- Signs or symptoms of bowel cancer
- Early detection of bowel cancer
- Where can I get a bowel test?
- How is a FOBT bowel test done?
- What do my results mean?
- Who is at risk?
- Family history of bowel cancer
- Reducing my risk of bowel cancer?
- Useful information and links
Bowel cancer, also known as colorectal cancer, is the second most commonly diagnosed cancer in Australian men and women. Up to 90 per cent of bowel cancers can be treated effectively if found early.
Cancer Council recommends all Australians aged 50 years and over undertake a bowel cancer screening test (faecal occult blood test) every two years, in line with the National Health and Medical Research Council guidelines and the Royal College of General Practice guidelines.
Regular screening is important because bowel cancer can develop without noticeable symptoms.
However, it is a good idea to be aware of what is normal for you. You should see your doctor if you notice any changes such as:
- bleeding from the back passage or any sign of blood after a bowel motion
- a change in usual bowel habit, such as straining (constipation) to go to the toilet or loose motions (diarrhoea)
- abdominal pain or bloating
- weight loss for no obvious reason or loss of appetite
- symptoms of anaemia including unexplained tiredness, weakness or breathlessness
Your doctor can investigate further to check for bowel cancer or other bowel conditions.
Some cancers can be detected at an early stage when treatment is likely to be more effective. Bowel cancer is one of those cancers.
Faecal occult blood test (FOBT)
An FOBT is a simple test that can be done at home, that looks for the early signs of bowel cancer before any noticeable symptoms are present. If early signs of bowel cancer are found, it can be treated early, making the treatment more effective and potentially curing the disease.
An FOBT is not a diagnostic test (it cannot tell if you have cancer). It is used to identify people who need further testing.
Although no screening test is 100 per cent accurate, the FOBT is currently the most widely available screening test available for bowel cancer. If you are aged 50 and over and complete an FOBT every two years, you can reduce your risk of dying from bowel cancer by up to one third.
An FOBT looks for tiny amounts of blood (that often can't be seen by the naked eye) in bowel motions. Blood is usually caused by something less serious than cancer, however it may be a sign of an early bowel cancer or a polyp which is a growth on the inside of the bowel that could develop into cancer.
The test is quick and painless and can be done in the privacy of your own home.
There are a number of options for accessing a bowel screening test (FOBT).
If you are experiencing any symptoms, go to your GP immediately to discuss.
National Bowel Cancer Screening Program
The National Bowel Cancer Screening Program (NBCSP), provided by the Australian government, currently offers free bowel cancer screening to people turning 50, 54, 58, 60, 62, 64, 66, 70, 72 or 74 years of age in 2018, who hold a Medicare card or DVA card. By 2020, a free FOBT kit will be offered every two years to people aged 50-74 years.
Kits are sent to eligible people in the mail close to their birthdays. Those who do receive a free screening test kit from the national program are strongly encouraged to complete the test.
Samples are collected in the privacy of the participant’s home and sent on to a pathologist for analysis. Results are sent to the participant and their GP. If the FOBT is positive, further tests are needed.
Illustration of the faecal occult blood test (FOBT) envelope as provided by the National Bowel Cancer Screening Program
For information about the NBCSP, please call the National Bowel Cancer Screening Program Information Line on 1800 118 868 (between 8.30 am-5.00 pm across Australia) or visit cancerscreening.gov.au/bowel
For information about how to complete the kit, call the NBCSP Test Kit Helpline on 1800 930 998, or if you received your kit in 2017, call 1800 738 365.
FOBT instructions are available in other languages on the Multilingual Information page or you can ring Translating and Interpreting Services for assistance on 13 14 50.
General practitioners or general practice
If you are not eligible under the national program, it does not mean you cannot be screened.
Contact your usual general practitioner (GP) or general practice to discuss your screening options. Your usual GP or general practice can request a faecal occult blood test, which is eligible for a Medicare benefit. Most pathology practices bulk bill for this test.
Other options for getting a kit
- Some pharmacies have FOBT kits available for purchase over the counter.
- Some pathology services or health organisations provide online options for purchasing a kit.
You should discuss the use of FOBT kits with your GP before purchasing a kit.
For further information, call Cancer Council 13 11 20.
Other diagnostic tests for bowel cancer are available. Discuss these options with your doctor.
An FOBT can detect minimal amounts of blood in your bowel motions.
The test involves taking samples from two or three bowel motions using a test kit. The samples are then sent to a laboratory for testing. If blood is found, then more tests are required-usually a colonoscopy-to find out what's caused the bleeding.
There are currently two types of FOBT in Australia–guaiac and immunochemical. Guaiac tests require alterations to diet and medications, and samples from three separate bowel motions. Immunochemical tests do not require changes to diet or medication, and samples are only taken from two separate bowel motions.
Different brands of FOBT have slightly different ways of collecting the sample. It may be just a swirl with the provided brush or a smear on the tip of the sampling stick. Each kit comes with clear instructions.
The National Bowel Cancer Screening Program uses an immunochemical kit.
Negative (no blood has been found in your samples)
Some bowel cancers may not bleed or may only bleed every now and then. So a negative FOBT does not mean that you definitely do not have bowel cancer–but it is reassuring. Always see your doctor if you notice any signs or symptoms of bowel cancer—even if you've recently done an FOBT. If you have a negative FOBT result, it's recommended that you continue to have FOBTs every two years, as bowel cancer may develop in following years.
Positive (blood has been found in your samples)
There could be several reasons for finding blood in a bowel motion that may not be related to bowel cancer. These could include bleeding from piles (haemorrhoids) or menstrual blood, for example. However, if blood is found, then it is important to make an appointment to speak to your doctor. Your doctor will talk with you about follow-up tests (such as colonoscopies) which check for bowel cancer, polyps or other causes of the positive FOBT result. Remember bowel cancer is 90 per cent curable if found at an early stage.
Everyone is at risk of developing bowel cancer; however, the risk greatly increases with age, particularly from age 50.
Cancer Council recommends that all Australians aged 50 years and over without any obvious symptoms of bowel cancer undertake a bowel cancer screening test using a faecal occult blood test every two years. This is in line with the National Health and Medical Research Council guidelines and Royal College of General Practice guidelines.
You are also at a greater risk if you have:
- a strong family history of bowel cancer
- previous family history of polyps in the bowel
- chronic inflammatory bowel disease (i.e. Crohn’s disease)
- familial adenomatous polyposis or hereditary non-polyposis colorectal cancer (Lynch syndrome)
- increased insulin levels or diabetes
If you think you are at increased risk or have any concerns, discuss your surveillance options with your GP.
If one or more of your family members (such as a parent, sibling or child) have been diagnosed with bowel cancer before the age of 55, it may run in your family. This is also a possibility if two relatives on the same side of your family have bowel cancer.
If you are concerned about bowel cancer because of your family history, then see your GP to discuss the need for regular check-ups or whether genetic testing would be suitable for you.
There are two very rare conditions that can run in families. About five to six per cent of bowel cancers are caused by these inherited genetic conditions.
Familial adenomatous polyposis (FAP)
This condition causes many polyps to form in the bowel. If polyps caused by FAP are not removed they usually become cancerous.
Hereditary non-polyposis colorectal cancer (HNPCC) / Lynch Syndrome
This condition is a rare inherited bowel cancer syndrome. Less than 5 per cent of all bowel cancer cases are HNPCC. It is also known as Lynch syndrome.
People with Lynch syndrome often develop large bowel cancer before the age of 50. They commonly have one or more adenomas (small polyps) in the bowel. People not only have an increased chance of developing bowel cancer but also a number of other cancers. Not everyone with Lynch syndrome will develop bowel cancer.
Understanding whether you have a history of bowel cancer in your family could save your life. You can use Know Your Risk, an online risk assessment tool to understand your risk of developing bowel cancer based on your family history.
The website will guide you through a series of steps to build a family tree, including close relatives whose history will impact your bowel cancer risk. You will then be presented with a personalised risk assessment of whether your bowel cancer risk is average or elevated. You can print the family tree and take it to your doctor to discuss further and determine if any follow-up testing and/or clinical management is needed.
Bowel cancer is one of the most preventable cancers.
Your most effective protection is to:
- Do an FOBT every two years from age 50.
- Get 30 to 60 minutes of moderate to vigorous exercise per day.
- Maintain a healthy body weight.
- Eat a fibre-rich, well balanced diet.
- Avoid processed and burnt meat, and limit red meat intake to three to four times per week.
- Limit or avoid alcohol.
- Quit smoking.
Contact your doctor with any concerns or questions.
Early detection of bowel cancer—fact sheet (Cancer Council Australia)
Faecal Occult Blood Test—fact sheet (Cancer Council Australia)
Know Your Risk—an online tool ito help people understand their risk of developing bowel cancer based on their family history.
Want to know where this information comes from? Click here.
This website page was last reviewed and updated March 2019.