Health screening

I tend to opt for going to the screening on the grounds that it might be a good thing. I have been presented with apparently positive breast screening results which were then studied in more detail and I was given the all clear, so I always assume that things will be looked into in more depth if required.

I take part in all screening offered to me... but if ever given a positive result I may well ask for a second opinion before embarking on any treatment options offered.

katek I go for the breast screening and just adopt a "whatever" approach. I understand that it can be frightening, this sense of "failing the test" is well described by people like Dr Margaret McCartney who wrote a book about over-emphasis on screening.

A few years ago I had a call back on my mammogram and at that stage skipped blithely to the appointment, on my own, despite being told in the letter that I may want to bring someone with me. I had an ultrasound and then was led into a room with a table and two chairs and two people waiting there for me, gave me the fright of my life. But it turned out they were there to offer reassurance that nothing was wrong. I apparently had reported "symptoms" (told the radiographer that I was experiencing breast pain in one breast only - that stopped when I came off HRT) - so all in all they were doing their best for me.

So after all that - I take whatever screening is on offer but I don't fret about the possible outcome until I know what that is! I hate the system here though - all that waiting weeks for a letter to come through the post is not ideal.

I take all that is on offer but I was very distraught when the bowel cancer screening said there was a possibility of a positive result and I had to have a colonoscopy. Everything turned out okay but I had many heart stopping moments.

I feel I should go but last time scared me half to death. I was called back for a repeat scan and alarm bells started ringing. Next thing is a phone call to attend breast clinic the following day where I was shown a suspect area on the mammogram. This was followed by an ultrasound scan where nothing showed up at all. Cue needle biopsy and I was then left alone for ages wondering if I had cancer and trying to work out if they would come in mob handed if it was positive, or just send in a single sympathetic doctor/nurse. I listened for every footstep. Eventually a nurse stuck her head round the door and said "it's ok, you can go." Turns out that I'd had a fluid filled cyst and the pressure of the original mammogram had popped it. One could say that this proves they're on the ball and move very quickly if they suspect anything, but I had two weeks of fear and anxiety and a day of trauma. Not sure if my current psychology would cope too well with a repeat performance.

KateK

There is no decision to be had for me, I take 'and value' every opportunity the NHS gives me for the protection of my welfare.

Is your concern they might find something nasty and you may have an uneccessary procedure undertaken? If so you can always ask for a second opinion.

I have had breast cancer, and I will now take everything going to aid early diagnosis in any form of cancer. Of course it is scary, and extremely uncomfortable, but not as uncomfortable as the possible alternative. And I include chemotherapy and radiotherapy in that!

Many breast lumps are discovered by the patient or her/his partner (300 men a year are diagnosed!) but the hidden ones are just that, often deep within the breast tissue or milk ducts, and can only be detected by a mammogram.

Part if my problem lies in the whole hospital experience I think. Spent a lot of time there as a child including one spell of a year when I was 9 undergoing some pretty difficult processes and operations. It has left its mark.

Katek some areas have mobile units for mammograms I used to go to one here in London , you could enquire it would mean a less stressful time as no hospital involved.

KateK

What you would you be telling your daughter if you have oneone, or your son if you have one. Don't take advantage of breast screening or prostate screening because I had a terrible experience of hospital when I was a child. What would you do if they took that advice and regretted it further down the line?

I'm sorry if I sound harsh but whilst I understand what you say, I too had a not too fond time in hospital when I was 6 years old, you have asked a question and the answers may be direct in their response.

Can you not try and concentrate on the positives of health screening at all? Perhaps you should mention your anxieties to your GP you might be pleasantly surprised at his/her response and help. I am sure your GP will have other patients who have anxieties so please speak to him/her before deciding not to take advantage of screening.

I think a lot of GN's possibly know at least one or two friends/family who are pleased they did.

I hear what you're saying POGS and agree with you entirely.....I have two daughters who have both undergone laser treatment for pre cancerous cells and encouraged them to take all the screening/treatment on offer. Somehow when it comes to me it doesn't seem as important, there's a disconnect.

My time in hospital was significantly traumatic involving being in plaster from neck to knee, unable to sit up or get out of bed, being stretched on a daily basis with some medieval torture device (or so it seemed), two major spinal surgeries which could have resulted in paralysis and only seeing my parents 3 afternoons a week. I only saw my brother through the window. and I communicated by writing them letters. I was a lost little soul.

Gerd Gigerenzer is a psychology professor who specialises in the understanding of risk and statistics, and has done a lot of research into breast cancer screening.

He has found that a large majority of the population, including doctors patients and journalists, don't understand the probabilities relating to breast cancer screening, and are making poor decisions as a result. The incidence of misunderstanding can be as high as 90% of the population. Consulting doctors tends to make the problem worse, not better, and attempts at education seem to have little effect.

www.amazon.co.uk/Reckoning-Risk-Learning-Live-Uncertainty/dp/0140297863/ref=asap_bc?ie=UTF8
psi.sagepub.com/content/8/2/53.short
jnci.oxfordjournals.org/content/101/17/1216.full.pdf+html

Charleygirl Screening tests can produce false negatives too, I had a growth found with the endoscope even though I'd previously had a negative faecal blood test.

I'm another who co-operates with each and every screen I'm asked to have. I always have a heart in the mouth moment when the results pop through the letter box but the sighs of relief when it's confirmed I'm ok (so far as the tests can tell of course) make it all worth it.

We are so very fortunate to live in the UK, despite the strain on the NHS it's still a great service for most of us, most of the time

katek here is an extract from an article published in the Guardian, on 10 things doctors wouldn't do. It's Professor Susan Bewley, professor of complex obstetrics at Kings College Hospital, on why she wouldn't have a screening mammogram:

"I won't go for a screening mammogram. Down the microscope, doctors can't always tell the difference between "dangerous" and "OK to leave alone". So it is possible to find things "too early" that are not really life-threatening cancer. The independent review of breast cancer screening published last year in the Lancet helpfully distinguished biases, uncertainties and some bad science. The latest quantification is that of every 10,000 women screened every three years from age 50-70, about 43 fewer will die from breast cancer. Approximately 700 will be given a cancer diagnosis and a whole lot more women will be frightened by being recalled for further tests. Although most women who are told they have cancer by screening are grateful, I wouldn't be sure whether my life was really "saved" or if I'd just become an extra cancer patient.

It appears that for every 15 women who are "screen-diagnosed", three will still die of breast cancer (so screening doesn't save their lives), eight will still live (so screening brought the diagnosis earlier, but treatment would have worked anyway), one will not die of breast cancer (so screening prevents this cause of death) but three extra will become "cancer victims" (so screening leads to having surgery and/or radiotherapy/chemotherapy that wouldn't have happened in her lifetime). Screening can only be credited with one woman not dying of breast cancer, but all 15 have to be treated once something is found. It's complicated enough to understand, and some women will take these odds. But I'm happy to wait until I have symptoms."

Susan Bewley, Professor of Complex Obstetrics, King's College London

I too take the offer for any screening and I think the article jaaneainsworth is pretty irresponsible.
I had a breast screening 'scare', luckily non-malignant after resection and having nursed 3 friends, all with young families (aged 32, 38 and 42) through terminal cancer originating from undiagnosed breast cancer, I'd rather chance a false +ve than miss an early diagnosis.

It's still a bit hit and miss though, and I think breast screening can lead to some degree of complacency. Three years between scans is plenty of time for a tumour to develop well before the next one's due - regular self-examination is vital.

Quite ana.
loopy I don't see how a professor, being asked to contribute to an article by a serious newspaper like the Guardian, can be accused of being irresponsible for expressing her honest, professional opinion.
She wasn't telling others not to have screening - just explaining why she herself wouldn't.
You are free to disagree with her, but that doesn't make her irresponsible.

I always go along for the mammogram, having several friends who have survived breast cancer thanks to early diagnosis and treatment.

Can I also pass on a heartfelt plea from a colleague concerning the bowel cancer screening"poo sticks" kit? His test kit arrived and he was going to throw it in the bin but was persuaded (nagged he said) by his wife to do the test. It picked up some abnormalities which were treated before they could turn nasty and he says it may have saved his life. He's now spreading the word about the importance of getting screened.

The test involves taking samples of your poo on three separate occasions and putting a small smear on a card which is then sent off for screening. It's not pleasant but no worse than changing a dirty nappy -and I'm sure we've all done a few of those!

Take the opportunity of any screening you are offered - for most people everything will be fine and if something is found early, there's a good chance it can be successfully treated.

Mammograms are not offered routinely over the age of 70 but I think a mammogram every 3 years is a good idea and shall be requesting one after I am 70.

Self-examination is not infallible - even a consultant cannot always feel a tumour that is deep in the breast.

many interesting points of view on this thread and as ive already said I will be back regularly in future if I have any slight symptoms and not wait as I have done recently.

Up to now I have never had problems with the breast screening and I have been 3 times, every three years, I mentioned I had breast pain to the person doing the scan each time and each time it was clear. I have mentioned it to my GP several times and been examined and told it was nothing, I have had breast pain for about 9 years now and just live with it, no one has asked me to have any other investigations and hopefully my MRI scans for the bowel tumour will have covered my breast too as they scan almost the whole body.

There seems to be different standards of treatment and investigations depending upon where we live.

Perhaps irresponsible was the wrong thing to say, I apologise if that is so.
I was looking at the article from the perspective of some people reading it being swayed by her opinion Janeainsworth and thinking that if a well-read Professor thinks that then they should do the same.
I know a couple who chucked their bowel screening kits away because a relative who works in America sent them an article from a professional journal.
Both have since been diagnosed with Ca bowel. I know this is an extreme example but they were influenced totally by the article, so it does happen.
Self examination / examination by my GP didn't find my breast lump, a mammogram did.

There's no need to apologise Loopy but thank you anyway

I think the bowel cancer screening is rather different, since all it is showing is whether there is hidden blood in the faeces.
Further diagnostic tests are needed before a diagnosis is made.

As I understand it, with mammograms there are questions about how specific, and how sensitive, it is in diagnosing cancer, leading to false positives as well as false negatives. Other clinicians, and statisticians, have their doubts, it is not just Susan Bewley. But because we have all been imbued with the idea that screening saves lives, no Department of Health would ever dare to disband it, no matter how much money the programme wastes, or how much needless anxiety it causes.

I'm not going to have any more mammograms, but I do regularly self examine, and I'd be off to the doctor like a shot if I was worried. I also do the poo sticks.

I'm extremely concerned about the over Medicalisation of Potentially Vulnerable Older People - due to my own direct experience and abuse.

Over the weekend their were 2 full page adverts from the NHS that said if you are over 60 you need screening. This is scare tactics.I've also seen articles by medics themselves complaining about this.

Behind this is a commercial target driven organisation, paid by results - like the un-employed. My experience with screening confirmed this as I pressured from day one, then not given instructions, then when I tried to speak to a doctor about it - given the impression I shouldn't be doing that. The level of negligent incompetance was laughable if it wasnt so serious.

Prior to this horror I had a hip replacement at the same - Lewisham Hospital which was perfect - luck of the draw they seem to take pride in this service there.

My attitude as an older person is that if I have a physical disorder - my body will tell me about it - the way it did when I was younger and found, myself, a lump in my own breast - which was cancer. I hadn't spent all my previous years being screened just in case - so why should older people?

It creats a mind-set that is wholely negative and focused on disease and death - the last thing older people need and worse as its for commercial gain.