I have had a positive FIT test. What happens next?
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Time to read 10 min
Dr Clive Price
Written by Dr Clive Price (MRCGP UK) Founder of True Proactive, practicing GP at Tara Road Medical practice, advocate for proactive medicine. Healthpoint
The Most Important Thing to Know
Your phone rings. You answer, and it is Dr Clive Price from True Proactive.
“Have you got a few minutes to discuss your screening result?”
Naturally, your heart rate starts to rise. Before saying anything else, I am quick to reassure you.
“Please do not panic. A positive FIT result means that further investigation is needed, but it does not mean that you have bowel cancer or anything else serious.”
A positive FIT result means that blood has been detected in your stool sample. It does not tell us where the blood has come from or what has caused it, and it certainly does not mean that you definitely have bowel cancer.
There are several possible explanations. These include bowel polyps (About 70% of our first 50 positive tests have had polyps found), haemorrhoids and other conditions that can cause bleeding. Sometimes (less than 10% of our initial 50 positive tests) the investigation does not find anything concerning at all.
However, because bowel cancer is one possible cause, a positive result should always be taken seriously and investigated appropriately.
The usual next investigation is a colonoscopy. This allows a doctor to examine the inside of the bowel and, where necessary, take biopsies or remove polyps at the same time. In some situations, a CT colonography may be an appropriate alternative.
If you have private medical insurance or are able to fund the investigation yourself, I can often refer you directly for a colonoscopy or CT colonography. This may make the process more straightforward and avoid unnecessary delays while waiting for a separate GP appointment.
If you require investigation through the public health system, it is important to understand that a positive result from a privately arranged FIT test does not automatically guarantee access to a publicly funded colonoscopy.
You will usually need to discuss the result with your GP. Depending on your symptoms, medical history and local referral criteria, the public service may ask you to repeat the test through the FIT for Symptomatic pathway before deciding whether further investigation is required.
Key Points
A positive FIT result is not a diagnosis of bowel cancer.
It means that blood was detected in your stool sample.
Further investigation is usually recommended to identify the source of the blood.
The most common next investigation is a colonoscopy.
A positive privately purchased FIT does not automatically guarantee access to a publicly funded colonoscopy.
True Proactive will contact you and explain the available options.
What does a positive FIT result mean?
A faecal immunochemical test, usually called a FIT, looks for tiny amounts of human blood in a stool sample.
The test cannot show where the blood came from or explain why it is present. It also cannot distinguish between blood caused by cancer and blood caused by another bowel condition.
A positive result therefore means:
''Blood has been detected and further assessment is needed.''
It does not mean:
''You have definitely been diagnosed with bowel cancer.''
Health New Zealand advises that small amounts of blood may be caused by haemorrhoids or bowel polyps, (Polyps are small growths that develop on the lining of the bowel. Most are not cancerous, but some types are precancerous and may develop into bowel cancer over many months or years if they are not removed) Further investigation is needed to determine the cause.
What will True Proactive do?
If you receive a positive True Proactive result, one of our clinicians will contact you personally, usually this will be me but if I am unable to do this call it will be one of my colleagues.
I will explain the result, answer your questions and discuss the most appropriate next steps.
During the conversation I will ask:
• Whether you have any bowel symptoms
• Your family history of bowel cancer
• Previous colonoscopies or bowel investigations
• Your medical history
• Current medication, particularly blood thinning medication
• Whether you have private medical insurance
• Whether you would consider funding an investigation privately
• Your GP details
This helps me understand your circumstances and explain which investigation pathways may be available.
For privacy purposes I do not automatically send a copy of your screening results and letter to your GP, I would recommend that you do forward this to your GP reception and ask them to add both of these to your medical records, this is important so your GP can give you ongoing care.
Do I need a colonoscopy?
In most circumstances, a colonoscopy is the recommended investigation following a positive screening FIT.
A colonoscopy allows a doctor or specially trained nurse to examine the lining of the large bowel using a thin flexible camera. One of the main benefits of a colonoscopy is that it can both diagnose and sometimes treat the cause of the bleeding. The endoscopist can examine the lining of the bowel, take a biopsy if needed and remove many polyps during the same procedure.
Polyps have been the most common significant finding among True Proactive customers who have completed follow up after a positive FIT result. Based on the follow up information currently available to us, approximately 70% have been found to have one or more polyps. These are usually sent to the laboratory to determine the type of polyp and whether there are any precancerous changes or signs of an early cancer.
The idea of having a colonoscopy can feel daunting. However, in more than ten years of working as a doctor, I have found that patients almost always say the procedure was easier than they expected.
Many people tell me that the bowel preparation is the least pleasant part. Before the colonoscopy, you need to take strong laxatives to empty the bowel. This is important because it allows the camera to clearly examine the bowel lining rather than having the view obscured by bowel contents (Poo!).
During the colonoscopy, medication is usually provided to help you feel relaxed and comfortable, and many people remember very little of the procedure.
Like any invasive medical procedure, colonoscopy carries some potentially significant risks. These can include bleeding, particularly if a polyp is removed, and a small risk of damage to the bowel. Before the procedure, the endoscopist will explain the benefits, risks and alternatives in detail so that you can make an informed decision about whether to proceed. For most people being investigated after a positive FIT result, the expected benefits of colonoscopy are considered to outweigh the risks.
How do I get a colonoscopy?
Health Insurance / Self Funding / Private
If you have private health insurance, or are able to pay for a colonoscopy yourself, arranging one is usually relatively straightforward. Most insurers will cover a colonoscopy when their policy criteria are met. However, some may require you to have relevant symptoms rather than accepting a positive screening FIT result on its own.
Our preferred referral partner is the MacMurray Centre. They have branches in Auckland, Cambridge, Tauranga, Queenstown and Christchurch. For Wellington, we recommend the Rutherford Clinic. We use these referral partners because we find they offer the best journey from start to finish process for our positive patients.
True Proactive will be able to refer you directly to either the MacMurray Centre or the Rutherford Clinic. They are able to accept our referral directly, meaning that you do not have to cause any additional delay in proceedings by booking a GP appointment. Not only does this save you money, but it also saves an appointment with your GP for someone else who may need it.
If you wish to self fund, meaning that you pay for your colonoscopy yourself, MacMurray Centre prices range from $2,665 to $4,545. They also offer a bowel screening package for $3,360. This includes a follow up if required and all procedural costs, regardless of what is done in theatre.
If you have insurance, the MacMurray Centre tends to work with your insurance company to get things sorted for you. Most of the time, insurers are happy to accept a True Proactive referral letter, but we recommend checking to ensure that they do not require a referral from your registered GP. If this is the case, please book an urgent appointment with your GP to discuss a private referral.
Even if you do not need to book a GP appointment it is good practice to inform your GP, so they can update your records and are aware of the referral being in place as they may need to manage things after your colonoscopy.
No Health Insurance / Unable to Self Fund / Public Investigation
A positive FIT completed through the National Bowel Screening Programme is followed through the programme and usually leads to a publicly funded colonoscopy. Health New Zealand states that the same automatic follow up is not available for FIT kits purchased and used outside the National Bowel Screening Programme.
A private positive result should still be discussed with your GP, but access to publicly funded investigation will depend on Health New Zealand criteria, clinical assessment and the pathway operating in your region.
The public system may consider factors such as:
• Whether you have symptoms
• The nature and duration of those symptoms
• Your blood results
• Your age
• Your family history
• Your FIT result
• Previous investigations
• Local referral criteria
In some circumstances, further assessment or another Health New Zealand supplied FIT may be requested before a decision about colonoscopy is made, this repeat FIT test would be funded by Health NZ via the FIT for symptomatic pathway.
True Proactive Results so far
As of July 2026 we have dispatched 3400 FIT tests. Out of the returned kits so far we have had:
- 50 Positive FITs
- 40 of those have been insured
- 5 half self funded further investigation
- 5 have required public investigation
Out of the 50 positive FITS this is how the outcomes break down.
- 2 patients had no cause for symptoms at all found
- 28 patients had at least one polyp found and removed
- 13 had multiple polyps or very large pre cancerous polyps removed - 'potentially life saving
- 2 Early cancers found - 'life saving'
- 1 had a genetic polyp syndrome, family now need screening - life saving
- 4 Patients awaiting for colonoscopy
FAQ
Should I repeat the FIT test?
You should not simply repeat a FIT privately in the hope that a negative result will cancel out the original positive result.
Bleeding from bowel conditions can be intermittent. A later negative sample does not necessarily explain why blood was detected in the first sample.
Any repeat testing should form part of an agreed clinical pathway with your GP, specialist or Health New Zealand.
What if I already know that I have haemorrhoids?
Haemorrhoids can bleed, but they should not automatically be assumed to be the cause of a positive FIT result.
People can have haemorrhoids and another bowel condition at the same time. Health New Zealand advises that bleeding from the bottom should be assessed to exclude more serious causes.
Tell the clinician if you have known haemorrhoids, but still follow the advice given about further assessment.
What if I have bowel symptoms?
True Proactive FIT screening is designed for people without bowel symptoms.
If you have symptoms, make sure that you tell the clinician and arrange an assessment with your GP. Important symptoms include:
• Visible blood in your stool
• A persistent change in bowel habit
• Unexplained weight loss
• Persistent abdominal pain
• Unexplained iron deficiency anaemia
• Increasing tiredness or weakness
• A feeling that your bowel is not emptying normally
A screening test should not be used as a substitute for assessing symptoms. Health New Zealand advises people with blood in their stool or a change in bowel habits to contact their healthcare provider rather than waiting for screening.
How quickly should I arrange further investigation?
A positive result should be followed up promptly, but it does not usually mean that you need to attend an emergency department.
The appropriate timing will depend on your symptoms, medical history and level of risk.
We recommend that you:
- Speak with the True Proactive clinician when contacted.
- Decide whether you are pursuing an insured, self funded or public pathway.
- Contact your insurer and colonoscopy clinic promptly if you are seeking private funding.
- Arrange a GP appointment if you need to access the public system or have symptoms requiring assessment.
- Tell us if you encounter difficulty arranging the recommended follow up.
I used to practice in the UK - we had the target of two weeks from a positive FIT to having a colonoscopy - this is a useful target to have in mind, it may be achievable particularly if you have insurance or are self funding. Public investigation can take longer, you should speak to your GP if you are having public investigation as to how long this may take.
What if my insurer declines the claim?
You can discuss self funding with a private provider or arrange an appointment with your GP to explore the public pathway.
Can my GP receive the result?
For privvacy reasons we will not send a copy of your screening results or letter to your GP without permission. We always recommend you send a copy of your results to your GP so they can add them to your record.
If you would prefer us to inform your GP we can also do this for you if you provide your GP details.
What if I feel completely well?
Many people with a positive FIT result have no bowel symptoms. This is the purpose of screening: to detect small amounts of blood that cannot be seen and identify possible problems before they cause symptoms. You should still arrange the recommended investigation even when you feel entirely well.
Dr Clive Price
Dr Clive Price is a UK trained General Practitioner with over 12 years of clinical experience. He currently practises in New Zealand and founded True Proactive to improve access to proactive, evidence based doctor led health screening services.