Bowel cancer screening
Bowel cancer screening is offered to people aged 60 to 74 to check for bowel cancer. Screening can help detect cancer at an early stage when treatment is more effective. Screening can also check for and remove polyps which can go on to develop into cancer over time.
Why screening is important
Bowel cancer is the fourth most common type of cancer found in men and women in Northern Ireland. It is more common in older people, especially men.
If bowel cancer is detected at a very early stage then treatment is very successful. More than nine out of 10 people diagnosed at the earliest stage will survive for five years or more after they were diagnosed.
Bowel cancer screening programme
If you are aged between 60 and 74 and registered with a GP you will automatically be sent a screening test every two years to your home address.
It is important that your GP has the most up-to-date contact details to make sure you receive this.
The home screening test is used to collect a small sample of bowel motion.
This is sent to a laboratory to be checked for tiny amounts of blood that you can’t normally see.
The bowel screening test is the first step in a screening process that may involve further tests and one or more hospital visits.
The bowel cancer screening programme in Northern Ireland is aimed at people who are experiencing no signs or symptoms of bowel cancer.
If you are outside of this age range, have a family history of bowel cancer, or are worried about symptoms or changes in your bowel movements, you should make an appointment with your GP.
Bowel cancer screening process
You will receive information with the bowel screening test to help you decide if you wish to take part.
There is strong evidence that screening programmes help to improve cancer outcomes by detecting cancers early, however taking part is a personal choice.
The information leaflet with the bowel screening test notes the possible benefits and risks of screening to help you with this decision.
Follow the instructions in the instruction leaflet that comes with your screening invitation on how to take the test.
You can view the information leaflet and watch an animated video on how to complete the bowel cancer screening test at the links below.
Post your completed test kit to the screening laboratory in the pre-paid envelope included as soon as possible. Make sure you seal the envelope before putting it in the post box.
Delays in returning your kit may prevent the sample from being processed.
You should receive your results within two weeks.
If you have any questions about bowel cancer screening, contact the Bowel Cancer Screening freephone helpline on 0800 015 2514.
You can contact the helpline to request a replacement screening test or return envelope.
Do not contact your GP practice for a replacement screening test or send a screening test to your GP practice.
Limitations of bowel cancer screening
Screening can’t tell if you have bowel cancer. It divides people who have been screened into two groups:
- those who need more tests
- those who do not need more tests
No screening test is completely reliable. Not everyone who has bowel cancer experiences bleeding, so there is a chance a cancer could be missed.
If you are concerned about bowel cancer symptoms, you should contact your GP, even if your last screening test was negative.
There is also a small risk that some of the further tests you might have after a positive screening result could damage your bowel, but this is rare.
There are no risks to your health from the home testing kit.
People who may not need bowel cancer screening
You may not need to complete the bowel cancer screening test if you:
- have had your large bowel removed
- are being treated for bowel cancer
- are awaiting bowel investigations
If you think you are in any of these categories and you receive a test kit, contact the Bowel Cancer Screening freephone helpline on 0800 015 2514 for advice.
Helping someone else complete the test
If you take care of the toilet needs of a person with a physical disability you can help them complete the test.
Before helping them you should make sure:
- they have asked for your help
- they understand the screening process (including colonoscopy)
- they don’t have a medical condition which means they shouldn’t be screened
If you take care of someone who does not have the capacity to give their consent to take part in screening, you should speak with the person’s GP to decide if screening is in their best interests.
Bowel cancer screening results
For most people, the result will suggest that no further investigations are needed at this time. In this case, routine screening will continue to be offered to you every two years until you reach the age when screening stops.
This result does not guarantee that you do not have bowel cancer, or that it will never develop in the future.
It is important to be aware of the possible symptoms of bowel cancer and to contact your GP if you have any concerns, even if you have recently completed a screening test.
For about two in every 100 people, the result will show that further investigations are needed. This result does not mean that you have bowel cancer. It means that some blood was detected in your sample and this needs to be investigated.
Other possibilities include:
You will need to have further tests to find the cause.
If your screening test shows traces of blood in your bowel motion, you will be asked to contact the freephone helpline on 0800 015 2514.
You will be referred to a specialist screening practitioner (SSP) for assessment.
Appointments with the Specialist Screening Practitioner (nurse) may be by telephone or in person. If a telephone appointment is arranged, a suitable time for the nurse to call you will be arranged by the helpline staff.
The nurse may call from a withheld number at the time of this appointment.
This nurse will discuss your result with you and give you details about the next step, which is usually a colonoscopy.
Bowel cancer screening and coronavirus
If you have symptoms of coronavirus, or have been in contact with someone who does, you must not go to your colonoscopy appointment.
Contact the Trust and let them know you have coronavirus symptoms so that your appointment can be rearranged.
Colonoscopy examination
A colonoscopy is a test where a thin tube (a colonoscope) with a camera at the end is inserted into your bottom to look for signs of bowel cancer. You may be offered a sedative to help you relax.
Polyps are clumps of cells that aren’t cancer but may develop into cancer over a number of years. They can usually be removed without any pain during the colonoscopy.
Any polyps or biopsies which are removed will be sent to the laboratory for examination.
Treatment after the colonoscopy
If your colonoscopy finds that you have polyps, you may be called back for a further colonoscopy in three years’ time to check that they haven’t recurred.
If the examination detects cancer, you will be referred to a specialist for further treatment. The person who does your colonoscopy will be able to answer any questions you may have.
Reducing your risk of bowel cancer
Regular bowel cancer screening has been shown to reduce the risk of dying from bowel cancer by 16 per cent.
As well as taking part in bowel cancer screening, there are some further steps you can take to reduce your risk of bowel cancer:
- eat a healthy diet :
- make sure you get five portions of fruit and vegetable each day
- include wholegrains, beans and pulses for fibre
- limit the amount of red meat you eat, especially processed red meat
- be active - moving more and sitting less can reduce your risk of serious illness (aim for at least two and a half hours each week)
- maintain a healthy weight - avoid gaining weight and try losing weight if overweight
- drink less - to keep risks to a low level, don’t drink more than 14 units of alcohol a week
- stop smoking
If you have concerns
If you have a family history of bowel cancer, or are worried about symptoms of bowel cancer, or changes in your bowel movements, you should speak to your GP.
Symptoms may include:
- unexplained bleeding/ blood in your stools
- a change in bowel habit
- pain or swelling in your abdomen
- unexplained weight loss
- unexplained tiredness
Bowel cancer screening is not a test for symptoms.
If you have any of these symptoms for three weeks or more, you should speak with your GP who can provide a different test.
This is important, even if you have recently taken part in bowel cancer screening.