From next month NHS England will make its at‑home bowel screening test more sensitive, lowering the faecal immunochemical test (FIT) threshold that triggers urgent investigation from 120 micrograms of blood per gram of stool to 80. The change is expected to generate roughly 35% more screening colonoscopies each year, detect about 600 additional early bowel cancers annually (an 11% increase) and find around 2,000 more people with high‑risk polyps who can have them removed before cancer develops.
FIT remains the same simple postal test: people aged 50 to 74 collect a small stool sample in a supplied tube and send it to the NHS. Most who complete the test will still not need further checks, but the share requiring follow‑up is forecast to rise from about 2 in 100 to about 3 in 100.
NHS England’s National Clinical Director for Cancer, Peter Johnson, said the lower threshold will act as a better early‑warning system so cancers can be found and treated earlier, often before symptoms appear, which typically means less intensive treatment and improved survival. Health Innovation Minister Dr Zubir Ahmed noted the NHS App will be used to notify people that a kit is on its way, part of a wider move from analogue to digital communications.
Charities welcomed the announcement. Bowel Cancer UK described the change as a major step that should prevent and detect more cancers at an earlier stage, and Cancer Research UK said it should save lives by catching disease when it is more treatable and preventing some cancers from developing.
When the lower threshold is fully rolled out it is expected to reduce late‑stage diagnoses and bowel cancer deaths by around 6% and save the NHS about £32 million a year. The expansion follows an early pilot at eight services, which identified more than 60 additional cancers and nearly 500 high‑risk polyps after improving coordination between screening and diagnostic teams. In line with the UK National Screening Committee’s recommendations, the NHS plans to extend the lower threshold nationwide by March 2028.
From February the NHS will add digital alerts via the NHS App to boost participation, while continuing to send postal letters to those who need them, including newly eligible people. Digital invitations have already been used for cervical screening, with nearly nine in ten women getting invites and reminders electronically. Almost 40 million people in England now use the NHS App.
Bowel screening was expanded last year so everyone aged 50 to 74 is eligible, adding more than four million invitations since 2021. The programme is aimed at people without symptoms; anyone who notices worrying signs should contact their GP. A personal example underlines the point: Ivan, a fit personal trainer who felt well, delayed his screening but when he finally returned the FIT it triggered checks that led to a diagnosis he says ‘‘changed everything’’. He urges anyone with a test to send it back promptly rather than leave it in a drawer.
