The NHS is set to make a significant improvement to England’s main bowel cancer screening test, a move health leaders believe will save hundreds of lives each year.
The faecal immunochemical test (FIT) — used to detect traces of blood in stool samples — will become more sensitive, meaning cancers can be picked up earlier, often before symptoms appear.
Currently, patients are referred for further investigation if the test detects 120 micrograms of blood per gram of stool. Under the new plan, that threshold will be gradually lowered to 80 micrograms by 2028, bringing England into line with Scotland and Wales, where the lower level is already in use.
NHS England says the change will act as a stronger early-warning system for bowel cancer, helping doctors diagnose the disease sooner and improve survival rates.
Professor Peter Johnson, NHS England’s national clinical director for cancer, said the move marked “a major step forward” in detection. He added that identifying cancer earlier allows treatment to begin sooner, when it is often more effective and less invasive.
Bowel cancer is the second deadliest cancer in the UK, with around 44,000 people diagnosed every year and more than 17,000 deaths. Health experts estimate that over half of cases could be prevented, with key risk factors including poor diet, obesity and alcohol consumption.
Once fully implemented, the lower testing threshold is expected to reduce late-stage diagnoses and bowel cancer deaths by around 6%. NHS England estimates the change will also save the health service approximately £32 million a year by preventing advanced disease that is more expensive to treat.
The increased sensitivity of the test is forecast to identify around 600 additional bowel cancer cases annually — an 11% rise on the 5,300 cases currently detected through the programme. However, it will also result in a 35% increase in colonoscopies, as more patients are flagged for follow-up tests.
The FIT test has been part of the NHS screening programme since 2019. Eligible patients receive the kit by post, collect a small stool sample at home, and return it for laboratory analysis.
Eligibility was widened in 2024 to include people aged 50 to 53, meaning an extra 1.2 million people are now invited to take part. In 2023–24, nearly seven million kits were sent out, with 68% returned.
Genevieve Edwards, chief executive of Bowel Cancer UK, welcomed the announcement, calling it “great news” for patients in England. She noted that a quarter of bowel cancers are still only diagnosed when people arrive at A&E with severe symptoms — something earlier testing could help prevent.
The changes will be formally outlined in the government’s upcoming National Cancer Plan, due to be launched on World Cancer Day on 4 February.
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