A simple home test is sparing thousands of people from unnecessary hospital investigations for bowel cancer, while helping patients who do have the disease receive faster answers, according to new data showing the impact of NICE‑recommended faecal immunochemical testing.
Figures for 2024/25 show there were 140,000 fewer urgent referrals for suspected bowel cancer than expected, a reduction of 22% compared with the pre‑pandemic trend – even as cancer detection rates remained stable.
The faecal immunochemical test detects small amounts of blood in stool, which can be an early sign of bowel cancer. The disease is the second biggest cancer killer in the UK, affecting the colon and rectum. While most cases are diagnosed in people over 50, bowel cancer can affect adults of all ages.
By allowing GPs to assess risk before referral, FIT helps identify patients who genuinely need urgent investigation while safely reassuring those unlikely to have cancer.
Since the rollout of FIT, urgent referrals for suspected bowel cancer have fallen, but crucially, the number of cancers detected has remained stable.
NHS England data shared with NICE shows the test is successfully targeting urgent investigations at those who need them most, improving patient experience while easing pressure on overstretched NHS diagnostic services.
Meanwhile, referrals for all other cancers combined have remained broadly in line with pre‑pandemic levels, underlining that the reduction is specific to bowel cancer pathways and linked to FIT use.
NICE issued updated guidance in 2023, recommending FIT for assessing patients with symptoms of bowel cancer, building on earlier guidance advising GPs to offer the test to certain symptomatic groups.
Since then, uptake has increased steadily:
- In June 2023, fewer than 60% of urgent bowel cancer referrals included a FIT result
- By June 2025, this had risen to almost 80%
The increased use of FIT has helped GPs make more targeted referrals, reducing unnecessary colonoscopies and helping services recover capacity.
Eric Power, Interim Director of the Centre for Guidelines, commented:
“It is encouraging to see the excellent adoption in primary care of this technology to avoid unnecessary procedures, reduce patient anxiety, and make more efficient use of NHS resources.
"By using FIT, clinicians can more safely and quickly reassure people who are unlikely to have cancer and remove them from the NHS waiting list for a cancer referral. This is not only better for the patient, but frees up appointments for people who do have cancer to be seen faster, and that will improve their chances of a positive outcome following treatment.
"NICE is committed to keep focusing on what matters most to support cancer pathways and deliver better outcomes for patients."
Research published last year analysing more than 10,000 patient records across nine NHS trusts in the South West found that widespread FIT adoption led to:
- Fewer colonoscopies
- Shorter waiting times
- A return to pre‑pandemic diagnostic performance
The findings reinforced FIT’s role in improving efficiency without compromising cancer detection. FIT is also helping people get answers more quickly.
Under the NHS lower gastrointestinal Faster Diagnosis Standard, patients urgently referred with suspected cancer should find out whether they have cancer within 28 days.
This improvement has been driven largely by patients being ruled out for cancer more quickly, allowing faster reassurance and reducing anxiety. By comparison, performance against the FDS for all other cancers combined improved by just four percentage points over the same period.
Despite clear improvements, the lower gastrointestinal Faster Diagnosis Standard still lags behind other cancer pathways. NICE and NHS leaders say continued adoption and consistent use of FIT will be critical to further improving outcomes.
Overall, the data shows that FIT is delivering earlier answers for patients, fewer unnecessary referrals, and more efficient use of NHS resources, marking a significant step forward in bowel cancer diagnosis.
Image credit: iStock
