The UK may be headed for some major health reforms in the forthcoming years. Today The Telegraph reported that cancer screening may be a casualty of the NHS reforms. Along with reductions in screening there are likely to be cuts in spending on immunisation programmes, mental health care, tobacco control and smoking cessation.
Cancer screening is a controversial subject. Some people believe that for some types of cancer the process of screening is mostly ineffective and causes emotional trauma that is really best avoided.
The purpose of cancer screening is to pick up new cases of cancer and provide early intervention. However, even with major screening programs, such as the screening for breast cancer, most new cases are actually discovered by the women themselves in the course of their lives.
As the population of the UK continues to grow older screening is slowly becoming more and more common and therefore more costly to the NHS and the tax payer. So the big question is, should we screen?
Screening too early is problematic, especially for conditions such as breast cancer. In younger breast tissue it is very hard to identify cancerous growths. It is only as the breast tissue ages and breasts become more fatty that screening is effective. Coupled with the fact that screening does increase exposure to harmful radiation, there is a strong argument to reduce screening. However, every year women are diagnosed with breast cancer as a result of screening, and for these women their lives, and breasts, can be saved. Spotting breast cancer early is more likely to result in successful removal of the cancer without the need for mastectomy.
But what of other types of cancer? If you listen to the radio you may have heard the new campaign for bowel / colon cancer – here is the NHS campaign page – http://www.nhs.uk/bowelcancer/Pages/bowel-cancer.aspx/?.
This is the key message:
Let’s be clear.
If for the last 3 weeks you’ve had blood in your poo or it’s been looser, tell your doctor
You can read the whole leaflet (pdf format) here: Be_Clear_On_Cancer_bowel_cancer
Colon cancer is one of the biggest cancer killers in the UK but until recently has been a largely ignored disease. The current radio campaign is raises awareness of the symptoms that could indicate that bowel cancer is present. Basically, any change in normal bowel movements, such as more regular trips to the toilet, or the presence of blood in stools, are indicators that bowel cancer is present.
This awareness campaign is a great example of how resources can be better used. It makes more sense to educate people about cancer first before screening on a national scale. If people go to the doctor at the first sign of a change then it increases the chances of successful treatment.
The NHS reforms may see local councils privatise screening services and focus on frontline treatments. At a very basic level, councils will essentially be able to decide whether to finance breast cancer screening programs or fix potholes. Which is more important?
Now may be a good time to learn more about the NHS Reforms before it is too late to speak up. Here are a few links to get you started:
- British Medical Association - NHS reform
- BMA letter opposing NHS reforms – The Guardian
- NHS reform bill ‘complex, incoherent and not fit for purpose’, say doctors – The Guardian
- FT – NHS reform (various articles on the topic)
- Bmj.com - NHS reforms
- Modernisation of health and care – Dept. of Health
This page was written by Jon Wade, principal author and editor of Medimise.