Participation in bowel cancer screening is recommended by Bowel Cancer Australia based on an individual’s personal risk profile. Australian medical guidelines advocate for screening using a faecal immunochemical test (FIT) every two years for those at average risk and without symptoms, particularly between the ages of 45 and 74. However, healthcare professionals may consider offering the FIT every two years to individuals aged 40-44 or 75-85 who are fit, well, and healthy, upon request, provided they are fully informed about the benefits and potential harms of testing.
The at-home bowel screening process involves a test designed to identify minuscule amounts of non-visible blood in stool in individuals without apparent symptoms of bowel cancer. This at-home screening test is known as the faecal immunochemical test (FIT).
The faecal immunochemical test has been designated as the preferred screening method for both Bowel Cancer Australia’s BowelScreen Australia Program and the Department of Health’s publicly funded National Bowel Cancer Screening Program (NBCSP). Utilizing the FIT for screening has proven to be one of the most effective methods for reducing the risk of mortality associated with bowel cancer. The test is adept at detecting blood in stool stemming from pre-cancerous polyps or early-stage bowel cancer. However, it’s important to note that the FIT itself does not directly identify bowel cancer.
Identifying bowel cancer at an early stage is crucial, as nearly 99% of cases can be successfully treated when detected early. The faecal immunochemical test involves collecting toilet water or stool samples, placing them on a card or in a container, and sending them to a pathology laboratory for analysis. Subsequently, the results are communicated to both the individual and their general practitioner (GP).
A positive result from the faecal immunochemical test signifies the detection of blood in the stool. In such cases, individuals are advised to promptly contact their GP to discuss the results and obtain a referral for further investigation via colonoscopy, ideally within 30 days. It’s important to acknowledge that the presence of blood in the stool could be attributed to conditions other than bowel cancer, including medications, polyps, haemorrhoids, or inflammation of the bowel. However, colonoscopy is essential to ascertain the underlying cause of the bleeding, during which any identified polyps can be removed, or a diagnosis of bowel cancer can be confirmed.
Conversely, a negative result from the faecal immunochemical test indicates that no blood has been detected in the stool. However, it is recommended to repeat the test every two years. It’s crucial to understand that a negative result does not imply immunity from bowel cancer, as certain types of bowel cancers may not exhibit bleeding or may do so intermittently. If any symptoms of bowel cancer manifest between screenings, individuals are urged to seek immediate consultation with their GP.
While screening tests are instrumental in early detection, they are not without risks. Decisions regarding screening tests can be challenging, and it is imperative to recognize that not all screening tests are universally beneficial, often carrying associated risks. Prior to undergoing any screening test, individuals are encouraged to engage in discussions with their GP or pharmacist. Understanding the risks of the test and its proven efficacy in reducing the risk of cancer-related mortality is paramount.
False-negative test results represent a potential drawback of screening tests, where results may appear normal despite the presence of bowel cancer. This can lead to delayed medical care for individuals receiving such false-negative results. On the other hand, false-positive test results can cause unwarranted anxiety, suggesting the presence of blood in stool when there is none. Such results often necessitate additional tests, such as colonoscopy, which also carry associated risks. Therefore, an informed and thoughtful approach to screening decisions is essential to ensure the most effective and beneficial outcomes for individuals undergoing bowel cancer screening.
