. There are separate programmes in England, Wales, Scotland and Ireland. Bowel cancer screening aims to detect bowel cancer at an early stage (in people with no symptoms) when treatment is more likely to cure the cancer.
Bowel cancer screening can also detect polyps on the inner lining of the bowel. These are not cancers, but may develop into cancers over time. They can easily be removed, which reduces the risk of bowel cancer developing.
In England, the NHS Bowel Cancer Screening Programme started in 2006 and now covers most regions. Men and women aged between 60 and 69 years old are sent a stool testing kit (faecal occult blood test) every 2 years. People aged 70 and over can request a kit. From 2010, people aged 70 to 75 will also be included in the screening programme.
In Scotland men and women aged between 50 and 74 years are sent a stool testing kit (faecal occult blood test) every 2 years.
In Wales the NHS tests people between the ages of 50 and 74 every two years. They currently send out stool testing kits to men and women aged between 60 and 69. They hope to roll the service out to everyone else in the target age group by 2015.
A similar scheme is planned for Northern Ireland. It will offer tests to men and women between the ages of 60 and 69, and then up to age 74 by 2012.
Stool testing means a test to look for hidden (occult) blood in your stool (faeces). It is also called faecal occult blood testing, or FOB, for short.
If you are within the age range of the bowel cancer screening programme, you are sent a testing kit through the post every 2 years. The testing kit is a simple way for you to collect small samples of your bowel motions. You do this in your own home. You wipe the samples on a special card, which you then send in a hygienically sealed, prepaid envelope to a laboratory for testing. There are detailed instructions with each kit. You may think that doing the test sounds a bit embarrassing or unpleasant, but collecting the samples only takes a few minutes. You will be sent the results of your test by post within 2 weeks.
Only around 2 out of every 100 people tested (2%) are likely to have blood in the stool sample (an abnormal result). Other medical conditions or some things in your diet can cause an abnormal FOB result so this does not necessarily mean you have cancer. If you have an abnormal result, you will be offered an appointment with a specialist nurse at a bowel screening centre. You will have a more detailed examination, and may be offered a colonoscopy to see whether there is a problem that may need treatment.
In England, for every 1000 people who have the FOB test, around 20 will have an abnormal result and may be asked to do the test again. Around 16 of those people will have a colonoscopy. Of those 16
- About 8 people will have nothing abnormal detected at colonoscopy
- Around 6 will have polyps
- About 2 will have cancer
Some people have an unclear result, which means there was a slight suggestion of blood in your FOB test sample. If you have an unclear result, you will be sent another FOB test kit and asked to do the test again. This is because the result could have been caused by medical conditions such as haemorrhoids (piles) or stomach ulcers. A false positive test can happen if you eat a lot of red meat, turnips, or horseradish within 3 days before the test. Or have had recent dental work that caused bleeding.
A normal test result doesn't completely rule out bowel cancer. So, it is important to be aware of the symptoms of bowel cancer and see your GP if you are worried.
People who have an abnormal stool test (faecal occult blood test) as part of the NHS bowel cancer screening programme are offered a colonoscopy. You can read more about this on the detailed information about colonoscopy page.
A large UK clinical trial looked into another way of screening healthy people for bowel cancer using a test called flexible sigmoidoscopy. There is detailed information about flexible sigmoidoscopy in the section about tests for bowel cancer. The screening involved having a thin, bendy tube put a short way into the rectum and lower bowel to look at the inside wall of the bowel and remove any small growths (polyps) there. Bowel cancers usually develop very slowly from polyps called adenomas. By removing them at an early stage, before they become cancerous, the researchers think it may be possible to prevent bowel cancers from developing. The trial finished in 2007 and showed that this type of screening across the country could help to prevent bowel cancer in some people. The cost of the screening test would be partly offset by preventing cancers and so not having to treat them.
The Government is doing large scale pilot studies across the UK to see whether it is worthwhile using this type of screening for men and women in their 50s.
Some people are offered regular screening if they are thought to be at higher than average risk of bowel cancer. You can read more about this on the screening people at high risk of bowel cancer page.
Until screening is phased in completely, if you don't live in an area offering screening you should go and talk to your GP about any bowel problems that you have. Your GP can refer you to a doctor who specialises in bowel problems if they think it is needed. For example, if you have a family history of bowel cancer, or there is some other good reason, you may be able to have a stool test (FOB test) or a sigmoidoscopy.
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