The bowel screening kit in the drawer

Bowel cancer is one of the most common cancers in Australia, and one of the most treatable when it is found early. It also tends to grow quietly for years before it causes any symptom at all, which is precisely why a screening test exists for it.

Who gets a kit, and when

The National Bowel Cancer Screening Program covers people aged 45 to 74. Kits are mailed out automatically every two years from age 50. People aged 45 to 49 can request their first kit themselves, which most are unaware of.

If yours has not arrived, or you have lost it, you can request one through the program, and your GP can also give you one. Ask at your next appointment.

What the test actually does

It is a faecal immunochemical test, which looks for traces of blood in the stool too small to see. Polyps and early cancers often bleed slightly and intermittently long before they cause symptoms.

The kit contains everything you need and clear instructions. You take small samples from two separate bowel motions using a stick that goes into a tube, and post it in the reply-paid envelope. It takes a couple of minutes, it is not messy in the way people expect, and there is no preparation, no fasting and no diet change.

What the result means

Around nineteen out of twenty results come back negative, and you will be invited again in two years.

If blood is found, the result is positive. This does not mean you have cancer. Haemorrhoids, a small tear, inflammation, and several other harmless things can cause bleeding. But a positive result always needs following up, because the test cannot tell the difference — and that follow-up is a colonoscopy.

Your GP will explain what a colonoscopy involves, refer you, and talk through the waiting times and any out-of-pocket cost. If cost is a problem, say so — there is almost always a public pathway, and it is considerably better than not going.

When not to wait for a kit

Screening is for people without symptoms. If you have any of the following, book an appointment rather than waiting for a kit or relying on a recent negative one:

• Blood in your stool or on the toilet paper
• A change in your bowel habit that has lasted more than a few weeks
• Persistent abdominal pain, bloating or cramping
• Unexplained weight loss
• Unexplained tiredness, which can be a sign of low iron from slow bleeding

These need assessing on their own terms. A negative screening test a few months ago does not rule any of them out.

If bowel cancer runs in your family

The program is designed for people at average risk. If a parent, sibling or child has had bowel cancer — particularly if they were young when diagnosed — your own risk may be higher and you may need colonoscopy on a schedule rather than the mailed kit.

Bring what you know about your family history to your GP. Even a rough account is useful, and it is the sort of thing that changes the plan.