Bowel Cancer Screening — Colonoscopy, FIT Test, and Early Detection

Screening can detect bowel cancer before symptoms develop, when treatment is most effective. In many cases, it can even prevent cancer by finding and removing polyps before they turn malignant.

Why Screening Matters

Bowel cancer often grows silently, with no obvious warning signs in the early stages. Screening aims to pick up subtle changes — such as traces of blood in the stool or the presence of polyps — before cancer becomes advanced. Early detection significantly improves survival rates and reduces the need for aggressive treatment.

The FIT Test

What it is: A simple stool test (Fecal Immunochemical Test) that checks for hidden blood not visible to the eye.
How it works: You collect a small stool sample at home, which is analysed in a lab.
When it’s used: Often the first-line screening test in national programs. If blood is detected, a colonoscopy is usually recommended.
Pros: Easy, non-invasive, can be repeated regularly.
Cons: Cannot detect all cancers or polyps, may give false positives or false negatives.

Colonoscopy

What it is: A procedure where a flexible camera examines the inside of the colon and rectum.
Why it matters: It’s the gold standard — doctors can not only see the bowel lining but also remove polyps or take biopsies during the procedure.
When it’s recommended: If your FIT test is positive, or if you’re at increased risk due to family history, symptoms, or genetic factors.
Pros: Most accurate test, can treat as well as diagnose.
Cons: Requires bowel prep, sedation, and carries small risks (bleeding, perforation).

Burning vs. Removal — What’s the Difference?

🔎 Did you know?
During a colonoscopy, doctors can remove small polyps by “burning” them off with a wire loop and a mild electric current. This is painless under sedation and helps prevent polyps from becoming cancerous.

If bowel cancer is already present and has grown deeper, “burning” alone isn’t enough. In those cases, surgery is required to remove a section of bowel and surrounding lymph nodes.

Who Should Be Screened?

General population: Most guidelines recommend starting screening at age 50.
Higher risk groups: Screening may start earlier if you have a strong family history, genetic conditions (Lynch syndrome, FAP), or long-standing inflammatory bowel disease.
Frequency: FIT test every 1–2 years; colonoscopy intervals depend on findings and risk profile.

Preparing for Screening

FIT test: Minimal preparation, just follow collection instructions.
Colonoscopy: Requires dietary changes and bowel cleansing beforehand. Your doctor will provide a detailed plan.

Takeaway

Bowel cancer screening saves lives. A simple stool test can flag hidden warning signs, while colonoscopy can detect and remove precancerous growths before they develop further. If you’re eligible, take part in screening — it’s one of the most effective cancer prevention tools available.