NHS England lowers FIT threshold to catch more bowel cancers early

NHS England will enhance bowel cancer screening sensitivity starting next month, potentially detecting 600 additional early-stage cases annually and preventing thousands more through polyp removal.

NHS lowers FIT threshold to detect bowel cancers: Enhanced Screening Threshold

From February 2026, NHS England reduces the faecal immunochemical test (FIT) positivity threshold from 120 µg Hb/g to 80 µg Hb/g, increasing colonoscopy referrals by 35% for patients over 50. This targets smaller blood traces in stool samples, identifying ~600 more invasive colorectal cancers yearly (11% detection increase) plus 2,000 additional high-risk adenomas for pre-cancerous intervention.

Projected Clinical Impact

Lower threshold implementation across England by March 2028 should cut late-stage diagnoses and bowel cancer mortality by ~6%, while colonoscopy positivity rises from 2% to 3% of screened individuals. Pilot programs across eight sites already identified 60+ extra cancers and 500 high-risk polyps through streamlined screening-to-diagnostic workflows.

NHS Cost Savings

Annual NHS savings projected at £32 million stem from fewer advanced cancers requiring expensive late-stage treatment, offset by increased early colonoscopies. Digital reminders will boost screening uptake alongside the National Cancer Plan launching next week, targeting transformation by 2035.

Colorectal Cancer Context

UK's third most common malignancy (fourth overall) kills ~16,000 annually despite effective early screening via simple at-home FIT kits sent to all ≥50-year-olds. UK National Screening Committee endorsed the threshold reduction following pilot success, maintaining unchanged patient collection process—single stool sample in postal tube for lab analysis.