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!?

[LineyReborn]

Are you not reading the answers about sigmoidoscopies at 55?

[LineyReborn]

Not you, Crazy, the OP.

[lalalalyra]

I don't think it's the case that health care is specifically better in Scotland. My DD waited far less time to see her consultant than my cousin's DD for example (same condition). It's just different spending priorities.

People go on about the free prescriptions in Scotland, but the money comes from somewhere else. Would I swap free prescriptions for a shorter waiting time? Nope. Also lots of services are being cut in some parts of Scotland. The hospital where my cousin lives is fighting to save their A&E again. If it goes the nearest A&E to her will be 40 minutes away rather than 15 - again, not worth the swap for free prescriptions imo.

[user1471439240]

Scotland gets better healthcare, free prescriptions, free university.
They pay the same income tax as England.
Not sure why, it is cold and rains often, perhaps its a sweetener?

[GreatFuckability]

cost/benefit analysis is weighing up cost v how much good it does. thats not the same as 'they just want to save money'. not at all. its about best use of available funds for everyone.

i'd imagine, given the fact scotland has a reputation for poor nutrition, it is more beneficial to test from 50 there.

[Kaylasmum49]

I did read about the test at 55 but that's not 50! Not sure if it's started here or not. Certainly not heard about it until now.

I think the comment about poor nutrition in Scotland was a bit strange. Don't know what that's based on!!

I have health anxiety and cancer is a huge fear of mine so just feel that everyone should be equally treated when it comes to screening for this horrible disease.

[PurpleDaisies]

I have health anxiety and cancer is a huge fear of mine so just feel that everyone should be equally treated when it comes to screening for this horrible disease.

You don't mean treating people equally-you mean treating people appropriately. There really wouldn't be any benefit on a population level if every person being screened for everything we could possibly screen for throughout the whole of their lives. It's much better to target those for whom the risk is higher and the screening test is shown to be worthwhile.

[Kaylasmum49]

Crazy, has your gp mentioned sending you for a colonoscopy because of your symptoms?

[CrazyNameCrazyGuy]

Crazy, has your gp mentioned sending you for a colonoscopy because of your symptoms?

Yes. My sphincter slammed shut when he mentioned it! He did a physical exam and couldn't find any issues but referred me to the hospital as I'm in a high risk group.

Colonoscopy revealed no problems, thank goodness.

[CrazyNameCrazyGuy]

I think the comment about poor nutrition in Scotland was a bit strange. Don't know what that's based on!!

"In Scotland, eating habits are the second major cause, after smoking, of poor health. The national diet contributes to a range of serious illnesses which include coronary heart disease, certain cancers, strokes, osteoporosis and diabetes.

www.gov.scot/Topics/Health/Healthy-Living/Food-Health

[Kaylasmum49]

That's good news crazy! It's a bit concerning that he said that a fobt is'nt a good indicator if someone has bowel cancer. Like you said, what's the point then?

[Kaylasmum49]

PurpleDaisies,

I mean that I think that the age at which screening starts for a particular illness should be the same in the whole of the UK.

As it is it looks like the nhs in England seems to think that the risk of bowel cancer up to age 60 is low enough to not need testing.

[CrazyNameCrazyGuy]

Kaylasmum49

I think his comment was based on the fact it relies on faecal blood being present. Not everyone has rectal bleeding as a symptom, plus there are many things that can affect the outcome of the test giving a false positive or negative.

I think the FOB test detected 50% which is much better than nothing but still not that reliable.

Scotland has now introduced the FIT bowel cancer test which (I think) is more straightforward and reliable.

[PurpleDaisies]

I mean that I think that the age at which screening starts for a particular illness should be the same in the whole of the UK.
It's a devolved issue though. Different countries come to different conclusions on the evidence. Should our screening match, say Iceland's?

[MrsTerryPratchett]

I think your anxiety is understandably making you worried about matters of health policy that aren't concerning. There's no need for the screening ages to be the same everywhere. How would we know if there's a benefit in earlier or later testing without different places doing it differently?

If it turned out that Scotland was saving lives based on its system, it could be adopted.

[RhodaBorrocks]

NHS England, NHS Wales, NHS Northern Ireland and NHS Scotland are all separate entities though. They have no obligation to agree to spend their budget in the same way.

[ratspeaker]

Im in Scotland and got the invite to play poo sticks at 50.
They sent me a repeat one as I'd obviosly had a positive FOB.
Then a colonoscopy. They removed a couple of polyps and told me Ihave diverticular disease , which I was diagnosed with years ago so not a surprise, it was probably that that gave the +ve fob.

The only reason I knew about the diverticular disease is because Id had an MRI for another reason.

Basically what Im saying its not just bowel cancer that can be detected , in fact cancer is a small % of +ve fobs but investigation can mean you can get information and advise on how to control or regulate intestinal conditions.

[keeptheheid]

Scotland also used to start smears at 19. This changed recently (last year?) to 25 in line with England.

[Kaylasmum49]

Ok, thanks to everyone for your input, very enlightening.

I do wonder though if England has a higher rate of bowel cancer due to the later screening age.

[GreatFuckability]

I do wonder though if England has a higher rate of bowel cancer due to the later screening age.

i think its the other way round, scotland has a higher rate, so the age is lower.

[YoungGirlGrowingOld]

Anyone with a family history can get tested sooner because genetics are a major risk factor for colon cancer. I have routine colonoscopies every year and my DS will have them from age 20 (i.e. 10 years prior to my own diagnosis).

The poo kits are a bit of a false economy from what I have read - many people have piles and constipation which cause rectal bleeding and can lead to a positive test and investigations (and accompanying stress/worry etc).

[PurpleDaisies]

I do wonder though if England has a higher rate of bowel cancer due to the later screening age.

The incidence of bowel cancer is independent of screening. Screening tests are designed to detect cancer before it causes symptoms.

[Kaylasmum49]

I have read that 2% of people who do the fobt have positive result and that 6.7% of those people have bowel cancer. So I would say it definitely detects cancer.

[zeezeek]

Apologies, skimmed through the thread. If you are in England then you may get invited to have a sigmoidoscopy when you are 55. Otherwise the bowel screening programme will start when you are 60.

As a disclaimer, I'm not a clinician, but have done a lot of research studies in the cancer area.

Most cancers, 60% of bowel cancers in fact, are diagnosed in people over the age of 70 years. Primarily cancer is a disease that affects older people. That is the reasoning behind the screening starting at 60. However, a family history of of the disease, of polyps etc is different.

At present, the test that is offered at 60 is not very good and the screening programme is in the middle of changing to a better one.

Few cancers are actually picked up by screening. People still need to be aware of the symptoms that doctors class as "red flags". Change in bowel habit, rectal bleeding...the Cancer Research UK site has a lot of information and i would suggest that anyone who is worried checks it out.

If you have a family history of bowel cancer, ie a first degree relative had it, then you may be at a higher risk and so wel, worth talking to your GP

[Kaylasmum49]

Sorry purpledaisies,

I did'nt read your last post properly