Don’t Delay Bowel Cancer Screening, It Could Save Your Life

March is Colorectal Cancer Awareness Month, a perfect time to talk about a topic many avoid: bowel cancer screening. It might not be dinner-table conversation, but it’s one that could save your life. Bowel cancer is Australia’s second deadliest cancer, claiming over 5,300 lives each year​. The good news? It’s also one of the most treatable cancers if caught early – over 90% of cases can be successfully treated when detected at an early stage​. Early detection is key, and that’s exactly what Australia’s free screening program is all about. In this article, we’ll explain how the National Bowel Cancer Screening Program works, why you shouldn’t be embarrassed to do a simple at-home “poo test,” and what to do if you have warning signs or need further tests. This will be a no-nonsense conversation about your health, because not talking about it is far worse than a bit of temporary discomfort.

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Why Early Detection of Bowel Cancer Matters

Bowel cancer (also called colorectal cancer) often develops without any symptoms at first​. You could feel perfectly healthy while a hidden tumor grows in your bowel over years. By the time obvious symptoms appear, the cancer may already be advanced. That’s why early detection through screening is so important. When found early, 9 out of 10 bowel cancers can be successfully treated​. In other words, screening can catch bowel cancer before it causes trouble – when it’s easier to remove and before it spreads.

Yet despite these odds, many people put off screening. Bowel cancer is the second deadliest cancer in Australia (after lung cancer)​, but it doesn’t have to be. Each year over 15,000 Australians are diagnosed with bowel cancer – men and women, young and old. Tragically, about 6 in 10 eligible Aussies don’t participate in the free screening program, often due to fear, embarrassment, or simply tossing the kit in a drawer and forgetting. We’re here to tell you why you should make screening a priority and address those concerns head-on.

Early detection means small problems can be fixed before they become big problems. In fact, bowel cancer usually starts as tiny growths called polyps on the bowel wall. These polyps can turn into cancer over time​. If found early (say, during a screening test or follow-up colonoscopy), polyps can be removed before they ever become cancer. That’s a lifesaving preventive strike – and it all starts with a simple test you do at home.

How Australia’s Free Bowel Cancer Screening Program Works

Australia’s National Bowel Cancer Screening Program (NBCSP) is a government initiative that provides free at-home screening kits to eligible Australians. The program’s goal is to catch bowel cancer early, even before symptoms appear​. Here’s how it works:

• Eligibility: If you’re aged 50 to 74, you will automatically receive a bowel cancer screening kit in the mail every two years. The kit usually arrives around your birthday (so, think of it as an odd sort of birthday present from the government!). Your kit is sent to the address listed on your Medicare card, so keeping your details up-to-date is important. (Note: As of 1 July 2024, the program has started to include people aged 45–49 on an opt-in basis. If you’re 45–49, you won’t get a kit automatically, but you can request a free kit by filling out an online form or calling the program’s hotline​.) All eligible people 45–74 can also talk to their GP about getting a kit if they haven’t received one​.
• What You Get: The kit contains everything you need to complete a faecal occult blood test (FOBT), often called the “poo test.” This is a simple, clean, at-home test that checks for tiny traces of blood in your stool (poo) that you can’t see with the naked eye​. Don’t worry – it does NOT mean you have to collect a whole stool sample in a jar or anything messy. The kit has a small stick or brush that you use to take just a little smear from your bowel movement, and you do this for two separate bowel motions.
• How to Use It: The instructions in the kit will walk you through it step by step, but essentially: you put a paper liner or plastic sheet (provided) in the toilet to catch your poo, use the little stick to dab a tiny sample from it, and secure the sample in the container provided​. You repeat this for two different poos (on the same day or on two days close together). After collecting your two tiny samples, you seal them up, complete the consent form with your details, and pop everything into the reply-paid envelope included in the kit​. Then you mail it off – postage is free.
• Getting Results: Your samples go to a pathology lab, and in about 1–2 weeks you’ll receive your results by mail (and your GP will too). The result will either be negative (no blood detected) or positive (blood was found). We’ll talk more about what each means in a moment.
• If the result is negative: Great news – no blood was found in your samples. Keep in mind, a negative result doesn’t 100% guarantee you’re in the clear, but it’s a very good sign. You should still repeat the test every two years as invited​. (And of course, if you develop any symptoms in the meantime, see a doctor – more on symptoms below.)
• If the result is positive: Don’t panic. A positive FOBT result doesn’t mean you have cancer. In fact, only about 1 in 14 people who do the test get a positive result, and of those, many turn out not to have cancer. What it does mean is that blood was detected in your poo, so further investigation is needed​. The next step will usually be a colonoscopy (more on that soon) to find out why there was blood. The blood could be from a polyp, haemorrhoids, inflammation, or other causes – not necessarily a tumor. But it’s critical to follow up and find out. The screening program will advise you to see your GP, who can refer you for the appropriate follow-up tests​.

One important thing to remember: the screening test is for people without symptoms. It’s a preventive check. If you do have symptoms (e.g. blood in your stool or persistent gut issues), don’t wait for a screening kit – see a doctor straight away. The program is designed to catch the silent cases that give no warning. Which brings us to…

Overcoming the “Yuck” Factor – Don’t Let Embarrassment Stop You

Let’s be honest – collecting a poo sample isn’t anyone’s idea of fun. It’s awkward, a bit yucky, and easy to procrastinate. Many of us receive that kit in the mail and think, “Ugh, I’ll deal with that later,” or not at all. But let’s put things in perspective. Doing this test might be slightly uncomfortable for a few minutes, but bowel cancer is a lot more unpleasant. A tiny inconvenience now could spare you major surgery, chemotherapy, or worse down the track.

If you feel squeamish or embarrassed, you’re far from alone. It’s completely normal to feel that way! The key is not to let those feelings stop you from taking action. Here are some points to keep in mind:

• It’s private and easy: You do the test by yourself at home, in your own bathroom. No one is watching or involved. The kit is designed for cleanliness – you’re using a small tool to dab a sample, not handling the poo directly. There’s no bad smell, no mess if you follow the instructions. It’s about as hygienic as dealing with poo can possibly get (much cleaner than changing a baby’s nappy, for example).
• It’s quick: Collecting the samples literally takes a couple of minutes, and you only need to do it twice. Many people say the anticipation was worse than the actual process – once they did it, they realized it wasn’t a big deal at all.
• Nobody has to know: If the embarrassment is social (you don’t want your partner/housemate to know you’re doing a poo test), remember you can keep it discreet. You can do it when you have the bathroom to yourself, and the samples go straight into the sealed tubes and envelope. The package you mail back is plain and doesn’t scream “there’s poo in here!” or anything like that.
• Think of it as self-care: Just like you might grit your teeth to get a flu shot or a blood test because it’s good for you, this is the same idea. You’re taking care of your future self. Be proud that you’re responsible enough to do this for your health.

It might also help to remind yourself that bowel cancer is common and nothing to be ashamed of. Pretty much everyone has to deal with poop – it’s a universal human experience. By doing the test, you’re joining millions of Australians in taking a positive step. If you need a slogan to pump yourself up, Bowel Cancer Australia often says: “Break the taboo, check your poo!” It’s cheesy but it might just stick in your head.

Bottom line: Don’t let a bit of ick factor potentially cost you your life. The brief awkwardness of the test far outweighs the regret of a missed early diagnosis. If you’ve been putting that kit aside, make this month the time you get it done. Put it somewhere you won’t ignore (maybe right next to the toilet) and commit to doing it on your next day off. You’ve got this!

Know the Symptoms – Don’t Ignore These Warning Signs

Screening is crucial because it catches cancers before symptoms appear. However, bowel cancer can strike at any age, and it does sometimes cause symptoms even in people younger than the screening program’s age range. In fact, about 1 in 9 new bowel cancer cases in Australia occur in people under 50​. So, whether you’re 28 or 78, it’s important to know the warning signs of bowel cancer and see a doctor promptly if you notice them.

Key symptoms to watch for include:

• Changes in bowel habits: Persistent changes in how often you go or how your stool looks. This could be new-onset constipation or diarrhoea, or going more frequently than usual, especially if it lasts more than a couple of weeks​.
• Blood in the stool: Blood in your poo is a red flag. It might be bright red, or dark/black tarry stools, or even blood that’s not visible to the eye (which is what the FOBT can detect). Any sign of blood should be checked by a doctor.
• Abdominal pain or cramping: Ongoing tummy pain, bloating, or cramps that don’t have an obvious cause and don’t go away​.
• Unexplained weight loss: Losing weight without trying, or persistent loss of appetite.
• Unexplained fatigue: Feeling extremely tired or weak all the time can be a sign of internal blood loss (even microscopic) leading to anemia​.

These symptoms can be caused by many things other than cancer – for example, hemorrhoids can cause blood in stool, and stress can upset your bowels. But you should not self-diagnose or ignore them. If any of these issues persist for more than a couple of weeks, see a GP and get it checked​. This advice applies even if you’re younger than the screening age. Bowel cancer in younger people is less common, but it’s on the rise, and doctors are seeing more cases in people under 50 than in decades past. Never assume “I’m too young for bowel cancer” – if something feels off, get it looked at.

Remember, you don’t have to wait for a mailed kit if you have symptoms. The screening program is for asymptomatic people. If you have concerns, a doctor might skip straight to diagnostic tests like a colonoscopy or other assessments rather than doing an FOBT​. The principle is: screening is for when you feel fine; if you don’t feel fine, that’s when you go straight to the doctor. Trust your gut (pun intended) and advocate for your health.

Who Needs a Colonoscopy and Why

By now you’ve heard us mention colonoscopy a few times. A colonoscopy is a follow-up procedure that comes into play if something needs further investigation – typically if you have symptoms or if your screening test was positive. But what exactly is a colonoscopy, and who needs one?

A colonoscopy is a medical procedure where a specialist uses a thin, flexible camera (a colonoscope) to examine the inside of your large intestine (colon and rectum). It’s considered the gold standard for detecting bowel abnormalities because the doctor can directly see any tumors or polyps and even remove suspicious growths on the spot. Here are the key points:

• When is a colonoscopy recommended? In Australia, you’ll generally be referred for a colonoscopy if you receive a positive FOBT screening result (meaning blood was found)​, or if you have symptoms suggestive of bowel cancer, such as those we listed above, that persist for more than about two weeks​. Additionally, if you have a strong family history of bowel cancer or certain genetic conditions, your doctor might recommend periodic colonoscopies even if you have no symptoms (this would be a personalized surveillance plan).
• What happens during a colonoscopy? The idea of a camera going up your backside might sound daunting, but the procedure is done under sedation or light anaesthetic, so you won’t be awake or feeling discomfort during it. It usually takes about 20–30 minutes. The doctor gently inserts the colonoscope (lubricated, of course) into the rectum and guides it through the colon, looking at a video feed of your bowel lining. If they see any polyps or unusual areas, they can use tiny instruments through the scope to remove polyps or take biopsies (small tissue samples) on the spot. Removing polyps is preventative – many polyps are benign, but some can turn into cancer over time​. By snaring them early, the doctor prevents future cancer. If there is an actual tumor, biopsies will confirm the diagnosis so treatment can begin.
• Is it painful or risky? Colonoscopy is generally safe and routine. You’ll be groggy or asleep thanks to the sedation, so you shouldn’t feel pain during the procedure. Afterwards, you might have some gas or bloating (they pump a bit of air in the colon during the test) and maybe mild cramps, but serious complications are rare. The thought is scarier than the reality for most. Tens of thousands of Australians get colonoscopies each year, and for the vast majority it’s a smooth experience. You will need someone to drive you home afterwards, since you’ll be a bit drowsy until the sedation fully wears off​.
• Why is colonoscopy so important? If your FOBT was positive, a colonoscopy can find where that blood came from and treat it if necessary. Many times it could be a bleeding polyp that can be removed then and there. If it is cancer, catching it via colonoscopy at an early stage means you can get curative treatment ASAP. If you have symptoms, colonoscopy can identify the cause – maybe it’s inflammatory bowel disease, maybe it’s polyps, or maybe cancer – and get you on the right treatment. It’s thorough and accurate. In fact, colonoscopy is such a powerful tool that some countries use it as the primary screening method. In Australia, we start with the non-invasive home test and use colonoscopy as the follow-up or for higher-risk individuals. This two-step approach is effective and efficient.

If you ever need a colonoscopy, your GP will explain how to prepare (you usually have to drink a special solution the day before to clear out your bowels – that’s actually the hardest part for many, as it causes diarrhoea to clean you out). The procedure itself is done at a hospital or day clinic by specialists. It might sound a bit scary, but knowledge is power: knowing what’s going on inside your body is far better than worrying in the dark. And if nothing is found, you get tremendous peace of mind.

Taking Action and Getting Support (Yes, Even via Telehealth)

By now we’ve covered what you need to do – complete your screening kit if you’re eligible, and see a doctor if you have any concerns or a positive result. But we understand that taking action isn’t always straightforward. You might be busy, find it hard to get to a GP, or feel anxious about the whole process. The important thing is: don’t delay. There are plenty of supports to help you move forward, including modern telehealth services if an in-person visit is a barrier for you.

If you have a positive screening test or concerning symptoms, the next step is to see a GP for further advice or a referral (for example, a referral to get a colonoscopy with a specialist). If getting an appointment with your regular GP is difficult, consider using a telehealth service. For instance, NextClinic’s telehealth doctors are available online and can assist you with many steps of this journey from the comfort of home. Through a quick online consultation, they can provide specialist referrals – meaning if you need to see a gastroenterologist or have a colonoscopy, they can write you the referral letter you’ll require. This can save you time and help you get into the queue for a specialist sooner rather than later.

Telehealth can also help with the little things around a bowel check-up. Say you need to take a day off work for a colonoscopy or because you’re not feeling well – NextClinic can issue online medical certificates to cover your sick leave. If you’re prescribed medication (for example, iron supplements if you’re anemic, or a bowel prep solution for your colonoscopy), services like NextClinic can arrange online prescription repeats so you don’t have to scramble for a refill. All of these conveniences mean you can focus on your health without added hassle.

Importantly, these telehealth options are AHPRA-registered doctors just like your regular GP, and the services are designed to be fast and easy. So if embarrassment or scheduling has been holding you back from talking to a doctor, that’s no longer an excuse – you can literally hop on your phone or computer and get the process started. The key is to do something: whether it’s booking an in-person GP visit or a video call, just make that commitment to yourself.

Empower yourself by taking action. Open that screening kit and use it. If you lost it or threw it out, you can request a new one online or via your GP​. If you have symptoms, call up a doctor or use a service like NextClinic today. Bowel cancer is urgent, but it’s also very beatable when addressed early. Every step we’ve discussed – the home test, the colonoscopy, the doctor’s consult – is a step that puts the odds in your favor.

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Disclaimer

This medical blog provides general information and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult with your regular doctor for specific medical concerns. The content is based on the knowledge available at the time of publication and may change. While we strive for accuracy, we make no warranties regarding completeness or reliability. Use the information at your own risk. Links to other websites are provided for convenience and do not imply endorsement. The views expressed are those of the authors and not necessarily representative of any institutions.