Bowel cancer screening FIT

Overview

Bowel cancer, also called colorectal cancer, is a cancer that starts in the large bowel (colon) or back passage (rectum). The FIT (Faecal Immunochemical Test) is a screening test that looks for hidden blood in your poo, which can be an early sign of bowel cancer. It is a simple, non-invasive test you do at home.

Bowel cancer is one of the most common cancers in the UK and worldwide. About 1 in 15 men and 1 in 18 women will develop it in their lifetime.

It mainly affects people over 50, but it can occur at any age. The FIT screening is usually offered to people aged 50 to 74, though some areas start earlier for those at higher risk.

Symptoms

Common symptoms

• A change in your bowel habits that lasts more than three weeks (like going more often or looser poo)
• Blood in your poo (dark or bright red)
• Unexplained weight loss
• Tiredness or feeling out of breath (due to low iron levels)
• A lump in your tummy or back passage

Symptoms in children

• Bowel cancer is extremely rare in children. If a child has these symptoms, it is usually due to other causes like infections or food allergies. Always talk to a doctor.

Symptoms in older adults

• In older adults, symptoms are the same but may also include constipation or feeling like you need to poo even after going.
• Older adults may be less likely to notice subtle changes, so regular screening is important.

Causes

Main causes

• The exact cause is unknown, but bowel cancer often starts from growths called polyps inside the bowel. Not all polyps become cancer, but some can over time.

Risk factors

• Age over 50
• A family history of bowel cancer
• A diet high in red or processed meat
• Being overweight or obese
• Smoking
• Drinking alcohol regularly
• Having a long-term bowel condition like Crohn’s disease or ulcerative colitis

When to see a doctor

See a doctor urgently if:

• If you see blood in your poo, find a lump in your tummy, or have had a bowel habit change for three weeks or more, see a doctor promptly.

Book a routine appointment if:

• If you are aged 50 to 74 and have not yet been offered screening, ask your GP about it. You can also request a FIT test if you are younger and concerned.

Diagnosis

The first step is usually the FIT test, which you do at home by collecting a small sample of your poo and sending it to a lab. If the result is abnormal (shows hidden blood), you will be offered a colonoscopy to look inside your bowel.

Tests that may be done

• FIT (Faecal Immunochemical Test) – a home stool test
• Colonoscopy – a thin, flexible tube with a camera is passed into your bowel to see the lining and take samples (biopsies) if needed
• Biopsy – a small piece of tissue is taken during colonoscopy and checked under a microscope

What to expect at your appointment

For the FIT test, you will receive a kit with instructions. You collect a tiny sample of poo on a stick or card, put it in a plastic container, and post it to a lab. You can eat and drink normally. The result usually arrives by letter in a few weeks. If you need a colonoscopy, you will be given instructions to empty your bowel beforehand, and the test is usually done with sedation to keep you comfortable.

Treatment

If bowel cancer is found, treatment depends on the stage (how far it has spread) and your general health. The main options are surgery, chemotherapy, and radiotherapy. Your healthcare team will create a plan tailored to you.

Self-care at home

• Eat a balanced diet with plenty of fibre (fruits, vegetables, whole grains)
• Stay as active as you can – gentle walking after treatment can help
• Drink plenty of water to stay hydrated
• Attend all follow-up appointments and tests

Medical treatments

Treatments may include surgery to remove the cancer and nearby lymph nodes, chemotherapy (drugs that kill cancer cells, usually given in cycles), and radiotherapy (high-energy rays aimed at the cancer). Your doctor will explain which treatments are recommended for your situation. No specific drug names or doses are mentioned here.

When is surgery considered?

Surgery is often the main treatment for early-stage bowel cancer. The surgeon removes the part of the bowel containing the cancer and joins the healthy ends together. In some cases, you may need a temporary or permanent stoma (a bag on your tummy to collect poo).

Living with this condition

Many people live well after bowel cancer treatment. You may need to manage changes in bowel habits, such as looser or more frequent poo. Some people have a stoma, which takes time to adjust to but does not stop you from doing most activities.

Lifestyle tips

• Eat a healthy, high-fibre diet to keep your bowels regular
• Stay physically active – aim for at least 30 minutes of moderate exercise most days
• Limit red and processed meat, and avoid smoking
• Drink less alcohol (if you drink, stick to the recommended limits)

Diet and exercise

A diet rich in fruits, vegetables, and whole grains can help with recovery and reduce the risk of the cancer coming back. Regular exercise also lowers that risk and improves energy and mood.

Mental health and emotional wellbeing

A cancer diagnosis can cause anxiety, sadness, or stress. It is normal to feel worried. Talk to your doctor about counselling or support groups. Many people find it helpful to share experiences with others who have been through similar treatment.

Prevention

Not all cases of bowel cancer can be prevented, but a healthy lifestyle can lower your risk. The most effective way to prevent bowel cancer from becoming serious is through screening, which can find polyps before they turn into cancer and remove them.

Screening programmes

Bowel cancer screening using the FIT test is offered every two years to everyone aged 50 to 74 in the UK. It is a simple, free test that can detect cancer early or find polyps that can be removed. If you are outside this age range but worried, talk to your doctor about your options.

Complications

If left untreated

• If bowel cancer is not treated, it can grow deeper into the bowel wall and spread to nearby lymph nodes or other organs, such as the liver or lungs, making it much harder to treat.

Long-term outlook

When bowel cancer is found early through screening, the outlook is very good – over 90% of people survive for five years or more. Even when it is found at a later stage, treatments have improved greatly, and many people live for many years with good quality of life.

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