NHS bowel scope screening is a relatively new test to help prevent bowel cancer. It finds and removes any small bowel growths, called polyps, that could eventually turn into cancer.
The NHS bowel scope screening programme is gradually being rolled out to all men and women in England aged 55. This page aims to help you make a choice about whether to have bowel scope screening.
It includes information about why the NHS offers bowel scope screening, what to expect from it, and the possible risks.
To help you decide whether to have the screening test, you can also read the leaflet NHS Bowel Cancer Screening: Bowel scope screening (PDF, 261kb).
Why does the NHS offer bowel scope screening?
NHS bowel scope screening helps to prevent bowel cancer. For every 300 people screened, it stops two from getting bowel cancer and saves one life from bowel cancer.
Some health problems mean that it might not be possible for you to have bowel scope screening. For more information, read Can everybody have bowel scope screening at 55?.
When are you offered the test?
Bowel scope screening is a one-off test offered to men and women at the age of 55. This is a new type of screening that is gradually being rolled out across England – depending on where you live, it may not yet be offered in your area.
As of March 2015, about two-thirds of screening centres were beginning to offer this test to 55 year olds.
As long as you’re registered with a GP and living in an area where the test is being offered, you should automatically be sent an invitation.
If you decide not to have bowel scope screening when you are first invited, you can still have it at any time up until your 60th birthday. Just call the freephone helpline number 0800 707 60 60 to ask for an appointment.
At around the age of 60, you will be invited to have more bowel cancer screening using a different kind of test that looks for traces of blood in poo. This test is known as the FOB test.
What does bowel scope screening involve?
Bowel scope screening uses a thin, flexible tube with a tiny camera on the end to look at the large bowel. It can find and remove small growths called polyps from the bowel. Polyps don't usually cause symptoms, but some might turn into cancer if they're not removed.
The technical term for bowel scope screening is flexible sigmoidoscopy screening (sometimes called "flexi-sig").
Bowel scope screening is done by a specially trained nurse or doctor at an NHS bowel cancer screening centre. They look at the lower part of your large bowel, because that's where most polyps are found.
When the nurse or doctor puts the tube into your bowel, they gently pump some carbon dioxide gas inside. This opens up the bowel, so they can see any polyps.
If they find any polyps, they usually remove them straight away. This is usually done using a tiny wire loop passed through the tube. Sometimes the nurse or doctor takes a tiny piece of the bowel (a biopsy) to be looked at under a microscope.
What does bowel scope screening feel like?
Most people do not find this test particularly uncomfortable.
If you do feel pain, it will only last for a few moments. It's most often caused by the carbon dioxide used to open up the bowel, which may give you a bloating or cramping feeling in your tummy. If you do feel pain, tell the nurse or doctor and they will change what they are doing to make you feel as comfortable as possible. Having polyps removed from the bowel is not usually painful.
A few people say they find bowel scope screening embarrassing. The nurse or doctor will do their best to help you feel as relaxed as possible.
How do I prepare for it?
Two weeks before your appointment, your NHS bowel cancer screening centre will write to you. The letter will include an enema and instructions for using it. The enema is a liquid used to clear the poo out of your large bowel, so the nurse or doctor can get a good look at your bowel. The enema comes in a small plastic pouch with a nozzle. Most people find it easy to use.
Use the enema about one hour before leaving home for your bowel scope screening appointment. To use the enema, squeeze the liquid from the plastic pouch into your bottom. The enema will make you poo very soon after you have used it. It should keep your bowel clear for several hours.
On the day of your appointment
After you arrive at the NHS bowel cancer screening centre, the nurse or doctor will explain what will happen, answer any questions and listen to your concerns. They may ask you to put on a hospital gown and then you'll be asked to lie down on a bed ready to have bowel scope screening.
During the screening, if you want, you will be able to see the inside of your bowel on a TV screen. The nurse or doctor will tell you straight away if they remove any small growths (polyps).
Having bowel scope screening usually takes a few minutes, but the whole appointment may take around an hour and a half.
Getting ready for your appointment and having bowel scope screening may take up to half a day, depending on how far away you live from the screening centre.
Bowel scope screening results
You will be told if nothing was found or that samples have been taken for analysis. You will then be sent a letter explaining the results of your bowel scope screening in the two weeks after your appointment. Your GP will also get your results.
Most people will have a normal result
Out of 300 people who have bowel scope screening, 285 will have a normal result. This means that no polyps or cancers were found.
Even if you have a normal result, it is important to look out for symptoms of bowel cancer. This is because people can sometimes get bowel cancer even after a normal result.
Some people will have polyps
The nurse or doctor will usually remove any polyps they find. They will tell you straight away if they have done this. Any polyps that are removed are sent to be checked under a microscope.
Learn more about bowel polyps.
Out of 300 people who have bowel scope screening, about 14 will be offered another test because of the type of polyps found. This test is usually a colonoscopy. This uses a longer tube, which can look for polyps further up the bowel. Learn more about having a colonoscopy (PDF, 270kb).
Very occasionally, people may be asked to come back for an operation to remove their polyps. This only happens to about one person out of every 1,000 who have bowel scope screening.
Rarely, the screening will find cancer
Out of 300 people who have bowel scope screening, about one will be found to have bowel cancer already. If the screening does find cancer, the nurse or doctor will arrange for you to see a specialist as soon as possible.
If cancer is found, it is likely to have been found at an early stage. This means you are likely to have a better chance of successful treatment and survival.
Read about the treatment options for bowel cancer.
Does bowel scope screening have risks?
Bowel scope screening is usually safe, but in rare cases it can cause harm to the bowel. About one person in every 3,000 may have serious bleeding caused by bowel scope screening. Sometimes the bowel can be torn during bowel scope screening, but this is even rarer.
In either case, you would be admitted to hospital straight away and you might need surgery. Most people make a full recovery.
When you go home after bowel scope screening, if you have any severe pain, or blood in your poo that does not go away after 24 hours, you should see a doctor straight away.
The carbon dioxide pumped into the bowel is not harmful.
Read some FAQs on bowel scope screening.