If you have received a positive FOBT or FIT test result, it is completely normal to feel worried. Many people see the word “positive” and immediately think it means bowel cancer. However, a positive bowel screening test does not mean you definitely have bowel cancer. It means that blood was found in your stool sample, and the cause of that bleeding needs to be investigated.
The bowel screening test used in Australia is designed to detect tiny traces of blood in your bowel motion. This blood is often not visible to the naked eye. A positive result can be caused by several conditions, including bowel polyps, haemorrhoids, inflammation, diverticular disease, or bowel cancer. Because bowel cancer can also cause hidden bleeding, it is important not to ignore the result.
The most important next step is to book an appointment with your GP. Your GP will discuss the result with you, review your symptoms and medical history, and may refer you for a colonoscopy. A colonoscopy allows a specialist to examine the inside of the bowel and identify the cause of the bleeding.
In Australia, bowel screening is offered through the National Bowel Cancer Screening Program. According to the Australian Government, if you have a positive bowel screening test result, you should see your GP to find out what is causing the bleeding. Your GP will probably refer you to a specialist for a colonoscopy.
Article index
- What is an FOBT or FIT test?
- What does a positive FOBT or FIT test result mean?
- Does a positive result mean you have bowel cancer?
- What should you do first after a positive result?
- Should you repeat the bowel screening test?
- Why colonoscopy is usually recommended after a positive FOBT or FIT result
- What can a colonoscopy find after a positive test?
- Polyps, haemorrhoids and other possible causes of blood in stool
- What happens before your colonoscopy?
- What happens during the colonoscopy?
- What happens after the colonoscopy?
- What if you feel completely well?
- Symptoms you should tell your GP about
- How quickly should you act after a positive bowel screening test?
- Private colonoscopy in Melbourne after a positive bowel screening result
- How Direct Endoscopy can help after a positive bowel screening test
- Final thoughts
What is an FOBT or FIT test?
An FOBT, or faecal occult blood test, is a bowel screening test that checks for hidden blood in the stool. “Occult” means hidden, so the test is designed to find blood that may not be visible when you go to the toilet.
A FIT, or faecal immunochemical test, is a modern type of stool test that also detects blood in the bowel motion. In Australia, the test used through the national bowel screening program is commonly referred to as an immunochemical faecal occult blood test, or iFOBT.
The test is usually completed at home. You collect small samples from your bowel motions using the test kit and send them to a laboratory for testing. The test does not diagnose bowel cancer. Instead, it identifies whether blood is present in the stool, which may mean further investigation is needed.
The National Bowel Cancer Screening Program provides free home bowel screening tests to eligible Australians aged 45 to 74 every two years. People aged 45 to 49 can request their first kit through the National Cancer Screening Register, while people aged 50 to 74 are generally sent a kit in the mail every two years.
What does a positive FOBT or FIT test result mean?
A positive FOBT or FIT test result means that blood was detected in your stool sample. It does not show where the blood came from, how much bleeding there is, or what condition is causing it. It simply means that further investigation is needed.
Blood in the stool can come from different parts of the bowel. Sometimes the cause is minor, such as haemorrhoids. Sometimes it may be related to bowel polyps, inflammation, diverticular disease, or another bowel condition. In some cases, blood in the stool may be a sign of bowel cancer.
This is why a positive result should always be taken seriously. It is not something to panic about, but it is also not something to ignore. The correct next step is to speak with your GP and follow their advice about further investigation.
Cancer Council Australia’s information on FOBT results explains that a positive result means blood has been detected in the sample. It also notes that bleeding may be caused by conditions such as polyps, haemorrhoids or inflammation, and may not necessarily be cancer-related, but it still needs to be investigated.
Does a positive result mean you have bowel cancer?
No. A positive FOBT or FIT result does not mean you definitely have bowel cancer. This is one of the most important things to understand after receiving a positive result.
The test detects blood, not cancer. There are several possible reasons why blood may be present in a stool sample. Some causes are serious, while others are not. The purpose of follow-up is to find out what is causing the bleeding.
Many people with a positive test result will not have bowel cancer. However, bowel cancer is one of the possible causes, which is why further investigation is important. A positive test result is not a diagnosis, but it is a warning sign that should be followed up properly.
The Cancer Council Victoria screening resources note that about one in 14 people will have a positive FOBT result, and that bleeding may be caused by polyps, haemorrhoids, inflammation or other conditions. The key point is that the bleeding needs to be investigated.
What should you do first after a positive result?
The first thing you should do after receiving a positive FOBT or FIT result is book an appointment with your GP. Take your result letter or screening information with you if you have it available.
Your GP will talk with you about your result and ask questions about your bowel habits, symptoms, medical history, medications, family history and previous bowel tests. They may also ask whether you have had previous colonoscopies, previous polyps, inflammatory bowel disease, unexplained iron deficiency, rectal bleeding, or a family history of bowel cancer.
Your GP may refer you for a colonoscopy or to a specialist. In many cases, colonoscopy is the recommended follow-up test after a positive bowel screening result. This is because colonoscopy allows the bowel lining to be viewed directly, and polyps can often be removed during the procedure.
The Australian Government’s advice on understanding your bowel screening test results states that if you have a positive result, you should see your GP to find out what is causing the bleeding.
Should you repeat the bowel screening test?
It may be tempting to repeat the bowel screening test, especially if you feel well or think the result may have been caused by something minor. However, repeating the test is generally not recommended as a substitute for proper follow-up.
A positive FOBT or FIT result means blood was detected. Even if a second test came back negative, it would not necessarily explain why blood was found the first time. Bleeding can be intermittent, which means it may happen on one day and not another. A repeat test can give false reassurance.
RACGP guidance on colorectal cancer screening in Australia states that one positive iFOBT is adequate to refer for colonoscopy and that repeating a positive FOBT is not recommended.
If you have received a positive result, the safer and more appropriate next step is to see your GP and discuss referral for further investigation. Do not ignore the result or try to “test again” without medical advice.
Why colonoscopy is usually recommended after a positive FOBT or FIT result
A colonoscopy is usually recommended after a positive bowel screening result because it allows the inside of the large bowel and rectum to be examined directly. This helps identify the source of bleeding and check for polyps, inflammation, cancer, or other bowel conditions.
The home screening test is useful because it detects hidden blood, but it cannot tell where the blood came from or why it is there. A colonoscopy provides a much more detailed view of the bowel.
During a colonoscopy, a specialist uses a thin, flexible tube with a camera to examine the bowel lining. If polyps are found, they can often be removed during the procedure and sent to a laboratory for testing. If abnormal tissue is seen, a biopsy may be taken.
Cancer Council Australia’s bowel cancer screening policy states that colonoscopy is the recommended follow-up test for people with positive findings at iFOBT or screening sigmoidoscopy.
What can a colonoscopy find after a positive test?
A colonoscopy can help identify a range of possible causes of a positive bowel screening result. These may include bowel polyps, haemorrhoids, inflammation, diverticular disease, inflammatory bowel disease, bleeding from another bowel condition, or bowel cancer.
One of the important benefits of colonoscopy is that it can detect and remove polyps. Polyps are small growths in the bowel lining. Many polyps are benign, but some types can develop into cancer over time if they are not removed.
If a polyp is removed, it is usually sent to a laboratory for analysis. The results help determine whether any further follow-up is needed and when your next bowel check should occur.
If cancer is found, your doctor will discuss the next steps with you. This may involve further scans, specialist review, and treatment planning. Finding bowel cancer earlier can make a major difference to treatment options and outcomes.
Polyps, haemorrhoids and other possible causes of blood in stool
A positive FOBT or FIT result means blood has been detected in the stool, but it does not automatically mean the blood is from cancer. There are several possible causes.
Haemorrhoids are swollen blood vessels around the anus or lower rectum. They can bleed, especially after a bowel motion. However, even if you think you have haemorrhoids, you should not assume they explain a positive screening result unless your doctor has assessed you.
Polyps can also bleed. Some polyps are small and cause no symptoms, which is why they may only be found during colonoscopy. Removing certain types of polyps can reduce the risk of them becoming cancerous in the future.
Inflammation in the bowel may also cause bleeding. This can occur with infections, inflammatory bowel disease, diverticular disease or other bowel conditions. Some medications can also increase the chance of bleeding, so it is important to tell your GP about any medications or supplements you take.
Because there are many possible causes, the aim of follow-up is to identify the source of bleeding rather than guess based on symptoms alone.
What happens before your colonoscopy?
If your GP refers you for a colonoscopy, you will receive information about how to prepare. Preparation is important because the bowel needs to be clean so the specialist can see the bowel lining clearly.
Bowel preparation usually involves dietary changes for a short period before the procedure and taking a bowel preparation solution as directed. This causes the bowel to empty. While the preparation can be inconvenient, it is a key part of getting an accurate result from the colonoscopy.
You may also be asked about your medications, allergies and medical conditions. This is particularly important if you take blood thinners, diabetes medications, iron tablets, or medications that may affect the procedure or preparation. Do not stop prescribed medications unless you have been advised to do so by your doctor.
Direct Endoscopy provides detailed information on its colonoscopy preparation page for patients who are preparing for the procedure.
What happens during the colonoscopy?
During a colonoscopy, a specialist examines the inside of your large bowel and rectum using a thin, flexible camera. Most patients receive sedation, which means they are comfortable and usually do not remember much of the procedure.
The specialist carefully checks the bowel lining for polyps, inflammation, bleeding, cancer or other abnormalities. If polyps are found, they can often be removed during the same procedure. If an area needs closer assessment, a biopsy may be taken and sent for testing.
The procedure itself usually does not take very long, although you will need time before and after the procedure for admission, preparation checks, sedation and recovery. Because sedation is used, you will need someone to take you home afterwards, and you should not drive for the rest of the day.
If you are having a colonoscopy in Melbourne after a positive bowel screening result, the clinic or hospital will provide instructions about arrival time, fasting, bowel preparation and transport home.
What happens after the colonoscopy?
After the colonoscopy, you will be monitored while the sedation wears off. You may feel bloated or pass wind because air or carbon dioxide may be used during the procedure to help the specialist see the bowel lining clearly. This usually settles.
Your doctor will explain the initial findings. In some cases, you may be told straight away that the bowel looked normal or that polyps were removed. If biopsies or polyps were sent for laboratory testing, final results may take longer.
Your follow-up plan depends on what is found. If the colonoscopy is normal, your doctor will explain whether you can return to routine screening or whether any further review is needed. If polyps are found, your doctor will explain when your next colonoscopy or follow-up should occur. If cancer or another significant condition is found, you will be referred for appropriate specialist care.
It is important to attend any follow-up appointments and make sure you understand the results. If you are unsure what your results mean, ask your doctor to explain them in plain language.
What if you feel completely well?
Many people who receive a positive bowel screening test result feel completely well. They may have no pain, no visible bleeding, no change in bowel habits and no weight loss. This can make the result feel confusing or easy to dismiss.
However, the purpose of bowel screening is to detect warning signs before symptoms appear. Bowel cancer and polyps can sometimes bleed in small amounts that are not visible. A person can feel well and still have bowel changes that need investigation.
This is why you should still speak with your GP after a positive result, even if you have no symptoms at all. Feeling well does not rule out bowel polyps, early bowel cancer, inflammation or other causes of hidden bleeding.
The National Bowel Cancer Screening Program is designed to detect early signs of bowel cancer in people who may not have symptoms. Following up a positive result is a key part of the screening process.
Symptoms you should tell your GP about
When you see your GP after a positive FOBT or FIT result, tell them about any bowel or general health symptoms you have noticed, even if they seem minor or unrelated.
Bowel Cancer Australia’s symptoms guide lists symptoms such as blood in the stool, a persistent change in bowel habit, changes in stool shape or appearance, abdominal pain or cramping, unexplained weight loss, and signs of anaemia.
Symptoms to mention include:
- Blood in your stool or bleeding from the rectum
- A persistent change in bowel habits
- Ongoing diarrhoea or constipation
- A feeling that your bowel does not empty properly
- Narrower stools or a change in stool shape
- Unexplained abdominal pain, bloating or cramping
- Unexplained tiredness, weakness or iron deficiency
- Unexplained weight loss
- A family history of bowel cancer or bowel polyps
These symptoms do not always mean bowel cancer. They may be caused by haemorrhoids, irritable bowel syndrome, infections, inflammatory bowel disease, diverticular disease, diet changes or medications. However, in the setting of a positive screening result, they are important for your GP to know.
How quickly should you act after a positive bowel screening test?
You should not panic, but you should act promptly. A positive FOBT or FIT result should be followed up with your GP as soon as reasonably possible. Your GP can assess your situation and advise on the next step.
Bowel Cancer Australia advises that if blood is detected, you should contact your GP immediately to discuss the result and obtain a referral for further investigation via colonoscopy within 30 days. This does not mean every patient will have the same urgency or pathway, but it does highlight the importance of timely follow-up.
Delaying follow-up can create unnecessary uncertainty and may delay diagnosis if there is a significant bowel condition. Even if the cause turns out to be non-cancerous, it is better to know rather than ignore the result.
If you are having difficulty getting an appointment or are unsure what to do, contact your GP clinic and explain that you have received a positive bowel screening result. This can help them understand why you need timely advice.
Private colonoscopy in Melbourne after a positive bowel screening result
After a positive bowel screening result, some patients are referred through the public system, while others choose to have a private colonoscopy. The right pathway depends on your circumstances, including your GP’s advice, urgency, location, preferences, private health insurance status and expected wait times.
A private colonoscopy may be suitable for patients who want timely assessment, a choice of location, or access to a specialist through a private pathway. Your GP can help you understand your referral options and whether a private referral is appropriate.
For patients in Melbourne, Direct Endoscopy provides colonoscopy services across multiple locations, including Frankston, Hampton, Bayswater, Narre Warren and Rosebud.
If you have received a positive bowel screening result, bring your result information to your GP appointment and discuss whether referral for colonoscopy is the next step. Your GP can provide the referral and any relevant medical information needed for the procedure.
How Direct Endoscopy can help after a positive bowel screening test
Direct Endoscopy provides specialist gastroenterology and endoscopy services for patients who need investigation after a positive bowel screening result, bowel symptoms, previous polyps, family history, or other bowel health concerns.
If your GP has recommended colonoscopy, Direct Endoscopy can support you through the process, including booking, preparation information, the procedure itself and follow-up guidance. You can view Direct Endoscopy’s hospital locations on the locations page.
A positive screening result can be stressful, but the next step is clear: speak with your GP and follow through with the recommended investigation. In many cases, colonoscopy helps identify the cause of bleeding and provides reassurance. If polyps are found, they may be removed during the procedure. If something more serious is found, early detection can help guide treatment sooner.
If you would like to understand more about the procedure, read Direct Endoscopy’s guide on when to get a colonoscopy and how it works. Patients preparing for the procedure can also read the colonoscopy preparation instructions.
Patients can visit the Direct Endoscopy book online page for more information about appointment options.
Final thoughts
A positive FOBT or FIT test result can be unsettling, but it is not a bowel cancer diagnosis. It means blood was found in your stool sample, and the cause needs to be investigated.
The most important thing is to act promptly. Book an appointment with your GP, discuss your result, and follow their advice. In many cases, the next step will be referral for colonoscopy.
Do not ignore the result, even if you feel completely well. Do not rely on repeating the test to reassure yourself. A positive bowel screening result should be properly followed up so the cause of bleeding can be identified.
If you have received a positive result and your GP recommends colonoscopy, Direct Endoscopy can assist with specialist investigation and support throughout the process.