Bowel cancer screening: 3 things I’ve learned from 5,500 kits

We’ve now sent out more than 5,500 bowel cancer screening tests through True Proactive. There are three things I’ve learned along the way that I think everybody should know.

Some of it has reinforced what I already knew as a GP that has been practicing for over 10 years. Some of it has surprised me. But the conversations I keep thinking about are the ones with people who felt well, looked after themselves and never really imagined bowel cancer would affect them.

I wanted to tell you about the lessons I have learned, because i feel they can really clear up some of the misinformation regarding bowel cancer and hopefully give people some information so they can make a fully informed decision on whether bowel cancer screening is right for them.

Around half of our positive FIT results have been in people who reported no symptoms at all. And over half of the bowel cancers identified following our tests have also been in people who reported no symptoms.

These are observations from our own service at the time I recorded the video (29/09/2026), rather than figures for New Zealand as a whole. The 5,500 figure refers to kits sent out, not completed tests.

Even with that distinction, it is something I think about a lot. If you’re waiting to feel unwell before you think about bowel cancer, you can miss the opportunity to find it earlier.

That is the purpose of screening. A FIT test, or faecal immunochemical test, looks for tiny traces of blood in your stool that you would not necessarily be able to see. It can help identify people who need further investigation before obvious symptoms develop.

A positive FIT does not mean you have cancer. It means blood has been detected and the cause needs investigating, usually with a colonoscopy. I’ve explained that in more detail in what happens after a positive FIT test.

There is good research behind regular FIT screening. The COLONPREV trial, published in The Lancet in 2025, compared inviting adults aged 50 to 69 to repeated FIT screening with inviting them to a one-off colonoscopy. Bowel cancer mortality was similar over ten years, and more people took part when offered FIT. That supports FIT as a screening programme; it does not mean one negative stool test gives you the same information as a colonoscopy.

Earlier diagnosis generally gives us more treatment options and a better chance of a good outcome. Feeling well is exactly when screening is worth thinking about. I’ve written more about bowel cancer without symptoms here.

I’ve spoken to young patients diagnosed with bowel cancer who live healthier lives than I do. People in their 30s who exercise, eat incredibly well, don’t smoke and drink very little alcohol.

After the diagnosis, they’re often completely bewildered.

I don’t think I’ll ever forget some of those conversations.

There is an awful lot of misinformation around this. Social media is full of people suggesting that if you eat the right foods and look after yourself, you won’t get bowel cancer.

That simply isn’t true.

Healthy habits matter. Being physically active, avoiding smoking and limiting alcohol can help lower your risk. But there are also things you cannot choose, including your age, family history and inherited conditions. The National Cancer Institute’s overview of bowel cancer risk explains these factors in more detail.

Reducing your risk does not mean removing it altogether. And you cannot look at someone who has bowel cancer and decide they must have done something wrong.

In the video, I say that bowel cancer is not self-inflicted. What I mean is that a diagnosis is not something a person deserves, or evidence that they have failed to look after themselves. We need to talk about prevention without leaving people feeling blamed for being ill.

Bowel cancer is more common as we get older, but younger people can get it too. Being fit, young or careful about what you eat should never be a reason to dismiss a concern. My article on bowel cancer in young adults goes into that further.

This is probably the one that has surprised me most.

I’ve lost count of how many people with a positive test have said something along these lines:

Often there wasn’t anything obvious or dramatic. They had just noticed something subtle had changed.

I’m a firm believer that people know their own bodies well. You live in your body every single day. You know what is normal for you, and sometimes you notice a change before you can properly explain it.

That does not mean a feeling is a diagnosis, or that every change is cancer. Most bowel symptoms have other causes. It does mean your concern deserves to be heard.

And there is an important distinction here: if something has changed, please speak to your GP. Even a subtle change can be a symptom. A private screening test should not replace a proper assessment, and a negative result should not stop you going back if the problem continues.

A 2024 review in JAMA Network Open, covering 81 studies, found that rectal bleeding, abdominal pain and changes in bowel habit were common in people diagnosed with bowel cancer before 50. Delays of four to six months from symptoms to diagnosis were common too. That does not tell us what is causing any one person’s symptoms, but it does show why we need to take them seriously.

Visible blood, a persistent change in your bowel habit, unexplained weight loss, ongoing abdominal pain or unexplained iron deficiency anaemia all deserve medical assessment. You do not need to wait until you have several of them. Health New Zealand has more information about bowel cancer symptoms.

If you’ve already been seen and things still aren’t right, make another appointment. Tell your GP what has changed and that it is continuing.

If you feel well, think about an appropriate bowel cancer screening plan. If you’re eligible for the National Bowel Screening Programme, please take part when your kit arrives. If you have a strong family history or a known inherited risk, speak to your GP about the right approach for you.

For people without symptoms who are considering private screening in New Zealand, our True Proactive FIT test can be completed at home, with laboratory analysis and a doctor reviewing your result. There is also a two-person FIT test pack if you and your partner both want to screen. Please read the suitability and follow-up information before ordering.

If you have symptoms or something has changed, book in with your GP. That is the next step I would want you to take.

Thanks for reading.

Dr Clive Price
GP and founder of True Proactive

This article accompanies my video on three things I’ve learned from bowel cancer screening. The service figures are those reported in the video. Screening tests can give false positive and false negative results and do not provide a diagnosis. Persistent or new symptoms need medical assessment.