Bowel Cancer Screening in Australia

Why Screening Matters

About 1 in 14 Australians will be diagnosed with bowel cancer during their lifetime. That is a lot of people — and it is natural to feel anxious when you hear numbers like that. But here is the genuinely reassuring part: when bowel cancer is caught early, the chances of a full recovery are very good. Stage I bowel cancer has a five-year survival rate of around 90%. The challenge is that early bowel cancer — and the small growths called polyps that can become cancer over time — usually cause no symptoms at all. By the time you notice something is wrong, the disease may have already progressed. This is why screening exists: it looks for cancer and pre-cancerous polyps before your body gives you any warning signs.

The National Bowel Cancer Screening Program (NBCSP)

The Australian Government runs a free screening programme called the NBCSP (National Bowel Cancer Screening Program). If you are aged 45 to 74, a free home test kit is automatically posted to you every two years. The test is called an FOBT — a faecal occult blood test (FOBT). "Occult" simply means hidden: it picks up tiny traces of blood in your stool that are too small to see. If blood is found, a follow-up colonoscopy — a camera examination of the bowel — is needed to find out why.

How to Do the FOBT

• The kit is sent to your home automatically when you become eligible
• You collect a small sample from two separate bowel motions on different days
• Both samples go back to the laboratory in the prepaid reply envelope — no cost to you
• Your results are posted to you and your GP within 2–4 weeks

You do not need to fast, change your diet, or do any preparation. The whole process takes just a few minutes and is completely painless. Unfortunately, fewer than half of Australians who receive a kit actually return it. That matters, because every kit that goes unused is a missed chance to catch something early — when treatment works best.

Who Needs More Than the NBCSP?

The standard two-yearly FOBT is the right starting point for most Australians. But some people have a higher-than-average risk and need to start earlier, or have a colonoscopy instead of relying on the FOBT alone. You may be in this group if:

• One close family member (parent, sibling, or child) has had bowel cancer: guidelines recommend starting colonoscopy around age 40–45, or 10 years before the age they were diagnosed — whichever comes first. Repeat every 5 years if all is clear.
• Two or more close family members have had bowel cancer: colonoscopy from around age 35–40; your GP can refer you to a specialist to discuss what is right for you.
• You have previously had polyps (small growths in the bowel): your specialist will recommend regular colonoscopies at intervals based on the type and number found.
• You have had bowel cancer before: regular check-up colonoscopies after treatment are a standard part of your ongoing care.
• You have inflammatory bowel disease (Crohn's disease or ulcerative colitis): regular colonoscopies are recommended; how often depends on how long you have had the condition and how much of your bowel is affected.
• You have a known or suspected hereditary condition such as Lynch syndrome or FAP (familial adenomatous polyposis — a condition that causes many polyps to grow): a referral to a genetics specialist is the right next step.

What Happens After a Positive FOBT?

If your result comes back positive, the next step is a colonoscopy — ideally within 30 to 60 days. It is completely understandable to feel worried when you get this news, but please do not let that worry stop you from following it up. Your GP can refer you to a colorectal surgeon who will arrange the colonoscopy. If you have received a positive result and have not yet taken the next step, please call our rooms on (03) 9816 3951 or ask your GP to refer you to Mr Nguyen. We are here to help, not to alarm you.

What If I Am Under 45?

The NBCSP screening programme starts at age 45, but that does not mean you can relax until then if something feels wrong. If you are under 45 and have noticed any symptoms — blood in your stool, a change in your bowel habits, persistent abdominal pain, unexplained weight loss, or extreme tiredness — or if a close family member has had bowel cancer or polyps, please do not wait. Speak to your GP about a referral to a colorectal surgeon regardless of your age. Bowel cancer in younger adults is genuinely becoming more common, and your age does not make your symptoms safe to ignore.

Frequently Asked Questions