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The NHS posts a home test for hidden blood in the poo to everyone aged 50 to 74 in England every two years. Most people are told no further tests are needed; if blood is found they are offered a colonoscopy. It is the only NHS cancer screening programme that can prevent the cancer as well as find it early, because the colonoscopy removes the polyps.
What is offered. England invites everyone aged 50 to 74 registered with a GP for a faecal immunochemical test every two years. The programme was extended down from 60, so depending on when a person turned 50 the first kit arrives at 50, 52 or 54. An invitation letter and information leaflet come first, the kit about a week later, and results about two weeks after the laboratory receives the sample. People aged 75 and over can request a kit every two years on the free helpline (0800 707 6060). An abnormal result leads to an appointment with a specialist screening practitioner and usually to a colonoscopy; blood in the stool is more often an anal fissure or a polyp than a cancer. Screening does not stop a person getting bowel cancer, and symptoms after a normal result still need a GP (NHS; GOV.UK).
The threshold. The faecal immunochemical test measures haemoglobin in micrograms per gram of faeces, and the programme chooses a cut-off that its colonoscopy capacity can absorb. England screens at 120 micrograms per gram. Modelling from the English pilot of 27,238 people aged 59 to 75 estimated that two-yearly screening at that threshold generates 16,092 colonoscopies per 100,000 screened, prevents 186 cancers, and detects 1,142 cancers, 7,086 adenomas and 4,259 advanced adenomas (Br J Cancer 2022). The same test used in primary care for people with symptoms refers at 10 micrograms per gram, twelve times lower, because the pre-test probability there is far higher (NICE NG12 1.3.2).
How well it works and who takes it up. The programme standards set an acceptable uptake of 62 percent and an achievable level of 73 to 76 percent for ages 60 to 74, with levels for the newly invited 50 to 59 group not yet set. In England in 2019, 12 percent of bowel cancers were diagnosed through screening, against 38 percent through an urgent suspected cancer referral and 22 percent after an emergency presentation (Cancer Research UK). The randomised evidence behind faecal testing and endoscopy is in the colorectal screening technology record and the glossary term for the faecal immunochemical test.
Showing the technology this term belongs to: Colorectal cancer screening (colonoscopy, FIT, stool DNA, blood).
Shares Interval cancer, Surveillance intervals after polypectomy, Colonoscopy, Colorectal cancer screening (colonoscopy, FIT, stool DNA, blood) and the tags gi, colorectal.
Shares Surveillance intervals after polypectomy, Colonoscopy, Colorectal cancer screening (colonoscopy, FIT, stool DNA, blood), Colon cancer (adenocarcinoma of the colon) and the tags gi, colorectal.
Shares Interval cancer, Surveillance intervals after polypectomy, Colonoscopy, Colorectal cancer screening (colonoscopy, FIT, stool DNA, blood) and the tags gi, colorectal.
Shares Surveillance intervals after polypectomy, Colonoscopy, Colorectal cancer screening (colonoscopy, FIT, stool DNA, blood), Colon cancer (adenocarcinoma of the colon) and the tags gi, colorectal.
Shares Emergency presentation (route to diagnosis), Colon cancer (adenocarcinoma of the colon), Rectal cancer, Colorectal cancer and the tags gi, colorectal.
Shares Early-onset colorectal cancer (under 50), Colon cancer (adenocarcinoma of the colon), Rectal cancer, Colorectal cancer and the tags gi, colorectal.
Shares Colon cancer (adenocarcinoma of the colon), Rectal cancer, Colorectal cancer and the tags gi, colorectal.
Shares Colonoscopy, Colorectal cancer and the tags gi, colorectal.