Bowel Cancer Screening

Overview

Bowel cancer screening is a way to check people who have no symptoms for early signs of bowel cancer. It aims to find cancer early, when treatment is more likely to work. Screening can also find small growths called polyps, which can be removed before they become cancer.

Bowel cancer is one of the most common cancers, but screening is routine and can save lives.

Screening is usually offered to adults between 50 and 74, and some people at higher risk may start younger. It affects men and women equally.

Symptoms

Common symptoms

• A change in your normal bowel habit lasting three weeks or more
• Blood in your stool or bleeding from your bottom
• Losing weight without trying
• A feeling that you have not fully emptied your bowel after passing stool

Symptoms in children

• Screening is not for children. If you are worried about a child's bowel symptoms, speak to their doctor.

Symptoms in older adults

• People over 75 may no longer be invited for screening, but you can still request a kit or speak to your doctor if you have symptoms.
• Older adults may experience constipation or blood in stool and should not dismiss these as just 'old age'.

Causes

Main causes

• Bowel cancer has no single cause. It happens when cells in the lining of the bowel grow out of control.
• Screening looks for early warning signs, not for the cause of cancer.

Risk factors

• Age (most cases occur in people over 50)
• Family history of bowel cancer
• A diet high in red or processed meat and low in fibre
• Being overweight or inactive
• Smoking and heavy drinking
• Long-term conditions like inflammatory bowel disease

When to see a doctor

See a doctor urgently if:

• If you have any blood in your stool
• If your bowel habit has changed for three weeks or more
• If you have severe stomach pain or vomiting

Book a routine appointment if:

• If you have received a screening invitation, do the test at home or contact your doctor to arrange it.
• If you are over 75 and wish to be screened, ask your local health service.

Diagnosis

Screening starts with a home test kit. You use a small stick to take a tiny sample of your stool and post it to a lab. If there is hidden blood, you are offered a colonoscopy. A colonoscopy can see the inside of your bowel and remove any polyps found.

Tests that may be done

• Faecal immunochemical test (FIT) — the home test kit that looks for hidden blood in your stool
• Colonoscopy — a thin, flexible tube with a camera is passed into your bowel
• Flexible sigmoidoscopy — a shorter tube that checks the lower part of the bowel
• CT scan — in some cases, to look at the bowel in more detail

What to expect at your appointment

The home test is quick and painless. If you need a colonoscopy, you will be given instructions to empty your bowel beforehand. You will usually be awake but relaxed. It takes about 30 minutes. Most people find it uncomfortable but not painful.

Treatment

If screening finds polyps, they can often be removed during a colonoscopy. If cancer is found, treatment plans depend on the stage, your general health, and your preferences. Treatment usually involves surgery, and may include radiotherapy or chemotherapy.

Self-care at home

• Do the screening test promptly if you receive it
• Tell your doctor if you have any symptoms, even if your screening test was normal
• Keep a record of your bowel habits if you have concerns
• Ask a family member or friend to join you at appointments if you feel anxious

Medical treatments

Treatment is planned by a team of specialists. For early bowel cancer, surgery to remove the affected part of the bowel is common. More advanced cancer may be treated with chemotherapy (medicines that kill cancer cells), radiotherapy (high-energy rays), or targeted therapy. Your doctor will explain the options and possible side effects.

When is surgery considered?

Surgery is often the main treatment for bowel cancer. It may be done using small cuts (keyhole surgery) or a larger cut. You may need a temporary bag (stoma) while the bowel heals.

Living with this condition

If you have had a polyps removed or treatment for cancer, you will have regular check-ups. Most people return to a normal routine, but you may need to rest more at first. Follow the advice from your care team.

Lifestyle tips

• Keep active — walking or moderate exercise helps recovery
• Eat a balanced diet with plenty of fruit, vegetables, and whole grains
• Limit red and processed meat
• Avoid smoking and limit alcohol
• Drink plenty of fluids, especially if you have had a colonoscopy

Diet and exercise

A diet high in fibre and low in processed foods supports bowel health. Regular exercise can reduce the risk of bowel cancer and help you feel better during recovery. Aim for 150 minutes of moderate activity per week, adjusted to what you can manage.

Mental health and emotional wellbeing

Waiting for screening results or dealing with an abnormal result can create anxiety. It is normal to feel worried. Talk to your doctor or a specialist nurse about your concerns. Anger, fear, and sadness are common—and so is support.

Prevention

Bowel cancer cannot always be prevented, but screening can reduce the chance of dying from it. Removing polyps before they become cancer can prevent the disease. Healthy habits also help.

Screening programmes

Screening is offered every two years in many countries to adults in a certain age range. If you are eligible, you will receive a home testing kit in the post or be invited to collect one. If you are not sure, ask your local health service.

Complications

If left untreated

• If bowel cancer is left undiagnosed, it can grow into the bowel wall and spread to other parts of the body.
• Cancer can cause a blockage (obstruction) in the bowel.
• Advanced cancer is harder to treat and may cause severe pain, bleeding, and weight loss.

Long-term outlook

When bowel cancer is found at the earliest stage, treatment is successful for most people. Even if it has spread further, treatment can often control it for a long time. Screening helps find it early.

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