Bowel cancer risk assessment

This information is for people who have had a family history risk assessment for bowel cancer. It provides advice and screening options to those with a high or moderate risk and for those with a risk about the same as the general population.   

Bowel cancer is a common disease. In the general population of the UK, about one in 14 men and one in 18 women will develop bowel cancer. 

Some people have an increased chance of developing bowel cancer because of their genes (their genetic makeup). Although bowel cancer is common, having an inherited tendency to developing bowel cancer is quite rare.

Only about 5 to 10 out of 100 (5 to 10%) of all bowel cancers happen because of an inherited tendency (also called a genetic predisposition).

Risk assessment

Your family assessment will identify your risk of having an inherited tendency to developing bowel cancer.

This is known as a ‘near population’ risk. It means that your risk of developing bowel cancer is estimated to be about the same as for anyone else in the general population.

People with a near population risk of developing bowel cancer are unlikely to have an inherited tendency to developing bowel cancer.


No additional screening is recommended other than the NHS Bowel Cancer Screening Programme.

The pattern of cancers in your family does not suggest that there is a high risk of an inherited bowel cancer condition.

Your family history means that there is a slightly higher risk of you and your relatives developing cancer than other people the same age.

However, it is more likely that you and your relatives will not develop bowel cancer.


Depending on your age and family history you may be offered bowel screening to check for changes in the bowel.

This type of screening is known as a colonoscopy.

A high risk of bowel cancer means that based on your personal history or your family history you are estimated to have a higher than average chance of getting bowel cancer during your lifetime.

It is possible that the bowel cancer in your family is caused by an inherited tendency, but more information may be needed about cancer in your family before your risk assessment can be confirmed.


Depending on your age and family history you may be offered bowel screening to check for changes in the bowel. This type of screening is known as a colonoscopy.

You may be given a short-term screening plan until more details about your family history can be confirmed.

Changes to your family history

Please let us know if your family history of cancer changes so we can review if this changes your risk assessment.

NHS bowel cancer screening programme

The NHS Bowel Cancer Screening Programme offers screening to anyone aged 60 to 74. The programme is being gradually increased to include those aged 50 to 59.

A bowel screening kit is automatically sent every 2 years.

If you are 75 or over you can ask for a kit every 2 years by calling the free bowel cancer screening helpline on 0800 707 6060.

You can also find NHS bowel cancer screening kit instructions on GOV.UK

Instructions are available in several languages.

Tests for inherited bowel cancer in the family

Testing for an inherited tendency is available in some families. This depends on the exact details of your family history and whether the necessary cancer tissue or blood samples are available.

Patients may attend a nurse-led family history clinic and then be referred to the genetics clinic to discuss testing. If you are seen in the genetics clinic we will explain the options available. If any testing does go ahead this could alter your risk assessment and screening recommendations.

People whose risk is about the same as the general population are not eligible for these tests as they are unlikely to have an inherited tendency to developing bowel cancer.

Diet and lifestyle

Research suggests that diet and lifestyle choices can contribute to bowel cancer risk. Cutting down on red meat, smoking and alcohol may help to reduce your risk, along with eating plenty of fruit and vegetables, and exercising regularly.

Find out more about our stop smoking service.


There are a few things to look out for which can help with the early detection of bowel cancer.

  • Bleeding from the bottom other than from piles (haemorrhoids)
  • Change in toilet habits such as persistent diarrhoea or constipation
  • Feeling of incomplete emptying of the bowel (having a poo)
  • Pain or discomfort in your tummy (abdomen)

If you experience any of these problems, do not panic. These symptoms can have a number of causes that are not related to cancer.

If your symptoms last for 2 weeks or more, please tell your GP.

Further information

Macmillan Cancer Support
Phone: 0808 808 0000

Bowel Cancer UK
Phone: 020 7940 1760

Bowel and bladder UK
Phone: 0161 214 4591

Resource number: 3032/VER4
Published date: March 2023
Review date: March 2026

Contact us

You can contact the clinic Monday to Friday (9am to 5pm)

Phone: 020 7188 1364

Email: [email protected]

Do you have any comments or concerns about your care?

Contact our Patient Advice and Liaison Service (PALS)

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