The main test for the UK’s second deadliest cancer is being made more accurate in England, in a move NHS bosses believe will save hundreds of lives.
The sensitivity of the faecal immunochemical test (Fit), which detects bowel cancer by spotting blood in the patient’s stool, will be increased as part of an overhaul of cancer diagnosis and treatment.
NHS England is lowering the threshold for the amount of blood detected through a Fit test needed to trigger the patient being sent for further investigation.
It is now 120 micrograms of blood a gram of stool. But that will be reduced to 80 micrograms by 2028 and will bring England into line with the threshold already used in Scotland and Wales.
“This is a major step forward in bowel cancer detection and will help save hundreds more lives from this devastating disease,” said Prof Peter Johnson, NHS England’s national clinical director for cancer.
“Testing at a lower level 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 occur.”
About 44,100 people in Britain are diagnosed with bowel cancer every year and it claims about 17,400 lives, making it the second commonest cause of cancer death. Risk factors include eating processed meat, being overweight and drinking alcohol, leading Cancer Research UK to conclude that more than half of cases – 54% – are preventable.
“Once fully implemented testing at the lower level threshold is expected to reduce late stage diagnoses and deaths from bowel cancer by around 6%,” NHS England said. Preventing and detecting more cases earlier will save the health service £32m a year, it estimates.
The change will lead to 600 more bowel cancers a year being detected in England, an 11% increase on top of the 5,320 cases that are identified annually by the current test.
It will also see the NHS carrying out 35% more colonoscopies, the diagnostic test offered to patients who the Fit test has identified as being at risk of bowel cancer.
The Fit test became part of the NHS’s bowel cancer testing programme in 2019. It is a home screening programme in which eligible patients are sent a Fit test in the post. They return it with a small sample of their stool, which is then analysed in a laboratory.
The move will be outlined in the government’s new national cancer plan, which is being launched on 4 February, which cancer organisations have designated as World Cancer Day.
The age of eligibility in England was expanded in 2024 from 54-74 to include those aged 50-53. In 2023-24 the NHS sent a kit to almost 7 million people, of whom 68% returned it, which identified 5,320 cancers. An extra 1.2 million people are now being sent one due to the widened age criteria.
Genevieve Edwards, the chief executive of Bowel Cancer UK, hailed the lower threshold as “great news for people living in England”. She said the change marked an important moment for bowel cancer screening in the country.
In a report last month the charity warned that 25% of bowel cancers were only finally diagnosed when someone ended up in A&E as a result of their symptoms.
