Built from the criteria NICE actually uses, rather than a generic list of warning signs. It tells you three things: whether guidance points towards a stool test, whether something needs examining instead, and where the criteria leave gaps. It runs entirely in your browser and nothing is sent to us.
National guidance moved away from symptom checklists in 2023, and it is worth knowing why. Individual symptoms are poor predictors of bowel cancer. No list, however carefully written, sorts people as accurately as measuring something does.
So this checklist does not tell you how worried to be. It tells you what the guidance would do with what you have described: offer a test, examine you, or neither.
One rule matters more than the rest. A rectal mass, an unexplained anal mass or unexplained anal ulceration should be examined rather than triaged with a stool test. Everything else generally goes through a test first.
Get help today rather than working through a form:
Call NHS 111, or 999 in an emergency. No test result is worth waiting for when any of this is going on.
This will not diagnose anything. It tells you whether national guidance would point towards a stool test, towards being examined, or towards neither.
This runs entirely in your browser. Your answers are never sent to us, never stored, and never leave your device. Nothing here is recorded against you, and closing the page erases it.
So you can see what is behind each answer rather than taking it on trust.
The threshold NICE sets for people with symptoms is 10 µg Hb/g in England, Wales and Northern Ireland, and 20 in Scotland. NHS screening in England is moving from 120 to 80 by March 2028. Same kit, same analysers, different line.
A rectal mass, an unexplained anal mass and unexplained anal ulceration. Guidance says these do not need a stool test before referral is considered. They need examining.
Most of the NICE criteria carry an age condition. This one does not, and it counts in either direction. It is the criterion people most often assume does not apply to them.
The 2022 ACPGBI and BSG guideline supports using FIT across suspected colorectal cancer symptoms generally. The numbered criteria are a floor, not a ceiling.
Guidance says there is not enough evidence to vary it. Adults of all ages are assessed against the same number, deliberately.
If you search for bowel cancer symptoms you will find the same list everywhere: bleeding, changed habit, tummy pain, weight loss, tiredness. The list is accurate. It is also close to useless for working out whether you personally need anything done, and the people who write national guidance know this.
The reason is that these symptoms are extremely common and bowel cancer is not. Millions of people have a changed bowel habit at any moment. The overwhelming majority have irritable bowel syndrome, a dietary change, a medication effect or a virus. A checklist cannot separate them because the symptom itself carries very little information.
What changed in 2023 was the move to a test led pathway. Rather than trying to predict from symptoms who should be referred, guidance now uses symptoms to decide who should be measured, and the measurement does the sorting. It works better, by a wide margin.
NICE guidance DG56 sets out when a quantitative FIT should be offered in primary care. The checklist above applies these. In summary, a test is offered to adults:
Two riders matter. A test should be offered even if you have previously had a negative result through the NHS screening programme, because the thresholds are not the same. And people with a rectal mass, an unexplained anal mass or unexplained anal ulceration do not need a test before referral is considered, because those findings need looking at.
Read that list again and you will notice the age qualifiers do a lot of work. A 44 year old with rectal bleeding and nothing else does not tick a numbered criterion. A 48 year old with weight loss alone does not either. Both would in a 51 year old.
The lines are drawn where they are for population level reasons: at some point the number of tests required to find one cancer stops being a sensible use of NHS resources. That is a defensible judgement about a system. It is a poor guide to whether you as an individual want to know.
The 2022 ACPGBI and BSG joint guideline is broader, supporting the use of FIT across suspected colorectal cancer symptoms generally, with the mass and ulceration exceptions. If the checklist tells you that you do not meet a numbered criterion, read that as information about where a line was drawn, not as a verdict about you.
A meta-analysis of 28,832 symptomatic patients found that at the 10 µg Hb/g threshold, FIT detected 88.7% of colorectal cancers, with specificity of 80.5%. At 150 that sensitivity falls to 66.3%. This is the whole argument for reporting at the symptomatic threshold rather than the screening one.
At the other end, symptomatic data from NHS Greater Glasgow and Clyde put colorectal cancer prevalence at roughly 0.2% in people with a result under 10, and about 1% between 10 and 19. Around 1 in 10 people with colorectal cancer have a result below the threshold, so a low number lowers the odds substantially without closing the question.
Nothing. The checklist runs entirely in your browser using local JavaScript. Your answers are not transmitted, not stored, not logged, and not attached to any order you might place afterwards. Closing the tab erases them. Symptom information is special category health data under UK GDPR and the simplest way to protect it is not to collect it.
All sourced at the foot of this page.
Including the obvious one, which is that a form on a website has never examined anybody.
No. The checklist runs entirely in your browser in local JavaScript. Nothing is transmitted to us, nothing is stored, nothing is logged, and nothing is linked to any order you place afterwards. Closing the page erases it. Symptom information is special category health data under UK GDPR, and the most reliable way to protect it is not to collect it in the first place.
NICE DG56 recommends offering quantitative FIT to adults with an abdominal mass, with a change in bowel habit at any age, with iron deficiency anaemia, aged 40 and over with unexplained weight loss and abdominal pain, aged under 50 with rectal bleeding and either unexplained abdominal pain or weight loss, aged 50 and over with unexplained rectal bleeding, abdominal pain or weight loss, or aged 60 and over with anaemia even without iron deficiency. It also says a test should be offered even if someone has previously had a negative NHS screening result.
A rectal mass, an unexplained anal mass, and unexplained anal ulceration. NICE says people with these do not need to be offered FIT before referral is considered, because they need direct assessment. The checklist stops and tells you to see a doctor if you tick either of the first two boxes.
No, it means a line was drawn somewhere and you fall on one side of it. Those lines are set at population level, balancing how many tests are needed to find one cancer against what a health system can deliver. The 2022 ACPGBI and BSG guideline is broader and supports using FIT across suspected colorectal cancer symptoms generally. If something is persisting or worrying you, see a doctor regardless of what any checklist says.
No. Guidance says there is not enough evidence to vary the threshold by age, sex or ethnicity, so adults of all ages are assessed against the same number. Age affects which criteria trigger a test being offered, and it affects how likely it is that blood means something significant, but it does not move the line at which the test flags a result.
Not if you have developed symptoms since. NICE states explicitly that FIT should be offered even if the person has previously had a negative result through the NHS bowel cancer screening programme. Screening is read against a much higher threshold: England is moving from 120 to 80 µg Hb/g by March 2028, and Scotland and Wales are already at 80. The symptomatic threshold is 10.
Figures are drawn from the sources above. Framing and commentary are the author’s own. Written and reviewed by Dr Rhea Bhadresha, GP. Last reviewed August 2026.
Reported at the symptomatic threshold with your exact figure, a written GP report, and a telephone consultation included whatever the result.
Your exact FIT figure, a written GP report and a telephone consultation are all included, whatever the number turns out to be. A one-off test with no subscription and nothing recurring.