Your guide to bowel cancer screening at home

Collecting a poo sample may not be glamorous, but it’s surprisingly simple, can be done from home, and could save your life.

99% of bowel cancer cases can be treated successfully when in their earliest stage.¹

“Most bowel cancers start as benign, non-threatening growths, called polyps, on the wall or lining of the bowel,” says Medical Director at Bowel Cancer Australia, Associate Professor Graham Newstead.

“Polyps occur frequently and are mostly harmless; essentially all the cancers will arise from these polyps, and if left undetected, will then become serious.”

“That’s why participating in regular screening is important.”

The at-home bowel screening test is called a faecal immunochemical test (FIT).

“At-home bowel screening involves a test that looks for very small amounts of blood in poo.”

“This blood isn’t visible to the naked eye in people who do not have any obvious symptoms of bowel cancer,” says Graham.

You can opt in to the National Bowel Cancer Screening Program (NBCSP) from 45. From age 50 the test is automatically mailed to you. It is free.

Bowel Cancer Australia’s BowelScreen Australia Program allows bowel screening for those ineligible for the government program. You can buy it from Bowel Cancer Australia.

“People aged 40 to 44 can be screened every 2 years if their health care professional has spoken to them about the benefits and potential harms,” says Graham.

“For people at average risk of bowel cancer and without symptoms, Australian medical guidelines recommend screening using a faecal immunochemical test every 2 years between the ages of 45 to 74.”

1.Prepare²

• Write your details on one of the tubes.
• Do a wee and flush the toilet.
• Put one toilet liner in the toilet with the writing facing up. It’s okay if it gets wet.

2.Collect

• Poo on to the liner.
• Twist open the tube. Drag the tip of the stick through the poo. Your sample only needs to be tiny.
• Put the stick back into the tube and click it shut. Flush the biodegradable liner down the toilet.
• Put the tube into the zip lock bag.
• Put the bag somewhere cool, such as a fridge. Don’t freeze.

3.Repeat

• Repeat steps 1 and 2 using the other tube when you do your next poo. Ideally, try to collect both samples within 3 days of each other.

4.Send

• Mail your samples as soon as possible.
• Complete the participant details form. Write the dates your samples were taken and sign the form.
• On the envelope, sign the front and write your name and address on the back.
• Put the form and the samples in the envelope.
• Mail the envelope. Samples need to stay cool for as long as possible. Place it in a mailbox in the cooler part of the day or take it to a post office.

Sample 1³

• Flush toilet before your bowel movement
• After your bowel movement, do not place used toilet paper in the toilet bowl. Instead put the used toilet paper in one of the blue waste bags from the brush kit envelope. Do not flush the toilet.
• Lift the flap marked ‘Lift here for sample 1’ on the test card to uncover the small white square marked ‘Sample 1’. Using one of the blue brushes, gently brush the surface of the poo for about 5 seconds. If the poo is loose, simply stir water around the poo.
• Remove the brush from the water and gently shake it once to remove excess water and any clumps of poo.
• Transfer the water sample by gently dabbing the bristles of the brush onto the small white square on the test card for about 5 seconds (some staining of the square may occur). Put the used brush in the blue waste bag and put the bag in your rubbish bin.
• Close the flap over ‘Sample 1’ and stick the flap down using one of the barcode labels on the information sheet.

Sample 2

• This sample must be from a different poo to increase the chance of detecting non-visible blood.
• Use the second blue brush, blue waste bag and the test card flap marked ‘Sample 2’ and repeat steps 1 to 5.
• Use the second barcode label to reseal flap marked ‘Sample 2’.
• Complete the information sheet. Place the test card and information sheet in the reply-paid envelope.

If you are screening with the National Bowel Cancer Screening Program, your results will be mailed to you and your GP.

If you are screening with BowelScreen, your results can either be mailed to you and your nominated GP or made accessible via a patient portal, depending on customer preference.

“A positive test result means blood has been detected,” says Graham. “If blood is found, contact your GP promptly to discuss the result and get a referral for a colonoscopy, ideally within 30 days.”

“The blood may be caused by conditions other than bowel cancer, such as polyps, haemorrhoids, medications, or inflammation, but the underlying cause needs to be investigated.”

“A negative test result means no blood has been detected. You should repeat the test every 2 years. A negative result does not guarantee you are free of bowel cancer, as some cancers do not bleed or only bleed intermittently. If you notice any symptoms between tests, see your GP immediately.”

“A positive screening test requires investigation via colonoscopy,” says Graham. “A colonoscopy is a quick and generally painless procedure that allows for the full examination of the entire inner lining of your bowel.

“During the procedure, the specialist spends most of the time looking for changes to the normal landscape of your bowel lining.”

During a colonoscopy, polyps can be detected and removed before they develop into bowel cancer, and if present, bowel cancer can be diagnosed.

“A colonoscopy usually lasts around 30 minutes or less and is typically performed under a general anaesthetic.”

“Even if your screening test is negative, it is important to understand the red flag signs and symptoms of bowel cancer,” says Graham. These include:

• Blood in your poo
• Obvious change in your bowel habit
• Weight loss you can’t explain
• Extreme tiredness for no reason
• Lump or swelling in your abdomen

Bowel Cancer Australia offers information and support for people with bowel cancer.

The National Bowel Cancer Screening Program provides information and resources, including free screening kits to eligible Australians.