Una Doherty reports
As retirement approaches health issues are often of concern, be they current or potential ones. It’s a time to take stock and review some of our long-held habits, such as our diet or exercise regimes. Many make an effort with healthy eating, increasing activity levels with new hobbies or sports, or visit their doctor in an effort to address their health and
The word ‘screening’ is often used by various providers to talk about general check-ups, which may include a plethora of tests, not all of which may be required or relevant at a particular time.
The national health screening programmes are based on the best available medical evidence. These government-funded screening programmes aim to catch disease at an early stage, to achieve the best possible outcome for participants. The National Screening Service oversees the screening programmes for bowel, breast and cervical cancer, as well as the screening for diabetic retinopathy.
Bowel cancer screening
Bowel cancer is one of the most common cancers diagnosed in both men and women, with approximately 2,500 new cases in Ireland each year. BowelScreen – The National Bowel Screening Programme – aims to find pre-cancerous changes in the bowel, reducing the number of deaths from bowel cancer. Chances of surviving bowel cancer are much higher if it is found at an early stage – before symptoms. Symptoms include: a change in your bowel habit – either diarrhoea or constipation, blood in your stool, losing weight, a lump or swelling in your abdomen or persisting abdominal pain.
At present, men and women aged 60 to 69 are eligible for this service. Eventually, everyone aged 55 to 74 will be included in the screening programme; this will be done on a phased basis. You may check online at www.bowelscreen.ie to ensure that you are on the register for bowel screening.
Home testing kits are posted to participants, who then return a small stool sample for analysis. The stool test itself doesn’t diagnose a cancer; the test finds tiny specks of blood invisible to the naked eye that, if present, warrant further investigation. Results are available within four weeks. The majority of people will have a normal result and will be re-called for repeat screening in two years.
However, 5-6% of people will have blood detected and will be asked to attend for a colonoscopy, or camera test, of their bowel. This procedure looks at the lining of the bowel for suspicious changes. According to BowelScreen, half of those attending for a colonoscopy will have a normal result; 40% will have a polyp (usually removed as some polyps may undergo cancerous changes) and one in ten will have a cancer.
The report on the first round of screening (from 2012 to 2015) showed that only 4 in 10 of those invited took the test. Cost is not a barrier to testing as it’s free, so there must be other reasons why people don’t engage with the screening programme. It is always a challenge to be proactive about our health when we feel well. Nevertheless, the process of ‘screening’ is aimed at those who are indeed feeling well, but may have an early stage cancer.
Cervical cancer screening
Cervical cancer kills about 90 women in Ireland each year. Symptoms of cervical cancer include unexpected vaginal bleeding and pelvic pain. Women aged from 25 to 60 are invited to participate in screening, which involves having a smear test, usually done by the local GP or practice nurse. The smear test itself takes minutes and will detect precancerous and cancerous changes. Having a smear test will pick up changes in the cervix before symptoms develop. What happens next depends on the specific result. As it is treatable if diagnosed early, going for a smear test is your best chance of reducing your risk of a poor outcome.
A press release from CervicalCheck (29 September 2017) stated that the screening numbers for 2015-2016 were the highest ever since the programme began in 2008, with almost 80% of the target 1.2 million women screened. A closer look at the figures shows that women are less likely to attend for a smear test the older they get. Professor Flannelly, the Clinical Director of CervicalCheck, stated ‘We have identified that over one in four women in the 50 to 60 year old cohort have not participated in the programme in the last five years. There might be a perception that this is a young woman’s issue, but women over 50 are still very much at risk.’
Find further information at www.cervicalcheck.ie, where you may also register/update your details.
Breast cancer screening
BreastCheck (www.breastcheck.ie) is probably the best known of the screening programmes. According to the Irish Cancer Society, breast cancer is the second most common cancer in women, after non-melanoma skin cancer.
At present, women aged 50 to 64 are called for a mammogram every two years. By 2021 all women aged 50-69 will have a two-yearly mammogram. The programme report for 2015-2016 showed that almost three quarters of eligible women attended for their screening mammogram. However younger women, those aged 50-54 years, were more likely to attend than older women.
Breast cancer symptoms include finding a lump in either breast; skin changes, including puckering or dimpling of the skin; inversion of a nipple. There are other symptoms – nipple discharge, change in the size or consistency of a breast, changes to the skin of the nipple and breast pain. If you are concerned about any changes to your breast it’s best to get checked out, even if you’ve recently had a mammogram.
Diabetic Retinopathy Screening
Diabetic retinopathy occurs when the tiny blood vessels at the back of the eye are damaged by having diabetes. There are different stages of retinopathy – the early stages may cause no eye symptoms, while late stage disease may cause blindness.
Luckily, early disease can be picked up by having an examination of the back of the eye (retina) using specialist photography. Diabetic RetinaScreen is the national programme for diabetic retinopathy screening and was launched in 2013. There are approximately 145,000 people in Ireland with diabetes, all of whom will be called for screening. The aim is to have annual screening for all individuals with diabetes over 12 years of age. Diabetic retinopathy can be treated by laser; this treatment is free.
If you have diabetes you may Freephone 1800 454555 to check you are on the register for screening. You may register for screening on the website www.diabeticretinascreen.ie.
Regular participation in health screening programmes is part of a comprehensive approach to maintaining our health. Someone with a family history of bowel or breast cancer may need earlier than usual screening, which is usually arranged through their GP. Many more men and women could avail of free bowel cancer screening. It’s important to keep breast and cervical cancer screening in mind as we age. As no screening test is 100% perfect, even the best of the screening tests will miss some cancers. Therefore it’s vital that any new symptoms are checked out.