To wonder why bowel screening starts at 50 in scotland

[Kaylasmum49]

Hi just wondering why bowel screening starts at 50 in Scotland but not until 60 in England. I just turned 50 so expect to receive my kit soon but was surprised to find out that it was started 10 years earlier here in Scotland.

Are we more at risk of bowel cancer here!?

No we just have better health care. Free prescription etc.

Ah right, think I'd be concerned if I lived in England and had to wait until I'm 60.

It's just the way Scotland chose to spend the money. In England we now have bowel screening from 55 in most areas ( the 55 program is still being rolled out). It's not a test kit it's a straight to camera test. The test kit at 60 still exists as well, for now anyway.

What's the test at 55? Does everyone get it?

Testing for most things is a cost;benefit analysis. False positives, cost of testing vs how many cases, people dropping off so the first test is important, how fast the progression of the illness is, how people are tested...

Some of it is quite counter-intuitive. For example, past a certain number, more appointments in pregnancy actually reduce outcomes.

Sorry, just noticed you said it's a camera test. Is that a colonoscopy then? Would 50 not be a better age to start that though?

In the US people get their first routine colonoscopy at 50. This saved my coworker's life when second stage cancer was found during a routine colonoscopy.

All the more reason it should be started at 50 nationwide!

In the US people get their first routine colonoscopy at 50. The US healthcare system loves tests. Because each one is money. The more tests, the better. Our system is designed to save money, which actually works well because cancer treatment is expensive so it behooves the NHS to test as soon as it is medically necessary.

But that will miss people. With sometimes tragic consequences for those people.

MrsTerry,

So do you agree with me that the testing should start at 50 nationwide? I've read that the fobt can have false negative results so maybe routine colonoscopies should be started here at 50

Choli, did your friend have any symptoms?

Wish it had been. My mother was diagnosed with bowel cancer aged 59 and died of it. By the time it was picked up due to symptoms, it was already quite advanced. She was very healthy living too with none of the known risk factors ( obesity, smoking, drinking, processed meat consumption etc).

Strangely, I've never been offered screening on the NHS (mid 40s but surely higher than average risk?)

I'm 55 and in England and have recently had the sigmoidoscopy bowel screening.

I'll also get the shit kit at 60.

Shit kit In France you get it at 50.

the chances of getting bowel cancer increase significantly from age 60 which is why the original program started then. But it's known now that we can help prevent bowel cancers by taking off polyps, you can get polyps at any age but actually you are far more likely to get them the older you are - they are a sort of age related thing generally. That's why the new program (sigmoidoscopy at 55) will help reduce the incidence of bowel cancer .
It's all about balancing cost/ benefit/ risk of harm. No screening program is without its risks.

In America it's all about money!!

I don't think the Healthcare in general is better in Scotland, some areas of the NHS are really struggling and below par. In saying that screening as early as possible does make sense in terms of cost/benefit.

Nennyrainbow, sorry to here that.

Looks like it's a money saving thing, surely people's lives come first.

A friend of mine nearly died from peritonitis due to a colonoscopy perforating his bowel, testing is not completely risk free. ( He had to have rather a lot of bowel removed!).

Routine colonoscopies would cost a great deal. I'm not qualified to decide if it's 'worth' it. Because I might believe that every life is priceless (and I do) but the NHS has to do the maths. Does routine colonoscopies mean that we have a million less hip replacements? So a million people living in pain. I don't know and I'm glad I don't have to decide!

Wiggly is right, there is around 1:1000 chance of perforation from colonoscopy.

Looks like it's a money saving thing, surely people's lives come first.

There isn't an infinite amount of money to fund the NHS. How would this be funded? Would you prefer tax increases or cuts elsewhere?

Wiggly, I have heard that 1 in a thousand colonoscopies end in perforation of the bowel, very concerning!

MrsTerry, I see your point but I would imagine the bowel test would be significantly cheaper than hip replacements.

Has anyone here done the bowel test?

MrsTerry, I see your point but I would imagine the bowel test would be significantly cheaper than hip replacements.

On a population level screening programmes are very expensive. You need the healthcare professional, maybe lab support, clinic time, results reporting and rescreening after a suitable interval.

The hips were an example. Nothing is free and everything has to be balanced. What if a healthy eating campaign could prevent more deaths with less money? Someone makes those decisions on a large scale.

I'm in England and recently request the FOB (faecal occult blood) test from my GP as my Mum died of bowel cancer. I had been experiencing some symptoms and was worried (I'm 50 so below the standard age for the test but within the 'at risk' age parameter based on family history).

My GP phoned back and made an appointment for that afternoon for a physical exam. He told me the FOB was not a good indication of whether someone has bowel cancer. Makes me wonder why they provide it tbh.