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Bowel cancer screening

The NHS offers bowel cancer screening to all older adults, and says these checks help to reduce bowel cancer deaths by detecting cancer earlier.

There are 2 types of bowel cancer screening:

Faecal occult blood testing (FOB). This test is usually done every 2 years and looks for hidden (occult) blood in your poo. 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 growths, polyps or cancer. If microscopic amounts of blood are detected, it is important to determine the source of bleeding so that the problem can be correctly diagnosed and treated.

This test is being replaced with the faecal immunochemical test (FIT), which is an easy to use home testing kit that can predict early signs of bowel cancer. The testing kit has a stick attached to the lid. This is used to take one small poo sample, which is then placed in a tube. The sample is then sent in the post for screening, which normally takes 2 weeks.

FIT became the standard bowel cancer test in Scotland in autumn 2017. England and Wales will start to introduce it during 2018.

The FIT test has also proven to be more accurate than FOBT, and the switch should mean that more cancers are detected.

Bowel scope screening. A newer routine one-off test being introduced in England where a flexible tubular device is inserted through the rectum to examine the lower part of the bowel. Small growths can be removed during this procedure.

In England, Wales, and Northern Ireland, postal screening tests are offered between 60-74. Bowel scope screening is offered at 55 at some centres.

In Scotland, FIT screening is offered from 50-74.

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

People can choose not to take part in screening, but doctors recommend everyone should have it.

What causes blood to appear in poo?

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

  • Benign (non-cancerous) growths or polyps in the colon
  • Malignant (cancerous) growths or polyps in the colon
  • Haemorrhoids (piles)
  • 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 postal 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 where 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:

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WebMD Medical Reference

Medically Reviewed by Dr Rob Hicks on November 21, 2017

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