What are the most common symptoms of bowel cancer, and how does the bowel cancer screening test process work in the UK for those worried about their health?

6 minute read

Bowel cancer is the fourth most common type of cancer in the UK and around 268,000 people in the UK are living with a diagnosis of bowel cancer.

Despite its prevalence, when caught in the early stages, bowel cancer is usually treatable. Routine screening for bowel cancer is a vital step in the early detection of the disease.

The NHS in England currently screens people between the ages of 60 and 74 by sending a home test kit every two years. The screening programme is gradually being expanded to lower the age of routine screening to 50 by 2025. In Scotland, screening already includes people aged 50 to 74. Despite a government campaign highlighting the importance of screening, around a third of people still aren’t returning their completed tests and run the risk of developing advanced bowel cancer that is harder to treat.

What is bowel cancer?

Cancer is a condition where body cells behave abnormally and grow out of control, sometimes spreading to other parts of the body. Bowel cancer is a type of cancer that affects any part of the colon or rectum (large bowel).

What are the symptoms of bowel cancer?

Bowel cancer may not have any obvious symptoms in the early stages, which is why screening for the disease is so important. The symptoms of bowel cancer can also be similar to those of other diseases, so if you have any of the following symptoms, see a doctor to ensure you get an accurate diagnosis.

Symptoms of bowel cancer may include:

• A change in your bowel habits (moving your bowels more or less often, diarrhoea or constipation)

• Changes in your poo, such as having softer or harder poo, or thin stools

• Blood in your poo, on the toilet paper, or in the toilet bowl which may look red or black

• Bleeding from your bottom

• Feeling like you need to open your bowels, even if you’ve just been to the toilet, or feeling your bowels aren’t completely empty after using the toilet

• Abdominal pain

• Bloating

• Unexplained weight loss

• Fatigue

• Anal or rectal pain

• A lump in the anus or rectum

• Anaemia

• A blockage in the bowel

Who is at risk of bowel cancer?

Sometimes bowel cancer can develop with no obvious cause. However, you may be at a higher risk of developing bowel cancer if you:

• Are over 50 years of age

• Have a family history of bowel cancer

• Smoke

• Are overweight

• Drink excessive amounts of alcohol

• Eat a diet low in fibre, fruit, and vegetables

• Eat a diet high in fat and processed meats

• Don’t take regular exercise

• Have certain medical conditions such as inflammatory bowel disease, bowel polyps, Lynch Syndrome or familial adenomatous polyposis

What is the test for bowel cancer?

The test for bowel cancer is quick and simple and can be done at home. Unlike tests for other cancers, you can carry out the test yourself.

The NHS uses the faecal immunochemical test kit, or FIT kit. This test looks for traces of blood in your poo, which may be an early sign of bowel cancer.

What does the test involve?

The bowel screening kit involves taking a small sample of your poo and sending it to a laboratory for testing in the envelope provided.

Full instructions come with the FIT kit. You can also find instructions on GOV.UK or watch this short NHS video:

Where can I get a home test for bowel cancer?

If you’re registered with a GP and within the eligible screening age range, you will receive a test through the mail. If you are over 74, you can request a bowel screening kit every two years by calling the free government helpline on 0800 707 60 60.

People under the eligible range aren’t normally routinely screened for bowel cancer as it’s much less common in people under the age of 50. However, if you are worried about bowel cancer, or have symptoms of the disease, make an appointment with your GP.

Who is eligible for bowel cancer screening in the UK?

In England, the NHS currently screens people aged 60 to 74 years. Since April 2021, the screening programme is being gradually expanded to include people from 50 to 59 years. People aged 56 and 58 are currently being invited to take part in screening as part of this expansion.

In Scotland, screening starts from age 50.

In Wales, screening is offered to people between 51 and 74.

In Northern Ireland, people over the age of 60 are eligible for screening.

How long do the bowel cancer screening test results take?

The results of the test are normally ready within two weeks of sending off your sample. If you do not receive your result within two weeks, call the free NHS bowel cancer screening helpline on 0800 707 60 60.

Getting your results

There are two types of results from bowel cancer screening:

1. No further tests needed - around 98% of people screened do not need to have further tests

2. Further tests needed - around 2% of people screened need to have further tests

No further tests needed - what does this mean for you?

If you receive this result, it means that no blood or an insignificant amount of blood was found in your sample, and you don’t need to have any further tests at this time. You will be screened again in two years’ time.

This result is not a guarantee that you do not have bowel cancer. If you have symptoms of bowel cancer, always make an appointment to see your GP. Even if your screening result was clear.

Further tests needed - what does this mean for you?

This result means blood was found in your sample and you need to have more tests to determine the cause. It doesn’t mean you have bowel cancer and is more likely to be due to another condition like haemorrhoids (piles), an anal fissure, or inflammatory bowel disease.

If this is the result of your test, you’ll be offered an appointment to have a colonoscopy. This is a procedure where a thin tube with a camera is passed into your bottom to examine your bowel.

How often should I get tested for bowel cancer?

The NHS currently invites people in the eligible age range to be screened for bowel cancer every two years. If you have symptoms of bowel cancer, always make an appointment with your GP, even if you are outside the eligible age range for screening or have already been screened.

Bowel cancer is one of the most common types of cancer in the UK. The NHS bowel cancer screening programme aims to detect cancer in the early stages by providing free bowel cancer testing for those at the highest risk of the disease. Early diagnosis of bowel cancer allows for early intervention and treatment that can be lifesaving.

If you’ve received your bowel cancer screening test kit, don’t put it off for another day (keep it next to the toilet to remind you). If you are worried about bowel cancer, or have symptoms of the disease, even if you are not eligible for screening, or have already done a test, make an appointment to see your GP.