Thousands more bowel cancers in England will be diagnosed earlier — or prevented — after NHS England announced it will increase the sensitivity of home bowel screening from next month.
The change lowers the faecal immunochemical test (FIT) threshold that triggers urgent investigation from 120 micrograms of blood per gram of stool to 80. The NHS estimates this will lead to about 35% more screening colonoscopies each year, detect around 600 additional early bowel cancers annually (an 11% rise), and identify roughly 2,000 more people with high‑risk polyps who can have them removed before cancer develops.
FIT remains the same simple home test: people aged 50 to 74 take a small stool sample in a tube and post it to the NHS. Most people who complete the test will still not need further checks, but the proportion requiring follow-up is expected to rise from about 2 in 100 to about 3 in 100.
Peter Johnson, NHS England’s National Clinical Director for Cancer, said lowering the threshold provides a better early‑warning system, allowing cancers to be spotted and treated earlier, often before symptoms appear, which can mean less intensive treatment and better survival. Health Innovation Minister Dr Zubir Ahmed highlighted the introduction of NHS App notifications so people know a test is on its way, calling the move part of shifting the NHS from analogue to digital.
Charities welcomed the change. Genevieve Edwards, chief executive of Bowel Cancer UK, described it as an important moment for screening that will prevent and detect more cancers earlier. Michelle Mitchell, chief executive of Cancer Research UK, said the step will save lives by finding cancers at a more treatable stage and preventing some from developing.
When fully implemented, testing at the lower threshold is expected to reduce late‑stage diagnoses and bowel cancer deaths by around 6% and save the NHS about £32 million a year. The roll‑out follows a pilot at eight early‑adopting services, which found over 60 additional cancers and nearly 500 high‑risk polyps by improving coordination between screening and diagnostic teams. In line with UK National Screening Committee recommendations, the NHS will extend the lower threshold nationwide by March 2028.
The NHS is also introducing digital alerts through the NHS App from February to boost participation by notifying people that a home testing kit is on its way and explaining what to expect; those who need postal letters, including newly eligible people, will continue to receive them. Digital communications were already used for cervical screening, where nearly nine in ten women have received invites and reminders digitally. Almost 40 million people in England now use the NHS App.
Last year the NHS completed expansion of bowel screening to everyone aged 50 to 74, adding more than four million invitations since 2021. The campaign emphasises that screening is for people without symptoms — anyone who notices worrying signs should contact their GP — and urges eligible people to complete and return their FIT promptly.
A personal story underlines the importance: Ivan, a personal trainer who felt healthy, delayed his screening until it picked up a problem that led to further checks and diagnosis. He said returning the test when he did “changed everything” and encouraged anyone with a test to send it back rather than leave it in a drawer.
