Positive Bowel Screening Test Not Followed Up, or the Colonoscopy Missed the Cancer: Can You Claim?

A positive screening test does not mean you have cancer, and not every cancer found after a clear colonoscopy was missed. The law asks two questions. First, did the care fall below what a competent GP, colonoscopist or hospital would have provided at the time? The standards help answer that. A positive National Bowel Cancer Screening Program result should lead to a follow-up appointment and, if you are referred, a category 1 colonoscopy, which in Victoria means within 30 days. A colonoscopy should examine the whole bowel and report its findings in writing. Second, did the delay cause harm? Under the High Court's decision in Tabet v Gett, you generally need to show that earlier diagnosis would probably, not just possibly, have changed your treatment or outcome.

Finding out that a cancer could have been caught earlier is its own kind of shock. The law does not ask only whether it was found late. It asks why, and what the delay changed. This guide is about Victoria.

What should happen after a positive bowel screening test?

Under the National Bowel Cancer Screening Program, eligible people aged 45 to 74 can do a free test at home every two years. People aged 45 to 49 have been able to join since 1 July 2024, by asking for their first kit.

A positive result means blood was found in one or both samples. The program's result letter says there could be several reasons, most not related to cancer, and asks you to see your doctor as soon as possible. If you nominated a doctor on the form, the result goes to them as well.

The program also tells GPs what to do with a positive result. Contact the patient to arrange a follow-up appointment. If referring for colonoscopy, state that the patient has a positive test as a program participant, which ensures they are waitlisted as category 1. Report the referral, or the decision not to refer, to the National Cancer Screening Register.

In Victoria, the Department of Health's Colonoscopy categorisation guidelines put a positive test in category 1, which is colonoscopy within 30 days. The Optimal care pathway for people with colorectal cancer, published by Cancer Council Victoria and the Department of Health, says that where symptoms suggest colorectal cancer, a colonoscopy should be completed within four weeks of the GP's referral.

None of these documents is law. They are evidence of what reasonable care looked like at the time, which is what the Wrongs Act 1958 (Vic) asks about. Section 48 sets the test for breach, and section 59 protects a professional who acted in a way widely accepted in Australia by peer professional opinion as competent practice, unless a court finds that opinion unreasonable. The wider framework is in how to prove medical negligence in Victoria.

Related guide How to Prove Medical Negligence in Victoria 8 min · Updated 26 Sep 2026

Who is responsible if a positive result was not followed up?

It depends on where the chain broke. The most common points are these:

• your GP received the result and did not contact you, or saw you and did not refer you;
• the referral went, but did not say it was a positive screening test, so it was not triaged as urgent;
• the hospital or clinic received a category 1 referral and did not book it for months; or
• the colonoscopy was booked, then cancelled or postponed, and nobody rebooked it.

Each of these points to a different party. A GP is usually responsible for their own care. A public health service is responsible for its triage, waiting list and booking systems. Our guide on suing a Victorian public hospital explains who answers for what.

If you received the letter and did not see a doctor, the question changes. It does not necessarily end a claim, especially if a doctor also had the result. But the other side may argue that part of the delay was yours, and the records will matter.

What if you were told it was haemorrhoids and it was bowel cancer?

Rectal bleeding has many causes, and haemorrhoids are common. A diagnosis of haemorrhoids that turns out to be wrong is not negligent just because it was wrong. The questions are how it was reached, and whether anyone revisited it.

The Optimal care pathway lists rectal bleeding as a higher-risk symptom. It lists a repeat presentation of rectal bleeding, and bleeding with abdominal pain, a change in bowel habit, diarrhoea or unexplained weight loss, among the highest-risk combinations. It says patients with those symptoms should be referred promptly for colonoscopy. It also says every patient should be given safety-netting advice, including a planned timeframe for follow-up agreed with the patient.

The Victorian categorisation guidelines say a complete assessment should come before a colonoscopy request, including examination of the abdomen and rectum. They say bright rectal bleeding requires specialist assessment of the anorectum. Where a likely cause such as haemorrhoids is found after that assessment, colonoscopy may not be needed. But if there is no response to treatment, or the bleeding recurs, the guidelines recommend a category 2 colonoscopy.

So an expert reading your GP records would usually ask:

• Was your rectum examined, and by whom?
• Were blood tests such as a full blood count and ferritin (iron) level done?
• When you came back with the same bleeding, was the diagnosis reconsidered?
• Was a review date set, and did anyone follow it up?

Can you sue if a colonoscopy missed the cancer?

Sometimes. A cancer found after a colonoscopy that was reported as clear may have been there and missed, or it may have developed afterwards. The Colonoscopy Clinical Care Standard lists missed pathology among the risks a patient should be told about before the procedure. So a missed cancer is not proof of negligence on its own. The records and an expert decide which it was.

The Australian Commission on Safety and Quality in Health Care's Colonoscopy Clinical Care Standard, updated in 2025, describes a careful colonoscopy. Quality statement 7 says the entire colon, including the caecum, is examined carefully and systematically. The adequacy of bowel preparation, the findings, biopsies, polyps removed and any adverse events are documented, and every polyp removed is sent for examination. The Standard asks clinicians to record whether the caecum was reached, with photographs, and the withdrawal time. It also says that if the bowel is not clear, polyps or even cancers may be missed.

Quality statement 9 says the colonoscopist sends the findings, any pathology results and follow-up recommendations in writing to your GP and to you. If your symptoms were not explained by the colonoscopy, you should be told and referred on if more investigation is needed.

When a missed-lesion claim is investigated, the questions are usually these:

• Does the report say the caecum was reached, and are there photographs?
• Was the bowel preparation adequate, and if not, was a repeat procedure recommended?
• Was a polyp removed, did the pathology come back, and did anyone act on it?
• Was a surveillance colonoscopy recommended, and was it booked?
• Did your symptoms continue after a normal report, and were you referred back?

A perforation or other complication of the colonoscopy itself is a separate question, covered in our guide to bowel perforation after surgery or colonoscopy. If you were one of the patients recalled in Albury–Wodonga, see our page on the Dr Liu-Ming Schmidt colonoscopy recall.

Does being under 50 change the question?

It changes the clinical picture, not the legal test. The Optimal care pathway notes that the evidence behind its symptom lists comes mainly from people over 40, but that colorectal cancer is increasing in younger people. It says a single test for blood in the bowel motion can be ordered through Medicare at any age for a patient with symptoms, outside the screening program.

The Victorian categorisation guidelines include patients under 50. For example, rectal bleeding for less than 12 months together with one or more other symptoms, in a person under 50, is listed in category 1.

So your age is part of what a reasonable GP would weigh. It is not a reason to stop looking. Whether a competent GP would have investigated your symptoms at the time is a question for independent expert evidence.

Would an earlier diagnosis have made a difference?

This is the question that decides most of these claims. Proving the care was substandard is not enough.

In Tabet v Gett [2010] HCA 12, the High Court held that the law of negligence does not compensate the loss of only a less than even chance of a better medical outcome. You must prove, on the balance of probabilities, that the negligence caused your harm. In Victoria, section 51 of the Wrongs Act 1958 requires the negligence to be a necessary condition of the harm, and section 52 puts the burden of proving causation on you.

For a delayed bowel cancer diagnosis, that usually means expert evidence from a colorectal surgeon or oncologist on three things:

• what stage the cancer probably was at when it should have been found;
• what treatment you would probably have had then; and
• what outcome would probably have followed.

If earlier diagnosis would probably have meant less extensive surgery, avoiding chemotherapy or a stoma, stopping the spread, or survival, the delay matters in law. If the cancer would probably have been at the same stage and treated the same way, it generally does not, however hard the delay was to live through.

The general principles are in our guide to misdiagnosis and delayed diagnosis claims. If someone has died, their family may have a claim of their own. See compensation when medical negligence causes a death.

How long do you have to claim after a delayed bowel cancer diagnosis?

Section 27D of the Limitation of Actions Act 1958 (Vic) gives you whichever expires first: three years from the date the claim was discoverable by you, or twelve years from the act or omission. Under section 27F a claim is discoverable when you knew, or ought to have known, that you were injured, that the injury was caused by someone's fault, and that it was serious enough to justify bringing a claim.

In a delayed diagnosis, the day you learn you have cancer is not always the day you learn it could have been found earlier. Sometimes that comes later, when you see an old screening result or colonoscopy report. But the twelve-year period runs from the missed opportunity, so a colonoscopy many years ago may be close to it. A court can extend time in some cases.

Requesting records does not stop the clock. See time limits for medical negligence claims and whether you can claim after many years.

What records show whether the cancer was missed?

Ask for the documents that show each step, with dates:

• the screening result letter, and the date your GP received the result;
• your GP records, including any attempts to contact you and the notes of each visit with bleeding or bowel symptoms;
• the referral letter, and the hospital's triage category and booking letters;
• the colonoscopy report, with photographs and the bowel preparation score;
• pathology reports for any polyps or biopsies; and
• the records of the later diagnosis, including staging scans.

You can also view your screening information through the National Cancer Screening Register's participant portal, linked through myGov. How to get your medical records in Victoria explains which law applies and what a provider can charge.

How does Clever Legal look at a missed bowel cancer claim?

These claims turn on dates across several providers: the screening laboratory, the GP, the hospital's waiting list, the colonoscopist and the pathologist. Building that timeline is the expensive part of finding out whether a claim exists. Clever Legal uses technology to organise the records, and a lawyer reviews the evidence and makes every legal decision.

If another firm has already said no, that may have been a judgement about the cost of investigating rather than about your care. A previous rejection is not a finding.

Start a free assessment. Tell us when you did the screening test or first noticed symptoms, who you saw, what you were told, and when the cancer was found. There is no obligation and no guaranteed outcome.

Common questions

Can you sue if your positive bowel screening test was not followed up?

You may be able to, if the failure to follow it up fell below reasonable care and the delay probably caused you harm. The National Bowel Cancer Screening Program asks GPs to contact a patient with a positive result and, when referring for colonoscopy, to mark the referral so the patient is waitlisted as category 1. A claim may lie against the GP, or against a health service that did not book a category 1 referral in time.

Can you sue if a colonoscopy missed bowel cancer?

Sometimes. A cancer found after a clear colonoscopy may have been missed or may have developed later. The Colonoscopy Clinical Care Standard expects the whole colon to be examined and photographed and the bowel preparation to be recorded. A claim usually depends on expert evidence that the examination fell below that standard and that finding the cancer then would probably have changed your treatment or outcome.

I was told it was haemorrhoids and it was bowel cancer. Can I claim?

Possibly. A wrong diagnosis is not negligent just because it was wrong. The question is whether a competent GP, on what you reported and what an examination would have shown, would have investigated further or referred you, especially when the bleeding came back. You also need to show that earlier diagnosis would probably have made a difference to your treatment or outcome.

When does the time limit start for a delayed bowel cancer diagnosis?

In Victoria, generally three years from when you knew, or ought to have known, that you were injured, that someone's fault caused it and that it was serious enough to justify a claim. That can be later than the date of diagnosis. A separate twelve-year limit runs from the missed opportunity itself, and the first to expire applies.

Sources

• Wrongs Act 1958 (Vic), sections 48, 51, 52 and 59
• Limitation of Actions Act 1958 (Vic), sections 27D and 27F
• [High Court of Australia, Tabet v Gett [2010] HCA 12](https://www.hcourt.gov.au/sites/default/files/eresources/2010/HCA/12.pdf), and the Court's judgment summary of 21 April 2010
• Australian Government Department of Health, Disability and Ageing, National Bowel Cancer Screening Program (page last updated 4 August 2026)
• National Bowel Cancer Screening Program, The role of health professionals (page last updated 29 June 2026)
• National Bowel Cancer Screening Program, Result letter: positive
• Australian Commission on Safety and Quality in Health Care, Colonoscopy Clinical Care Standard (2025), quality statements 1, 2, 3, 4, 7 and 9
• Victorian Department of Health, Colonoscopy categorisation guidelines (2017)
• Cancer Council Victoria and Department of Health Victoria, Optimal care pathway for people with colorectal cancer, 2nd edition (2021, updated April 2025 and June 2026), step 2
• National Cancer Screening Register, Participant Portal

This article provides general information and is not legal advice or medical advice. Medical negligence claims depend on their facts and are subject to strict time limits. Seek specific advice about your circumstances.