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Bowel cancer screening

The NHS offers bowel cancer screening to all older adults, usually every two years.

In England and Wales screening is offered to adults aged between 60 and 74.

In Scotland, screening starts at 50 and is offered up to age 74.

In Northern Ireland screening is offered to adults aged between 60 and 71.

Older people can also request a test kit. Screening tests are also available privately at any age.

The screening method is called faecal occult blood testing (FOB). This test looks for hidden (occult) blood in your stool (faeces). You do the test yourself at home using a kit sent to you through the post.

Faecal occult blood can be a sign of a problem in your digestive system, such as a growth, or polyp, or cancer in the colon or rectum. If microscopic blood is detected, it is important to determine the source of bleeding so that the problem can be properly diagnosed and treated.

 

What causes blood to appear in stool?

Blood may appear in the stool for a number of reasons. For example:

  • Benign (non-cancerous) or malignant (cancerous) growths or polyps in the colon
  • Haemorrhoids ( swollen blood vessels near the anus and lower rectum that can rupture causing bleeding)
  • Anal fissures (splits or cracks in the lining of the anal opening)
  • Intestinal infections that cause inflammation
  • Ulcers
  • Ulcerative colitis
  • Crohn's disease
  • Diverticular disease, caused by bulging (outpouching) of the colon wall
  • Abnormalities of the blood vessels in the large intestine

Gastrointestinal bleeding may be microscopic (occult blood), or may be easily seen as red blood, or black tar-like bowel movements, called melaena.

What does the faecal occult blood test involve?

When you reach the relevant age, you will automatically be sent a faecal occult blood test to carry out at home. The test involves smearing small samples from bowel motions (stools) onto the card provided. You then seal the samples in the special prepaid envelope and send it off by post. The screening centre sends the kits to a laboratory to be checked for hidden blood in the stools. You will be sent a test kit to carry out the test every two years.

You’ll receive a letter giving you the result. If the result is unclear, you'll be asked to complete another test and, if this is abnormal, you'll be invited for further investigation. This may involve a colonoscopy (a thin tube with a camera on the end is passed through your rectum into your bowel so that doctors can look at the lining of your bowel). 

You should avoid eating a lot of red meat, or foods such as beetroot, turnips, or horseradish, in the three days before you take the stool samples as these can cause a false positive result.

It’s best not to take the samples if you have:

  • Diarrhoea
  • Colitis
  • Constipation
  • Diverticulitis
  • Ulcers
  • Haemorrhoid flare-ups
  • Your period
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WebMD Medical Reference

Medically Reviewed by Dr Rob Hicks on October 09, 2014

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