What I want the follow-up to achieve
A low FIT can help the service decide how quickly to investigate, but I also need to know whether your symptoms have settled and whether the original concern has been addressed. Persistent bleeding, unexplained iron deficiency or a continuing change in bowel habit can justify further assessment even when FIT is low.
If symptoms continue, arrange review with your GP. Bring the FIT result and any previous endoscopy or histology reports. Explain what has changed. The next step may be colonoscopy, another test or a treatment trial with a planned review. FIT is not a replacement for colonoscopy, which remains the gold-standard examination for diagnosing bowel cancer and preventing it by finding and removing precancerous polyps.
Guidance behind this advice
What if symptoms continue after a negative FIT?
What FIT checks
FIT looks for blood in a poo sample. Some abnormalities do not bleed or do not bleed at the time of sampling.
What FIT checks
FIT looks for blood in a poo sample. Some abnormalities do not bleed or do not bleed at the time of sampling.
Persistent symptoms
A negative result does not explain continuing symptoms. Contact your GP for assessment rather than relying on another kit alone.
Further assessment
Your symptoms, examination, blood results and previous history determine whether colonoscopy or other tests are appropriate.
Urgent symptoms
Heavy bleeding, collapse or severe worsening pain needs urgent assessment. Call 111 if you collapse or are too unwell to travel safely.
Simplified illustrations, not to scale. These show an example, not your own anatomy or test result.
Read every diagram explanation
What FIT checks
FIT looks for blood in a poo sample. Some abnormalities do not bleed or do not bleed at the time of sampling.
Persistent symptoms
A negative result does not explain continuing symptoms. Contact your GP for assessment rather than relying on another kit alone.
Further assessment
Your symptoms, examination, blood results and previous history determine whether colonoscopy or other tests are appropriate.
Urgent symptoms
Heavy bleeding, collapse or severe worsening pain needs urgent assessment. Call 111 if you collapse or are too unwell to travel safely.
What does a negative result mean?
FIT measures tiny amounts of human blood in a sample of poo. A negative result means the amount was below the cut-off used by that testing service. It does not mean there was definitely no blood, and it is not a direct examination of the bowel.
For people with bowel symptoms, FIT helps prioritise investigation. A negative result lowers the likelihood of bowel cancer, but some cancers release little blood or bleed intermittently. Not all precancerous polyps bleed either. FIT also cannot diagnose coeliac disease, irritable bowel syndrome or every form of bowel inflammation.
When should I arrange another review?
Book a review with your GP if symptoms persist, come back or get worse. If they have already lasted six weeks or longer, arrange the review now. This is not an instruction to wait another six weeks after your result.
Seek advice sooner for visible blood, unexplained weight loss, a continuing change in bowel habit or increasing pain. Tell your GP about tiredness, breathlessness or a known low blood count or low iron. These symptoms can have several causes, but a negative FIT should not prevent further assessment.
What will the review involve?
When I assess ongoing symptoms, I consider when they started, your bowel pattern, examination findings, medicines, family history and any previous colonoscopy. Bring the FIT report and a list of medicines. A short record of pain, bleeding and bowel motions can be useful.
Your GP may check a full blood count and ferritin (iron stores). Depending on the symptoms, tests for coeliac disease, bowel infection or inflammation may be appropriate. If coeliac testing is being considered, speak to your GP before starting a gluten-free diet because removing gluten can make the tests less reliable. Not everyone needs the same tests.
Will I still need a colonoscopy?
Sometimes. Colonoscopy is the gold standard for examining the lining of the colon. It can detect and remove many polyps, and biopsies can help diagnose conditions that FIT cannot. I recommend it when your symptoms, blood tests, previous findings or other clinical concerns justify it.
If your FIT was negative, you may not meet the threshold for colonoscopy through the public system. That access threshold is separate from whether colonoscopy is clinically appropriate. A negative FIT does not replace a colonoscopy already recommended for symptoms or polyp follow-up.
For other people, treatment and a planned review, a scan or another investigation may be more appropriate. The decision is based on the whole assessment, rather than the FIT result alone.
What should I do after the review?
Make sure you know which treatment or investigation comes next, when your symptoms will be reviewed and who to contact if they worsen. If a referral has been made and you have not heard within the timeframe given, contact the referring team.
If you later have an endoscopy, the recommended follow-up will be documented in your endoscopy report and/or histology report once tissue results are available. Continue routine bowel screening when invited if you remain eligible, but use your GP for assessment of ongoing symptoms.
When to get urgent help
Seek urgent medical assessment for heavy or ongoing bleeding, black tarry stools, severe or worsening abdominal pain, persistent vomiting, or feeling faint or very unwell. Do not use a negative FIT to delay help.
Call 111 for an ambulance if you collapse, have heavy bleeding with faintness, or are too unwell to travel safely. Do not wait for a routine appointment or an email reply.
Three things to remember
- A negative FIT lowers the likelihood of bowel cancer. It does not explain ongoing symptoms or exclude every cancer or polyp.
- Arrange a GP review for persistent, returning or worsening symptoms. Seek advice sooner for bleeding, weight loss or increasing pain.
- Keep a recommended colonoscopy appointment. A negative FIT does not replace it.
Related information
Sources and further reading
English clinical master checked 15 October 2026.