Bowel Cancer Awareness Month: Why Early Testing Could Save Your Life

What is bowel cancer?

Bowel cancer, also called colorectal cancer, usually means cancer that starts in the colon or rectum. Together, these make up most of the large bowel. It is different from cancer of the small bowel or anus.

Some bowel cancers develop from polyps, which are small growths on the bowel lining. A polyp is not automatically cancer, and many never become cancer. Some types, however, can change over time, which is one reason screening can help find and remove certain polyps before they cause a problem.

Early bowel cancer does not necessarily cause obvious symptoms. That is why the NHS offers screening to people without symptoms, while people who do have symptoms should contact a GP rather than waiting for their next screening invitation. Cancer Research UK explains more about bowel cancer and how it develops.

Why early detection matters

Earlier diagnosis can give doctors more treatment options, but survival figures are not a promise about what will happen to one person. Cancer Research UK’s England figures are population statistics for people diagnosed between 2016 and 2020 and followed up to 2021. They show the proportion surviving bowel cancer for five years or more after diagnosis:

These are five-year survival statistics, not a “cure rate”, and they cannot predict an individual outcome. They do show why finding bowel cancer before it has spread can matter. Cancer Research UK also reports that only 47% of bowel cancers with a known stage in England in 2022 were diagnosed at stages I or II. Read the full Cancer Research UK survival figures.

Bowel cancer symptoms

NHS guidance lists several possible symptoms. They can be caused by conditions other than cancer, but new, persistent or concerning changes should be assessed by a healthcare professional:

• softer poo, diarrhoea or constipation that is not usual for you
• needing to poo more or less often than usual
• blood in your poo, which may look red or black
• bleeding from your bottom
• often feeling that you still need to poo after going
• tummy pain, a lump in your tummy or bloating
• unexplained weight loss
• feeling very tired or short of breath, which can be linked to anaemia

Having these symptoms does not mean you have bowel cancer. It does mean you should not try to diagnose yourself or dismiss a change that is worrying you. Read our full guide to the early signs of bowel cancer for a more detailed symptom overview.

Can bowel cancer cause blood you cannot see?

Visible blood may look bright red, darker red or black, depending on where bleeding occurs. But very small amounts of blood can also be present without being visible to the naked eye. This is often called occult blood or hidden blood.

FIT looks for human haemoglobin in a stool sample, including small amounts that may not be visible. Blood in poo does not automatically mean bowel cancer. Bleeding can have several causes, including conditions affecting the anus, rectum or bowel. The result still needs to be understood in the context of symptoms and, where necessary, further clinical assessment.

If you are specifically researching blood in the toilet or bowel cancer in a younger adult, our article about a 39-year-old whose warning sign was blood in the toilet explores why age should not be used to dismiss unexplained bleeding.

What is a FIT test?

FIT stands for faecal immunochemical test. It checks a poo or stool sample for small quantities of human blood, measured as haemoglobin. The blood may be too small in amount to see.

FIT is used in NHS bowel cancer screening and in symptomatic clinical pathways. It helps clinicians decide whether further investigation may be appropriate. FIT detects blood; it does not detect cancer cells, and a FIT result by itself is not a diagnosis of bowel cancer.

In a clinical pathway, a quantitative FIT result may be reported as micrograms of haemoglobin per gram of faeces. NICE recommends referral through the suspected cancer pathway for a symptomatic adult with a FIT result of at least 10 micrograms of haemoglobin per gram of faeces. That clinical threshold must not be assumed to be interchangeable with a qualitative rapid home test result.

NHS guidance on bowel cancer symptoms and NICE guideline NG12 explain how FIT fits into assessment.

How NHS bowel cancer screening works

In England, routine NHS bowel cancer screening is currently offered to people aged 50 to 74 every two years. The NHS sends a FIT kit to the home, the person collects a small poo sample, and the sample is returned for laboratory analysis. The laboratory checks for blood and sends a result explaining whether further tests are needed.

People aged 75 and over can request screening every two years through the NHS bowel screening service. The NHS describes screening as being for people who may not have symptoms. If you have symptoms, contact your GP rather than waiting for a kit or using screening as a substitute for medical advice.

Screening arrangements across the UK

Programmes are not identical in every UK nation. Scotland offers FIT screening every two years to people aged 50 to 74, with people aged 75 and over able to request a kit. Wales offers screening every two years to people aged 50 to 74. Northern Ireland currently offers screening every two years to people aged 60 to 74. Check the current guidance for England, Scotland, Wales or Northern Ireland.

NHS screening is finding around 100 bowel cancers every week

The NHS England Bowel Cancer Screening Annual Report for 2024/25 recorded 7,963,115 people in the invited population, with 5,195,407 adequately participating. That produced overall uptake of 65.2%. The programme diagnosed 5,170 people with cancer during the year, equivalent to around 100 diagnoses a week. Uptake was 56.2% among 54-year-olds and 73.5% among people aged 70 to 74.

These figures are for England’s programme and its 1 April 2024 to 31 March 2025 reporting year. They are not a guarantee that screening will find every cancer, but they show the practical value of returning an NHS kit when it arrives. NHS England summarised the 2024/25 results and the age-related uptake gap.

What is a home bowel health test?

Some rapid self-tests also check a stool sample for hidden blood at home. They can be useful as a quick source of bowel-health information, but they are not the same process as NHS screening and they do not diagnose bowel cancer.

The U-Test Bowel Health Test Kit is a home stool test intended to detect hidden blood. The current product information describes a result in under 10 minutes when used according to the supplied instructions. Follow the packaging instructions carefully and record the result.

A rapid self-test does not replace NHS screening, a GP assessment, a laboratory FIT, colonoscopy or any other investigation that a healthcare professional considers appropriate. It should be viewed as one piece of information, not a medical verdict.

Explore the U-Test Bowel Health Test Kit for hidden blood in stool →

NHS FIT screening vs a rapid home bowel test: what’s the difference?

Neither should be described as automatically “better”. They answer different questions in different pathways. Do not assume that a rapid home test uses the same threshold or clinical pathway as a quantitative NHS FIT.

What does a positive bowel test or FIT result mean?

It means blood has been detected at or above the relevant test’s threshold. It does not mean that bowel cancer has been diagnosed.

Blood can have several causes, including polyps and other bowel or anorectal conditions. An abnormal NHS screening result is followed up through the screening pathway; further assessment may include a colonoscopy, which allows the bowel lining to be examined and can allow polyps to be removed or tissue to be sampled where appropriate.

If a U-Test result is positive, contact your GP or another appropriate healthcare professional. Tell them which self-test you used, when you used it and what the result showed. Do not assume a positive home test guarantees an NHS referral. For a practical explanation of next steps, read what a positive test result can mean.

Does a negative FIT or home bowel test rule out bowel cancer?

No. A negative result does not completely rule out bowel cancer.

A negative result means that the test did not detect blood at its relevant threshold in that sample. It does not prove that no disease is present, and it does not explain persistent or worsening symptoms.

NICE says that where a symptomatic person has a FIT result below 10 micrograms of haemoglobin per gram of faeces, safety-netting should be in place. Referral should not be delayed if there is strong clinical concern because of ongoing unexplained symptoms. That quantitative clinical threshold cannot be transferred directly to a qualitative U-Test result.

If symptoms continue, change or worsen, arrange medical assessment even if a previous NHS screening test or home test was negative. Read the relevant NICE recommendations.

See the home bowel health test kit →

What happens after an abnormal NHS bowel screening result?

The NHS screening team contacts the person and arranges further assessment. A specialist screening practitioner may discuss the result and medical history. Many people who have blood detected do not have cancer, but the source of the bleeding needs to be investigated.

Further investigation may include a colonoscopy. This uses a flexible camera to examine the inside of the large bowel. Polyps may sometimes be removed during the procedure, and tissue can be sampled for laboratory analysis when appropriate. The exact next step depends on the person’s health, symptoms, test result and the screening pathway.

The NHS explains what screening results mean, while Cancer Research UK outlines the tests used when bowel cancer is suspected.

Can people under 50 get bowel cancer?

Yes. Bowel cancer remains much more common in older people, but age does not make persistent symptoms or unexplained bleeding irrelevant. Bowel Cancer UK reports that more than 2,900 people under 50 are diagnosed with bowel cancer in the UK each year. It also reports that rates in people aged 25 to 49 have increased by 51% since the early 1990s, while rates in people aged 50 and over have remained stable.

These figures do not mean bowel cancer is common in younger adults or that every symptom is cancer. They do mean that “you are too young” is not a safe reason to dismiss a change that needs checking. Read the supporting article about bowel cancer in a younger adult and blood in the toilet.

When should you contact a GP about bowel symptoms?

NHS advice is to get checked if you have symptoms of bowel cancer. A GP may ask about your symptoms, examine you, arrange a blood test or FIT, and decide whether further investigation or referral is needed.

Do not delay urgent care to use a home test. Read the full NHS symptoms and urgent-care guidance.