What you need to know about bowel cancer screening

Bowel cancer, or colorectal cancer, is one of the UK’s most common types of cancer. Screening, which can lead to early detection, significantly improves outcomes and survival rates. It also involves testing for signs of cancer in people who don’t have symptoms. By identifying abnormalities early, treatment can begin sooner, which is key to preventing the disease from progressing.

What is bowel cancer screening?

Bowel cancer screening is a routine test used to check for the presence of cancerous or pre-cancerous cells in the bowel. The screening process involves testing a stool sample for traces of blood, which can be an early sign of bowel cancer. If blood is detected, further tests, such as a colonoscopy, are usually recommended to examine the inside of the bowel and confirm any abnormalities.

Two main types of screening are offered:

• Faecal Immunochemical Test (FIT): This is the most common screening test. It detects small amounts of blood in stool samples, which may not be visible to the naked eye.
• Bowel scope screening: Also known as flexible sigmoidoscopy, this test involves using a thin, flexible tube with a camera to look inside the lower part of the bowel. It can detect polyps, which can sometimes develop into cancer.

Who is eligible for bowel cancer screening?

In the UK, bowel cancer screening is offered to people in certain age groups:

• England, Wales, and Northern Ireland: People aged 60 to 74 are invited to complete the FIT test every two years. However, in England, there are plans to lower the starting age to 50 over time.
• Scotland: Screening is offered from age 50 to 74 using the FIT test every two years.

People over 74 can request a test by contacting their screening helpline. Individuals with a family history of bowel cancer or other risk factors may be advised to undergo screening earlier or more frequently.

Why is bowel cancer screening important?

Bowel cancer screening is important because it helps detect the disease at an early stage when treatment is more likely to be effective. Many cases of bowel cancer do not present symptoms until the later stages, making early detection through screening essential. Some of the key benefits include:

• Detecting cancer early: When detected early, the survival rate for bowel cancer is much higher. Screening can identify cancers before symptoms develop, improving the chances of successful treatment.
• Identifying pre-cancerous polyps: Screening can find polyps in the bowel, which are small growths that can develop into cancer over time. Removing these polyps can prevent cancer from developing in the first place.
• Improving survival rates: In cases where bowel cancer is detected early, patients have a 90% chance of survival for five or more years after diagnosis. Screening plays a vital role in increasing these survival rates.

What are the signs to look out for?

While screening is important, it's also useful to be aware of symptoms that could indicate bowel cancer. These include:

• Persistent changes in bowel habits, such as diarrhoea or constipation
• Blood in the stool, which may appear bright red or dark
• Unexplained weight loss
• Abdominal pain or discomfort
• Fatigue or weakness

If you experience any of these symptoms, it’s important to contact your GP, even if you’re not due for a screening.

How reliable is bowel cancer screening?

The bowel cancer screening tests, especially the FIT test, are highly effective at detecting early signs of cancer. However, no screening test is 100 per cent accurate, and false positives or negatives can occur. A positive result on the FIT test doesn’t necessarily mean you have cancer, but it does indicate that further tests, such as a colonoscopy, are needed to investigate the cause of bleeding.

Conversely, a negative result doesn’t guarantee that you are cancer-free. It’s essential to remain vigilant for any symptoms and continue attending regular screening appointments.

What happens if your screening result is abnormal?

If your screening result is abnormal, you will be invited to undergo further testing, usually a colonoscopy. This is a procedure that allows a doctor to examine the inside of your bowel and remove any polyps or suspicious growths. While the prospect of additional tests can be daunting, it’s important to remember that an abnormal screening result doesn’t always mean cancer is present. Most abnormalities found during colonoscopy are benign.

Can bowel cancer be prevented?

While screening is crucial for detecting bowel cancer early, there are steps you can take to reduce your risk of developing the disease. Some lifestyle changes that can help prevent bowel cancer include:

• Eating a healthy, balanced diet with plenty of fibre
• Limiting red and processed meat consumption
• Maintaining a healthy weight
• Exercising regularly
• Quitting smoking and reducing alcohol intake

It’s important to have a bowel cancer screening if you meet the requirements. It could save your life. Always stay aware of the symptoms and seek medical advice if you notice any changes in your bowel habits or overall health.