NHS to detect and prevent thousands more bowel cancers with more sensitive screening

Thousands of cases of bowel cancer will be diagnosed earlier or even prevented in England, as part of major NHS plans to increase the sensitivity of bowel cancer screening to save more lives. 

NHS England today announced it is to lower the threshold for a home-screening kit to trigger urgent cancer testing from next month, with the NHS checking thousands more people identified with even smaller traces of blood in their poo.

The NHS estimates the change could help detect around 600 more bowel cancers early each year in England – around an 11% increase – and find 2,000 more people with high-risk polyps in their bowel, allowing patients to have preventative surgery before any cancers develop.

The home-testing kit, known as the faecal immunochemical test (FIT), is offered to all people over 50 years old and checks for blood in a small stool sample, which can be a sign of bowel cancer.

By reducing the level at which traces of blood in a FIT test trigger further investigation – from 120 micrograms of blood per gram of poo down to 80 – the NHS will offer 35% more screening colonoscopies each year to help diagnose or rule out bowel cancer.

The move comes as the NHS is set to launch new digital alerts that a screening kit is on its way in a bid to boost uptake, as part of a radical new National Cancer Plan to be published by the Government next week to transform cancer care by 2035.

Peter Johnson, National Clinical Director for Cancer at NHS England, said: “This is a major step forward in bowel cancer detection and will help save hundreds more lives from this devastating disease.

“Testing at a lower threshold will now provide a better early-warning system for bowel cancer, helping us to spot and treat cancers earlier, often picking up problems before symptoms appear.

“Earlier detection can mean less intensive treatment and ensures the best chance of survival, and in many cases people could avoid facing cancer altogether by having dangerous polyps removed before they cause harm.

“I would strongly encourage everyone who is sent a bowel screening test to complete it and return it as soon as possible — it really could make all the difference.”

Genevieve Edwards, chief executive at Bowel Cancer UK, said: “This is great news for people living in England. This change marks an important moment for bowel cancer screening in the country.

“Increasing the sensitivity of the test means more cancers will be prevented and found earlier, saving more lives from the UK's fourth most common cancer.”  

Michelle Mitchell, chief executive at Cancer Research UK, said: "This vital step from NHS England to lower the threshold for further tests after bowel screening will save lives. It means more cancers will be detected at an earlier stage, when treatment is more likely to be successful, while also preventing some from developing in the first place.

"Bowel cancer is the second biggest cause of cancer death in England, so it's crucial that progress like this continues.

"Screening is for people without symptoms, so if anyone spots something that isn't right for them, they should speak to their GP. It probably won't be cancer, but if it is, finding it early can make a real difference."

Bowel cancer is the third most common cancer in the UK for both men and women, and the fourth overall, but screening can catch it early — often before any symptoms appear.

Most people who complete their test will not need further checks, but for those who do, early action can be life-saving. It is estimated that, currently, around 2 in 100 people who take part in bowel screening will require further testing – this is expected to increase to 3 in 100 following the lowering of the threshold.

For patients, the test itself does not change and remains simple. FIT tests are done at home by putting a sample of poo in a small tube and returning it by post to the NHS for testing.

Once fully implemented, testing at the lower threshold is expected to reduce late-stage diagnoses and deaths from bowel cancer by around six per cent – while preventing and detecting more cancers earlier will also save the NHS £32 million each year.

The roll-out follows a pilot at eight early-adopting services, where closer working between NHS screening and diagnostic teams has helped more people get checked sooner, with over 60 additional cancers and nearly 500 high-risk polyps being found and treated.

In line with recommendations by the UK National Screening Committee, the NHS will now roll out the lower threshold across the country by March 2028.

Ivan, a personal trainer who felt fit and healthy, nearly ignored his bowel screening test. He said: “I felt fit, healthy and busy, and I kept putting my bowel screening test off. Cancer wasn't something I thought would affect me. When I finally sent the test back, it picked up a problem that led to further checks and my diagnosis.

“I'm convinced that doing the test when I did changed everything — and if I'd left it any longer, it could have been a very different story. If your test is sitting in a drawer, don't put it off. Send it back.”

At the same time, the NHS is making bowel screening easier to take part in, with digital alerts being introduced from February through the NHS App to make people aware that a home testing kit is on its way. The alerts will let people know what to expect, making it easier to complete the test promptly.

Anyone that requires letter sent by post, including anyone newly eligible for bowel cancer screening, will continue to receive them.

The NHS rolled out digital communications for cervical screening last year as part of a new ‘ping and book' service. So far nearly nine in ten women have received screening invites and reminders digitally, making screening quicker, more convenient and less reliant on paper.

The new functionality comes as record numbers – nearly 40 million people in England – are now using the NHS App to manage their health quickly and conveniently.

Last year, the NHS also completed the expansion of bowel cancer screening to everyone aged 50 to 74, with over 4 million more people invited since roll out began in 2021.

The NHS is urging everyone eligible to act promptly when their test or digital invite arrives – completing the test promptly can mean simpler treatment, better recovery, or avoiding cancer altogether.