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A positive FIT result: what happens next | CION Cancer Clinics
A positive FIT means the laboratory found a trace of blood in your stool sample. It does not mean you have cancer. Most positive results have another cause, often piles or a polyp, but only a colonoscopy can find out which. This page explains what a positive result can mean, what happens next step by step, and how soon you should act. At CION Cancer Clinics, our specialists help you judge which bowel symptoms need tests and plan screening that fits your risk.
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Medically reviewed by Dr. Naresh GunduConsultant Medical Oncologist · MBBS, DNB (Internal Medicine), DM (Medical Oncology, AIIMS) · last reviewed October 2026, next review due October 2027
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The short answer
Does a positive FIT mean I have colon cancer?
No. A positive FIT means the laboratory found a trace of blood in your stool sample, above the level it uses as a cut-off. It does not say where the blood came from or why. Most people with a positive result do not have cancer. The next step is a colonoscopy, and that is the test that finds the cause.
Why the next step is always a colonoscopy
FIT is a screening test. It sorts well people into those who need a closer look and those who do not. A colonoscopy is that closer look: a thin camera passed through the back passage that shows the whole lining of the colon. If a polyp is there, it can usually be removed during the same procedure, before it has any chance to turn into cancer.
How soon should it happen?
Soon, without panic. Aim to see a doctor in the next week or so and to have the colonoscopy in the weeks that follow. Long delays of many months between a positive result and the colonoscopy are linked with cancers being found at a later stage. A few anxious days, on the other hand, make no difference at all.
If you are passing a lot of blood, have severe belly pain with vomiting, or cannot pass stool or wind, go to an emergency department today. Do not wait for an appointment.Where the blood can come from
What can cause a positive FIT?
The test reacts to blood from anywhere in the lower bowel. These are the usual explanations, starting with the most common.
Piles or a small tear
Piles and anal fissures bleed easily and are very common in Indian adults, especially with constipation. They are a frequent reason for a positive result. The catch is that a person can have piles and a polyp at the same time, and the stool test cannot tell which one bled.
A polyp
A polyp is a small growth on the inner lining of the colon. Most are harmless, but one type, called an adenoma, can slowly turn into cancer over many years. Finding and removing these is the main thing screening is designed to do.
Why this is good news
- Most polyps are removed during the colonoscopy itself
- No operation is usually needed
- Removal lowers your future risk
Inflammation or another bowel condition
Colitis, a bowel infection, diverticular disease and small fragile blood vessels in the bowel wall can all leak a little blood. These are treated in their own right once a colonoscopy has found them.
A cancer
This is the less common answer, and it is the reason the colonoscopy should not be skipped. A cancer found through screening in someone who feels well is more often found early, when treatment is simpler and more likely to work.
Sometimes the colonoscopy finds nothing at all. That is a real result, and a reassuring one.Not sure whether this applies to you?
Ask an oncologistStep by step
What happens after a positive FIT?
A doctor goes through the result with you
Expect questions about bleeding, bowel habit, weight, family history and the medicines you take. Bring the FIT report and any recent blood tests. Do not stop aspirin or a blood thinner on your own; the doctor will plan that with you.
You prepare the bowel
The colon has to be empty for the camera to see the lining. That means a light diet and a strong laxative drink the day before. Our page on bowel preparation explains it, including what to do if you have diabetes.
The colonoscopy
It is usually done under sedation and takes less time than people expect. CION arranges it at an accredited diagnostic partner. What it involves is covered in screening colonoscopy.
The laboratory report
Any polyp removed and any tissue sample taken goes to a pathologist, who looks at it under a microscope. That report, which usually takes several days, is what tells you what the growth actually was.
A plan that fits what was found
A clear colon usually means going back to routine screening. Polyps mean a repeat colonoscopy at a set interval, explained in polyp surveillance intervals. If a cancer is found, scans follow and CION's tumour board reviews them before any treatment is planned.
On your reports
The words you will meet after a positive FIT
- Positive or abnormal
- Blood above the laboratory's cut-off was found. It describes the sample and says nothing about the cause.
- Colonoscopy
- A camera test that looks at the whole inner lining of the colon and can remove polyps during the same visit.
- Polyp and adenoma
- A polyp is any small growth on the lining. An adenoma is the type that can, over many years, become cancer if left in place.
- Polypectomy
- Removing a polyp during the colonoscopy, usually with a small wire loop. Most people feel nothing.
- Biopsy
- A small piece of tissue taken for the laboratory, so a pathologist can say exactly what it is.
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Commonly believed
Four things people say after a positive FIT
"A positive test means it is cancer."
It means blood was found. Most people who go on to have a colonoscopy after a positive FIT do not have cancer. Polyps, piles and inflammation are far more common findings.
"It is just my piles, so I can skip the colonoscopy."
Piles may well be the cause. But piles do not protect anyone from a polyp higher up, and the test cannot say which of the two bled. Only a colonoscopy can separate them.
"I will repeat the stool test, and if it is negative I am fine."
Polyps and cancers bleed on and off. A negative second test may simply have caught a quiet day. It does not cancel the first result, and guidelines do not use it that way.
"I feel perfectly well, so it can wait until something happens."
Feeling well is exactly when screening helps. Waiting for symptoms gives away the advantage the test was meant to buy you, which is finding a problem early or removing a polyp before it becomes one.
Being straight with you
What this page cannot tell you
It cannot tell you what caused your result. Nobody can, from the stool test alone, however high or low the number on the report. Only the colonoscopy, and the laboratory report on anything removed, can answer that. If someone offers you a different explanation without looking, ask how they know.
Who this does not apply to
If you already have symptoms, such as blood you can see, a change in bowel habit, weight loss or anaemia, meaning a low haemoglobin, you need a colonoscopy whatever the FIT says. A negative result would not have reassured you either. People with colitis, Crohn's disease, Lynch syndrome or earlier polyps should be on a colonoscopy schedule rather than relying on stool tests.
If a colonoscopy is not safe for you
Some very frail or elderly people are not fit for bowel preparation and sedation. Other tests, such as CT colonography, may be considered instead, and that decision belongs with your doctor. If the problem turns out to be in the rectum or anal canal, it is managed under rectal or anal cancer care.
Not sure what your report means, or how quickly to act? Call the helpline and read it out. Someone will tell you plainly.Questions we are asked
Common questions about a positive FIT
How quickly should I have the colonoscopy?
Within the next few weeks is sensible. Do not let it drift into months, because long delays are linked with cancers being found later. If you have heavy bleeding, severe pain, vomiting or cannot pass stool, go to an emergency department the same day.
Can piles cause a positive FIT?
Yes, and they often do. The problem is that piles are so common that many people with a polyp or cancer also have them. A doctor cannot safely blame the piles without seeing the rest of the colon, which is why the colonoscopy still matters.
Should I repeat the FIT before deciding?
No. A second negative does not cancel a positive, because growths bleed on some days and not others. Repeating the test only delays the colonoscopy. If your sample was collected during a period or left in the heat, tell your doctor rather than quietly retesting.
I take aspirin or a blood thinner. Could that explain it?
These medicines can make small sources bleed more easily, but they are not treated as the explanation. A positive result on aspirin or a blood thinner is investigated in the same way. Never stop them on your own; your doctor will plan around the colonoscopy.
Does a positive FIT mean my family should be tested?
Not yet. A positive stool test changes nothing for your relatives. What matters for them is what the colonoscopy and the laboratory find. If a cancer or certain polyps are confirmed, your doctor will tell you who in the family should be screened and how.
My father's FIT is positive and he refuses the colonoscopy. What can we do?
Fear, embarrassment and worry about cost are the usual reasons, and each can be talked through. A conversation with a doctor often helps more than pressure from the family. Our page on convincing a parent to get screened has practical ideas.
What if the colonoscopy finds nothing?
That is a genuine result. It usually means you return to routine screening at the interval your doctor sets. If you also have anaemia or other symptoms, the doctor may look elsewhere in the gut, because blood can come from places a colonoscopy does not reach.
Can CION help me with a positive FIT result?
Yes. A CION oncologist can go through the report with you, arrange the colonoscopy at an accredited diagnostic partner and review the findings with you afterwards. If anything serious is found, the tumour board plans the next steps together with you and your family.
Your Specialists
Meet CION's colon cancer specialists. Bring your colonoscopy, scan or biopsy report.
Our surgical and medical oncologists plan colon cancer care together: which operation, whether chemotherapy is needed, and the follow-up that comes after.
Medical Oncologist
Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
Medical Oncologist
Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
Medical Oncologist
Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
Medical Oncologist
Medical Oncologist
Surgical Oncologist
Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
Surgical Oncologist
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Sources
- American Cancer Society — Colorectal Cancer Screening Tests
- National Cancer Institute — Screening Tests to Detect Colorectal Cancer and Polyps
- NHS — Bowel cancer screening
- NHS — Colonoscopy
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Screening colonoscopy: what it involvesThe test that comes next, explained before you goA negative FIT result: what it does not rule outThe other result, and why symptoms override itColon polyps explainedThe most likely finding that matters, in plain wordsWhat happens after polyps are removedYour next steps if the colonoscopy finds polyps
Talk to us
Holding a positive FIT report and not sure what to do?
Tell us what the report says and how you are feeling, and an oncologist will explain the next step and arrange the colonoscopy if you need one. One helpline serves every CION centre.