Research shows bowel screening can stop you getting cancer

Taking a home bowel cancer test could stop you from developing cancer in the first place, research has discovered.

The study, published in the Colorectal Disease Journal, has shown that 20,000 cases of bowel cancer – also known as colorectal cancer – have been prevented since the bowel cancer screening programme was introduced in England in 2006.

There was already good evidence that screening can detect bowel cancer, which can then be treated, and reduce death rates as a result. Now it’s been shown that the screening can detect polyps that could later develop into cancer, which can then be removed, and this has led to a fall in cancer cases.

Screening is reducing the rate of bowel cancer

Corrie Drumm, head of policy and influencing (England) at Bowel Cancer UK, said: “It’s wonderful to see the impact that the screening programme has had on reducing the rate of bowel cancer in England.”

Researchers from the University of Bristol and University Hospitals Bristol and Weston NHS Foundation Trust used data from the National Cancer Registration and Analysis Service database to look at the frequency of bowel cancer between 2001 and 2017 (before and after the screening programme was introduced).

Results showed that rates of cancer in the lowest part of the large bowel have decreased by almost 15%. This is equivalent to around 20,000 patients who didn’t get bowel cancer as a result of testing. The findings also showed that the biggest reductions were in men and in people living in the most deprived areas.

"This is the first evidence that the screening programme has reduced the number of people who develop the disease."

Adam Chambers, one of the study’s lead authors and an academic clinical lecturer in colorectal surgery at the University of Bristol, said: “It has been known for some time that the programme reduces mortality from bowel cancer through identifying tumours at an earlier stage. However, this research is the first evidence of the screening programme reducing the number of people who develop the disease.”

Drumm said the uptake of bowel cancer screening has increased since the current test was introduced in 2019.

“Therefore, the effect on bowel cancer rates in relation to the current screening programme could be higher than this study suggests.”

Despite this, the authors found that the reduction was minimal in cancers of the highest part of the colon. This is because polyps in this area are harder to detect and remove during a colonoscopy. 

How can you get a bowel cancer test kit and why?

Currently, everyone between the ages of 60 and 74, who is registered with a GP and lives in England, is automatically sent an NHS bowel cancer screening kit every two years.

In 2018, the NHS committed to lowering the screening age to 50. This is happening gradually and began in 2021 with 56-year-olds. The programme has also started to include 58-year-olds and the phased roll out to 50-year-olds is due to finish in 2025.

"The bowel cancer screening programme saves lives."

In Scotland, bowel cancer screening already begins at the age of 50 and you will be invited to take part every two years until you reach the age of 74.

In Wales, those aged 55-74 are invited to take part in screening every two years.

And, in Northern Ireland, people over the age of 60 are invited to take part in screening every two years.

Dr Anisha Patel, a GP who was diagnosed with bowel cancer in 2018, believes doing a bowel cancer test is a “no-brainer". She urges people to do theirs when they get the opportunity.

“This screening programme saves lives, and it detects cancer before people have symptoms. If bowel cancer is caught early, it’s a treatable and curable disease with a very good prognosis.

“It’s critical that we nudge our partners and relatives to do a test and not feel embarrassed to talk about it, because pooing is something that we all do. I'd rather do the test and have my life saved than endure everything I have and still go through."

Dr Lisa Wilde, director of research and external affairs at Bowel Cancer UK, adds: “Screening is one of the best ways to detect bowel cancer early, and in some cases prevent it from developing in the first place.

"So, if you're invited for screening, please do take part, as it could save your life. And if you’ve lost your kit or thrown it away, you can request a new one by visiting the NHS bowel cancer screening website.”

How does bowel cancer develop and how can we tackle it?

Most bowel cancers develop from polyps in the large intestine over a 10- to 15-year period. Many polyps are harmless, but screening can help to spot the ones most likely to turn into cancer.

Bowel cancer is the fourth most common cancer in the UK, with almost 43,000 cases diagnosed every year. While bowel cancer can happen at any age, more than nine out of 10 new cases (94%) are diagnosed in people over the age of 50.

Dr Patel said: “The reduction of bowel cancer cases highlighted in this study is amazing and very encouraging.” But she says there is still more to be done in terms of encouraging people to do bowel cancer tests.

"A third of people who are sent testing kits don’t actually return them. “People from deprived groups and ethnic communities, as well as men, are less likely to take it up. We need to target those people through things like campaigns to try and increase uptake.”

Chambers added: "Future work should be focused on reducing the incidence of tumours of the upper part of the large bowel by increasing screening uptake through use of the new and improved bowel cancer test and improving the quality of colonoscopy."

How does bowel cancer screening work?

All bowel screening programmes across the UK use a test called a Faecal Immunochemical Test (FIT). This is more accurate as well as easier to complete than the previously available bowel test (called gFOBT). The gFOBT test needed samples of two or three separate bowel movements.

In 2019, the FIT test was introduced in most of the UK (2021 in Northern Ireland). It involves collecting a small sample of poo and posting it to a lab for testing. The test works by spotting traces of human blood in poo, and in this way helps to detect cancer, as well as pre-cancerous growths.

Between 2013 and 2020, 55-year-olds in England were also offered a one-off test called bowel scope screening. This used a tiny camera on a thin flexible tube to look for and remove any polyps. This was stopped because of the pressures of the pandemic and to free up resources to expand FIT testing.

The recent study says that these tests halved the number of cancers in the lower part of the colon and reduced death rates by a third.

Signs of bowel cancer to look out for

As well as regularly completing a bowel cancer test kit when you are eligible, keeping an eye on your gut health, checking your poo and being aware of the signs of bowel cancer is also important.

Campaigner Dame Deborah James, who died from bowel cancer aged 40 in 2022 and raised over £11 million for charity, developed the No Butts campaign alongside ITV’s Lorraine Kelly, which detailed symptoms to check for.

These may include:

• Unexplained weight loss
• Blood in your poo or from your bottom
• Feeling tired for no reason
• Bloating
• Tummy pain
• Changes in bowel habits. For example, having softer poo, diarrhoea or constipation that is not usual for you, needing to poo more or less often than usual, feeling like you need to poo even though you’ve just been.

If you notice any of these or are concerned about changes in your bowel habits, speak to your GP. You can also call Macmillan Cancer Support’s helpline on 0808 808 0000 or Cancer Research UK’s cancer nurses on 0808 800 4040 for advice and support. Check their websites for phone line opening hours.