The NHS plans to increase the sensitivity of bowel cancer screening in England as it aims to diagnose cases earlier.
NHS England has announced it is to lower the threshold for a home-screening kit to trigger urgent cancer testing from February 2026, 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.”
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 lifesaving. It is estimated that, currently, around 2% of people who take part in bowel screening will require further testing – this is expected to increase 3% following the lowering of the threshold.
Once fully implemented, testing at the lower threshold is expected to reduce late-stage diagnoses and deaths from bowel cancer by around 6% – 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.
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 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 four million more people invited since roll out began in 2021.