The envelope has been there for weeks: the invitation for the national bowel cancer screening programme, with a small test tube to use at home. You know you should do it, but it keeps getting put off. That feeling is completely normal. Yet this is exactly the test worth doing, because bowel cancer is one of the few types you can often detect early.
We will be honest: of all the preventive tests you can do at home, this simple stool test probably delivers the most health benefit per minute of effort. Below you can read calmly how it works.
Why does bowel cancer risk rise after 60?
Bowel cancer usually develops slowly, often from small polyps in the bowel wall that take years to grow. That slow growth is exactly why early detection helps: if something is found in time, the options are usually greater. The risk rises with age, which is why the Dutch programme focuses on people aged 55 to 75.
The RIVM coordinates this screening programme in the Netherlands and automatically invites everyone in that age group. You do not need to sign up yourself.
What is the bowel cancer screening programme?
Everyone aged 55 to 75 receives an invitation every two years. You do a stool test at home, the FIT (faecal immunochemical test), and send it back in the supplied envelope. The screening is free and voluntary. According to Thuisarts.nl, the aim is to find bowel cancer or its early stages before you notice any symptoms.
If you receive an invitation, our advice is simple: take part. It takes little effort and can mean a lot.
How does the FIT test work?
The FIT, the faecal immunochemical test, detects very small, invisible amounts of blood in the stool. Polyps and tumours can bleed a little, often without you noticing. You wipe a small stick across the stool and send the tube in. A normal result is reassuring, but does not rule everything out, which is why repeating it every two years matters.
What does each result mean?
The table below helps you understand what a result does and does not say. When in doubt, it is always wise to consult your GP.
| Result | What it means | What usually follows |
|---|---|---|
| No blood found | No sign at this time, not a guarantee | New invitation in two years |
| Blood found | Worth looking further, it is not a diagnosis | Invitation for a colonoscopy |
| Symptoms despite a normal result | Blood or bowel complaints deserve attention | Discuss this separately with your GP |
An abnormal result does not mean you have bowel cancer. Blood in the stool can also come from haemorrhoids, for example. It is a signal to look further, not a verdict.
Can you test outside the screening programme?
Yes. If you are under 55, over 75, or want certainty between two invitations, you can arrange a test for hidden blood yourself. At Levenswijs you can do this with the Occult Blood Test, without a referral. The result is reviewed by a doctor.
If you would like the bigger picture first, read which blood values change after 60, or see which preventive blood tests make sense at this age. That way you choose what suits you.
How do you do the FIT test at home correctly?
The test comes with clear instructions, but a few points make it easier. You collect a small amount of stool, for example on a sheet of toilet paper or a special collection sheet, and brush over it with the supplied stick. So you do not need to gather a large amount. Write the collection date on the tube if asked, and ideally send it the same day, so the sample stays fresh.
A common question is whether you should postpone the test during a stomach or bowel infection, or if you have bleeding haemorrhoids. If in doubt, read the instructions in the envelope again, or call the number provided. It is better to postpone the test briefly than to send in an unreliable result.
Can you test outside the screening programme?
Yes. If you are under 55, over 75, or want certainty between two invitations, you can arrange a test for hidden blood yourself. At Levenswijs you can do this with the Occult Blood Test, without a referral. The result is reviewed by a doctor. Keep in mind that testing yourself does not replace the screening programme: the programme is free and well founded, and continuing to take part is the best choice for most people.
If you would like the bigger picture first, read which blood values change after 60, or see which preventive blood tests make sense at this age. That way you choose what suits you.
What can you do to keep your bowels healthy?
Besides taking part in the programme, a fibre-rich diet, enough movement, and going easy on red and processed meat all help. The Voedingscentrum advises adults around 30 to 40 grams of fibre a day, for example from wholemeal bread, pulses, vegetables, and fruit. Fibre keeps the stool soft and seems to play a favourable role for bowel health. The Voedingscentrum also advises limiting processed meat such as sausage and cold cuts and not eating too much red meat.
Drinking enough, moving, and not smoking also belong on this list. These are not guarantees, but they are habits that can support your bowels in the long term. You do not have to overhaul your diet at once: an extra portion of vegetables a day and choosing wholegrain more often is already a good start.
Frequently asked questions about bowel cancer screening
Finally, we answer the questions we hear most often, briefly and clearly.
Does the test hurt? No. You collect a very small amount of stool at home with a stick. There is no needle or internal examination involved.
What if I have not received an invitation? If you receive no invitation after 55, contact the screening organisation or your GP. According to the RIVM, everyone in the target group is approached automatically, but addressing sometimes goes wrong.
A relative had bowel cancer, should I start earlier? With bowel cancer in close family, earlier or more frequent testing can be wise. Discuss your family history with your GP, because sometimes a different advice applies to you than the standard age.
Our advice: do not leave that envelope sitting any longer. And if you notice blood in your stool, ongoing abdominal pain, or a change in your bowel habits in the meantime, do not wait for the next invitation but discuss it with your GP. A normal result is reassuring, but new complaints always deserve attention.
Frequently asked questions
Is the FIT test reliable?
The FIT detects hidden blood in the stool reasonably well, but no test is perfect. A normal result does not fully rule out bowel cancer, and an abnormal result does not automatically mean cancer. If in doubt or with symptoms, your GP remains your point of contact.
Who is the bowel cancer screening programme for?
In the Netherlands everyone between 55 and 75 receives an invitation every two years. Taking part is free and voluntary. You can find more information at the RIVM.
Can I get tested if I have no invitation?
Yes. If you are younger than 55, older than 75, or want certainty in between, you can do the Occult Blood Test yourself at Levenswijs, without a referral.
What does blood in my stool mean?
That can have many causes, from harmless haemorrhoids to something that needs further investigation. An abnormal test is a reason to look further, not a diagnosis. Discuss it with your GP.
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