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Evidence-led screening guide

NHS Bowel Cancer Screening

A plain-language guide to eligibility, the home FIT kit, possible results, benefits, limitations and official support.

Check the current NHS bowel screening eligibility guidance (external link, opens in a new tab)Read this guide

Quick guide

Bowel screening at a glance

Who is usually invited
In England, people aged 50 to 74 who are registered with a GP and live in England are invited under current programme guidance. Arrangements differ across the UK.
The test used
A faecal immunochemical test (FIT), which checks a small poo sample for traces of human blood.
How the test is completed
At home, using the sampling stick and bottle supplied, then returning the kit by post.
How often screening is offered
Usually every two years while a person remains eligible. Check current guidance for your UK nation.
What happens after the result
A letter explains whether no further tests are needed at that time, whether the test needs to be repeated, or whether you should speak with the screening team about further investigation.

Last reviewed:

Next review due:

1. What is bowel cancer?

Bowel cancer is cancer that begins in the large bowel. Depending on where it starts, it may also be called colon cancer or rectal cancer.

Cells can sometimes grow in the inner lining of the bowel and form small growths called polyps. Most polyps are not cancer, but some can develop into cancer over time.

2. Why bowel cancer screening matters

NHS bowel screening is offered to people without symptoms to look for signs that could need further investigation. It may find bowel cancer at an earlier stage and can find polyps that may be removed before they develop into cancer.

Screening is a choice. Official programme information explains the possible benefits and risks so that each person can make an informed decision.

3. Who is eligible for NHS bowel cancer screening?

In England, NHS bowel cancer screening is being offered to eligible people within the programme’s current age range. Current GOV.UK programme guidance says people aged 50 to 74 who are registered with a GP and live in England are invited every two years. People aged 75 or over can request a kit every two years through the programme helpline.

Eligibility and programme arrangements can differ across England, Scotland, Wales and Northern Ireland, and can change over time. Use the official information for the nation where you live.

Check the current NHS bowel screening eligibility guidance (external link, opens in a new tab)

4. How the FIT screening test works

FIT means faecal immunochemical test. It looks for very small traces of human blood in a poo sample. Blood can be present for reasons other than cancer, and not all bowel cancers bleed.

  1. The screening programme sends an invitation and home test kit to an eligible person.
  2. The person follows the kit instructions to collect one small sample of poo using the sampling stick.
  3. The stick is returned to the labelled bottle and the sealed kit is posted to the laboratory in the packaging provided.
  4. The programme sends the result and explains any next step.

The test is completed at home and does not involve inserting anything into the body.

5. What your bowel screening result may mean

No further tests needed at this time

This means no blood was found, or the amount was below the programme threshold. It does not guarantee that you do not have bowel cancer. Contact your GP if you have symptoms or concerns, even after this result.

Further tests needed

This means the amount of blood found was at or above the programme threshold. It does not mean that you have cancer. The programme will contact you to discuss the result and further investigation, which may include a colonoscopy.

The test needs to be repeated

Sometimes another sample is needed because the kit could not be analysed or was not completed correctly. Follow the instructions in the result letter or contact the screening programme.

6. Benefits of bowel cancer screening

  • It can identify signs of bowel cancer before symptoms develop.
  • Finding cancer earlier may make treatment more effective.
  • It can find polyps that may be removed before they develop into cancer.
  • The first-stage FIT screening test is completed privately at home.
  • People with a result that needs investigation are offered a defined follow-up pathway.

7. Limitations and possible harms

Screening tests are not completely accurate. Understanding limitations is part of making an informed choice.

  • False-negative results can occur: FIT may not detect blood in the sample even when a bowel cancer or polyp is present.
  • False-positive results can occur: blood may be found for a reason other than cancer, leading to anxiety and further tests.
  • Further investigations have risks: colonoscopy is generally safe but can cause complications. The clinical team should explain these before a procedure.
  • Screening can give false reassurance: a result requiring no further tests does not rule out cancer now or in the future.
  • Screening and symptomatic FIT are different pathways: a screening FIT is not necessarily the same as a FIT requested by a clinician to investigate symptoms.

8. Bowel cancer symptoms

Symptoms can have many causes and do not necessarily mean cancer, but it is important to get checked. NHS-listed symptoms include:

  • a change in your usual poo, including softer poo, diarrhoea or constipation
  • needing to poo more or less often than usual
  • blood in your poo or bleeding from your bottom
  • tummy pain, bloating or a lump in your tummy
  • losing weight without trying
  • feeling unusually tired or short of breath, which may be signs of anaemia

Contact your GP if you have symptoms or a change that is not normal for you. Current NHS advice says to ask for an urgent GP appointment or use NHS 111 for black or dark-red poo or bloody diarrhoea, and to call 999 or go to A&E for severe or non-stop bleeding.

Read current NHS bowel cancer symptoms and urgent-action advice (external link, opens in a new tab)

9. Frequently asked questions

What age does bowel cancer screening start?
Eligibility differs by UK nation and can change. In England, current NHS programme guidance says people aged 50 to 74 who are registered with a GP and live in England are invited every two years. Check the current official guidance for the nation where you live.
What is a FIT test?
FIT stands for faecal immunochemical test. It looks for small traces of human blood in a sample of poo. Blood can have causes other than cancer, so a result that needs further tests is not a cancer diagnosis.
Is the FIT test painful?
No. The screening FIT kit involves collecting one small sample of poo at home. Nothing is inserted into your body.
How do I complete the FIT kit?
Follow the instructions supplied with your kit. You use the sampling stick to collect a small amount of poo, place it back in the bottle, label it as directed and return it in the prepaid packaging. Contact the screening helpline if you need support or an accessible format.
What happens if blood is found?
The screening programme will contact you about the next step. In England, this normally starts with an appointment with a specialist screening practitioner, and you may be offered a colonoscopy. Blood in poo can have causes other than cancer.
What happens if my result is normal?
A result saying that no further tests are needed means the amount of blood found was below the programme threshold. It does not rule out bowel cancer. You should still contact your GP if you have symptoms or concerns, and you will usually be invited again if you remain eligible.
Can I request a replacement screening kit?
In England, the NHS bowel cancer screening helpline can help if a kit has not arrived, has been lost or needs replacing. Use the contact details in your invitation or on the current NHS bowel cancer screening page.
What should I do if I have symptoms?
Contact your GP rather than waiting for a screening invitation or kit. Ask for an urgent GP appointment or use NHS 111 for black or dark-red poo or bloody diarrhoea. Call 999 or go to A&E for severe or non-stop bleeding, following current NHS advice.
Is a screening FIT test the same as a diagnostic FIT test?
Not necessarily. Screening FIT is offered through a population screening programme to eligible people without symptoms. A clinician may request FIT to help investigate symptoms, using a different pathway and potentially a different threshold. Follow the instructions and advice for the test you were given.
Does bowel screening detect every bowel cancer?
No. Screening tests are not completely accurate. A FIT result may not detect bleeding at the time the sample is taken, and some bowel cancers may not bleed. A result requiring no further tests does not rule out cancer now or in the future.

10. Evidence and references

This evidence list is designed to be expanded as the library develops. Sources were selected for authority, relevance and currency; programme details should always be checked at source.

11. Official NHS resources

Use these official sources for current eligibility, programme arrangements, results and support.

12. How BloomShield helps improve screening participation

Information alone does not remove every barrier. BloomShield’s connected programmes support understanding, equitable access and navigation across screening pathways.

ScreenAccess™

identifies and helps address practical, social and service barriers to screening access.

ScreenConnect™

supports navigation, coordination and continuity across screening and care pathways.

Work with BloomShield to improve screening access