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Bowel Cancer – What You Need to Know

Bowel cancer, sometimes called colorectal cancer, is one of the most common types of cancer in the UK. It usually develops in the large bowel (colon or rectum) and is most often diagnosed in people over 60, but it can affect younger people too.

Signs and Symptoms

It’s important to know the warning signs. See your GP if you notice:

  • Persistent change in bowel habit (such as needing to go more often, looser stools, or constipation)

  • Blood in your poo or bleeding from the bottom

  • Ongoing tummy pain, bloating, or discomfort after eating

  • Unexpected weight loss

  • Extreme tiredness without clear cause

Most people with these symptoms won’t have bowel cancer, but it’s always best to get checked. Early diagnosis saves lives.

Risk Factors

Some things can increase your risk, including:

  • Age (most cases are in people over 50)

  • Family history of bowel cancer

  • Medical conditions such as Crohn’s disease or ulcerative colitis

  • Lifestyle factors, including a low-fibre diet, high alcohol intake, smoking, and being overweight

Screening

The NHS offers a bowel cancer screening programme for people aged 56–74, with home testing kits sent every two years. Screening helps detect cancer early, even before symptoms appear, when treatment is most effective.

Diagnosis and Treatment

If bowel cancer is suspected, your GP may arrange tests such as:

  • Stool tests

  • Colonoscopy

  • CT scans

Treatment will depend on the stage and location of the cancer and may include:

  • Surgery – to remove the cancer

  • Chemotherapy and radiotherapy – to shrink or kill cancer cells

  • Targeted therapies – newer treatments aimed at specific cancer types

Reducing Your Risk

You can lower your chances of developing bowel cancer by:

  • Eating a healthy, high-fibre diet with plenty of fruit, vegetables, and wholegrains

  • Cutting down on processed and red meat

  • Staying physically active

  • Maintaining a healthy weight

  • Limiting alcohol and avoiding smoking

Getting Support

Being told you might have bowel cancer can be worrying. Support is available through your GP, NHS cancer teams, and charities such as Bowel Cancer UK and Macmillan Cancer Support.

FIT stands for Faecal Immunochemical Test.
 

• It detects hidden blood in/on stools, which can be an early sign of bowel cancer.

• The test can be set at different sensitivity levels to enable it to be used in different ways.

There are two types of FIT:
• FIT Bowel Cancer Screening
• FIT Bowel Symptomatic Testing
 

Specialist Screening Practitioner (SSP) Clinic appointment.

•Assessment
•Colonoscopy booked
•Bowel Prep provided
•Procedure Date Confirmed
•General Health Promotion Advice
•Outcomes from procedure
 

Key Differences between FIT Bowel Screening and FIT Symptomatic Testing

FIT Bowel Screening:
•Routine population screening – not patient initiated
•Targeted  population 50 – 74yrs -with no known symptoms
•Test invite every two years direct from the bowel screening hub

FIT Symptomatic Testing:
•Used when patient goes to GP with potential bowel cancer  symptoms
•Test is ordered by the GP and posted out by the lab
•Helps guide GP referral decisions
•Test threshold is more sensitive than bowel screening
 
Things to Note:
•Both kits look similar; process is the same other than who generates them and why
•Often seen as the same test
•Tests do not cancel each other out

Reassurance from negative bowel screening results – not presenting to GP when symptomatic

• Always complete and return your FIT screening kit if eligible
• Speak to your GP if you have symptoms, even if you recently did a screening test.
• FIT is a simple, non-invasive test that can help detect bowel cancer early.
• Early detection saves lives.
• Both tests look for hidden blood in poo, but they’re used in different ways.
• Screening is for healthy people to catch cancer early.
• Symptomatic testing helps doctors investigate symptoms quickly.
• Always return your test kit—it could save your life.
• Got symptoms go to the GP – even if last bowel screening was negative/clear
• Had a FIT from the GP still do your bowel screening

• Early Detection Saves Lives

More on FIT tests available further down this page.

FIT Test - Patient Information Leaflet - In Various Languages

The Faecal Immunochemical Test (FIT) detects traces of human blood in poo samples.

It is used to find early bowel cancer by the NHS Bowel Cancer Screening Programme and is a test for patients who attend their GP surgery with certain symptoms.

The short animation on this page has been produced by the Northern Cancer Alliance for patients who have been asked to a complete a test by their GP because they have presented with certain symptoms.

A patient information leaflet is also available here with instructions for collecting your sample.

This leaflet is also available in a number of different languages below.

FIT Animation Video - With Language Translations (Subtitles)

Urdu

Turkish

Tamil

Romanian

Bengali

Arabic

Gujarati

 

Hindi

Italian

Lithuanian

Polish

Who is eligible for bowel cancer screening in England?

Currently people aged 54 to 74 years who are registered with a GP and live in England are eligible for the NHS Bowel Cancer Screening Programme. We are gradually extending the age range, and expecting people aged 50 and 52 to also be invited as part of this process during 2024/25.

How do I get a Bowel Cancer Screening Test?

You will automatically receive a Faecal Immunochemical Test (FIT kit) for you to complete at home when you become eligible for the NHS Bowel Cancer Screening Programme. You will be sent a test every two years until you are 74 years old. If you would like to continue to receive a test once you become 75, you can inform the Bowel Cancer Screening Programme by contacting the free NHS Bowel Cancer Screening Helpline to request a FIT kit on 0800 707 60 60. If you have hearing or speech difficulties, you can use the Relay UK service to contact us. Dial 18001 then 0800 707 60 60 from your textphone or the Relay UK app.

What is a FIT aid?

The FIT aid is a tool that helps people complete their bowel cancer screening test. The FIT aid has a stand and a channel to guide the sample stick into the FIT kit. The FIT aid is currently being tested by people who are blind or partially sighted and/or have manual dexterity challenges.

Will everyone who is being invited to complete their bowel cancer screening be sent a FIT aid?

No, we are currently testing the FIT aid with people who are due to be invited to complete their bowel cancer screening between May 2024 and October 2024 and have registered that they need reasonable adjustments to complete their bowel cancer screening test. Participants are either blind or partially sighted and/or have manual dexterity challenges.

Who is eligible for a FIT aid?

We are currently testing the FIT aid with people who are due to be invited to complete their bowel cancer screening between May 2024 and October 2024. These people have registered that they need reasonable adjustments with the NHS Bowel

Cancer Screening Programme to complete their Bowel Cancer Screening Test because they are blind/partially sighted and/or have manual dexterity challenges.

When will the FIT aid be sent to me?

You will first receive a letter to let you know that you are due to complete the bowel cancer screening test. Your FIT aid will be sent to you after this letter and may arrive before the home test kit. If this happens, please keep it in a safe place.

The FIT aid will include instructions but if you require a different format contact the free NHS Bowel Cancer Screening Helpline to request it on 0800 707 60 60. If you have hearing or speech difficulties, you can use the Relay UK service to contact us. Dial 18001 then 0800 707 60 60 from your textphone or the Relay UK app.

Can I request instructions in a different format?

The FIT aid instructions are available in large print, audio CD, braille and email or text link to use with screen readers. If you require a different format, contact the free NHS Bowel Cancer Screening Helpline to request them on 0800 707 60 60. If you have hearing or speech difficulties, you can use the Relay UK service to contact us. Dial 18001 then 0800 707 60 60 from your textphone or the Relay UK app.

Did you consult with the blind and partially sighted community on this and to ensure the community’s view were considered?

Throughout the design and development of the FIT aid and instruction we have worked in partnership with the Royal National Institute of Blind People (RNIB), the Thomas Pocklington Trust and Parkinson’s UK. They supported us to test the design and instructions with a group of 30 people who were sent a FIT aid when completing their Bowel Cancer Screening in September 2023. Feedback from the small group has been incorporated into the current evaluation.

I haven’t received my FIT aid. What should I do?

If you have received a letter to inform you that you will receive a FIT aid, please contact the free NHS Bowel Cancer Screening Helpline to request a FIT aid on 0800 707 60 60. If you haven’t been sent a FIT aid but feel you would like to try it to see if

it helps you to complete your test kit, please call the NHS Bowel Cancer Screening Helpline on 0800 707 60 60. If you have hearing or speech difficulties, you can use the Relay UK service to contact us. Dial 18001 then 0800 707 60 60 from your textphone or the Relay UK app.

How will I know I am going to receive a FIT aid?

If you are due to receive a FIT aid, you will be sent an additional letter with your pre invitation letter. The letter will tell you that you will receive a FIT aid in the post either before or after you get your FIT kit. You will also be given information about how to request the instructions in a different format and opt out of receiving a FIT aid.

Will this change how I do my bowel cancer screening test?

You will still receive the FIT kit to complete your bowel cancer screening test, but you will also receive a FIT aid which has a stand and channel for you to place the FIT kit in and help you guide the sample stick into the FIT kit bottle.

I want to provide feedback about the FIT aid. Who should I contact?

Please contact the free NHS Bowel Cancer Screening Helpline on 0800 707 60 60 to give feedback on the FIT aid and/or the instructions. All feedback is very welcome to help us improve the service we provide. If you have hearing or speech difficulties, you can use the Relay UK service to contact us. Dial 18001 then 0800 707 60 60 from your textphone or the Relay UK app.

Why can’t the FIT test bottle be made bigger and easier to use?

The analyser machine that is used to test the samples in the laboratory require the test bottles to be a particular size to fit in the machine. The neck of the bottle is small to avoid the liquid inside the bottle spilling out.

Can I request a FIT aid from the NHS Bowel Cancer Screening Programme?

If you have received your FIT kit and you think a FIT aid might help you to complete your screening kit, please contact the free NHS Bowel Cancer Screening Helpline to request a FIT aid on 0800 707 60 60. If you have hearing or speech difficulties, you can use the Relay UK service to contact us. Dial 18001 then 0800 707 60 60 from your textphone or the Relay UK app.

How do I notify the NHS Bowel Cancer Screening Programme that I need reasonable adjustments?

If you need reasonable adjustments to access NHS bowel cancer screening, you can have this added to your record for your current screening invitation and future invitations, by contacting the free NHS Bowel Cancer Screening Helpline on 0800 707 60 60. If you have hearing or speech difficulties, you can use the Relay UK service to contact us. Dial 18001 then 0800 707 60 60 from your textphone or the Relay UK app.

How do I request my invitation letter and results in an accessible format?

If you do not receive a letter in an accessible format, you can contact the free NHS Bowel Cancer Screening Helpline to request an accessible version on 0800 707 60 60. If you have hearing or speech difficulties, you can use the Relay UK service to contact us. Dial 18001 then 0800 707 60 60 from your textphone or the Relay UK app.

Can I request a FIT kit and FIT aid if I have symptoms?

If you are showing symptoms such as changes in poo, needing to poo more often, blood in poo and tummy pain, you should contact your GP immediately. If you are

subsequently given a FIT kit, this would be a standard kit as the FIT Aids are only available for those people receiving a FIT kit via the NHS Bowel Cancer Screening Programme.

How do I or someone I know access sight loss counselling services?

The RNIB has a Helpline as a first point of contact for anyone who seeks information or support about sight loss, products and services. This includes people with sight loss, their friends, family or carers.

People can call the RNIB Helpline on 0303 123 9999 Monday-Friday 8am-8pm and Saturday 9am-1pm.

Is this available in Northern Ireland, Scotland and Wales?

England is the first country to design a tool to help people complete their bowel cancer screening test. The FIT aid has been designed and developed based on the test that is used in England. However, we will be sharing our evaluation with the other UK nations.

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