Australia's National Bowel Cancer Screening Program offers a free home-based test called the FIT (faecal immunochemical test — you may have also seen it called FOBT). It is sent every two years — automatically from age 50 to 74, and on request from 45 to 49. You collect a tiny sample from your stool at home and post it to a laboratory. The test looks for microscopic traces of blood that you could not see with your own eyes. If the result comes back positive, it simply means blood was detected in your sample — it does not mean cancer has been found.
Blood in the stool can come from many different places, and the vast majority of causes are not cancer. Common reasons include haemorrhoids (piles), a small tear in the anal area (fissure), bowel polyps (small growths that are usually benign), diverticular disease, or mild inflammation. That said, bowel cancer and pre-cancerous polyps can also bleed — which is why every positive result needs to be followed up with a colonoscopy. Roughly 1 in 14 people who screen positive are found to have bowel cancer; for the rest, there is another — usually more straightforward — explanation.
A colonoscopy is a camera examination of your large bowel. It is the only test that can both look at the bowel directly and deal with anything found on the spot — for example, a polyp can be removed at the same time it is discovered. After a positive bowel screening result, a colonoscopy is the necessary next step, and it should be arranged promptly. Mr Nguyen performs colonoscopies at Warringal Private Hospital and Epworth Eastern.
A normal colonoscopy is reassuring. It means the source of bleeding detected by the screening test is not coming from your large bowel. Your doctor may then suggest a gastroscopy — a similar camera test of your upper digestive tract — to look for other sources of blood loss, especially if blood tests show you have iron deficiency anaemia.
After your GP refers you, the rooms will contact you to arrange a consultation and schedule your colonoscopy. The day before the procedure, you will need to take a bowel preparation — a drink that clears out your bowel so the camera can see clearly. The colonoscopy itself is done under light sedation, so you will be comfortable and relaxed. Afterwards, you will receive a full report explaining exactly what was found.
A positive FOBT result should prompt a referral within days, not weeks. The target is a colonoscopy within 4–8 weeks of your result. If you also have any of the following, please ask your GP to mark the referral as urgent: a change in bowel habits, unexplained weight loss, significant rectal bleeding, or iron deficiency anaemia. Do not wait to see whether symptoms resolve — early investigation is always the right call.
Ask your GP for a referral to Mr Nguyen as soon as you receive your positive result. His rooms will triage your referral and arrange an appointment promptly — in many cases the consultation and colonoscopy booking are arranged together. After the colonoscopy you will receive a clear written report, and the findings will be discussed with you along with any further steps needed.
No — the majority of positive results turn out to be caused by something benign, like haemorrhoids or polyps, as explained above. But every positive result does need to be properly investigated with a colonoscopy — that is what the screening program is designed for.
It is important to arrange one as soon as you can — ideally within 4–8 weeks of your positive result. Please do not let it drift. Urgent referrals are triaged and seen as promptly as possible.
Yes. Ask your GP to refer you to a specialist — such as Mr Nguyen — as soon as possible after your positive result. Your GP is your first point of contact, and they can get the referral organised quickly.
Yes — and this is really important. Bowel cancer and pre-cancerous polyps very often cause no symptoms at all. That is the whole point of screening: to find things early, when they are much easier to treat, before you start feeling unwell. Feeling fine is not a reason to delay.
Have questions about positive bowel screen result (fobt/fit)?
Mr Nguyen sees patients at his consulting rooms in Heidelberg and operates at Warringal Private and Epworth Eastern. A GP or specialist referral is required.