DR TIM ALLISON: Screening helps to detect problems at an early stage

I have written recently about how there are some similarities between looking after a car, if we have one, and looking after our health. The comparison is not perfect, but I will stick with it even though I am writing this while travelling by train.

In order to look after a car correctly we need to make sure we give it regular checks. Sometimes these are things we can do ourselves, such as making sure that the tyres are at the right pressure, that there is enough depth of tread on the tyres and that there is water in the tank to wash the windscreen. There are also checks that need more expertise to do such as ensuring that the brakes are effective and after three years all cars need an MOT to ensure that they meet safety and environmental standards.

People sometimes talk about getting an MOT for their health. There isn’t a standard set of tests for everyone like there is for cars. However, for people who live with long-term conditions such as diabetes it is important to have regular checks on health. Also, for all of us when we reach certain ages, just like the three years for an MOT, we will be invited for screening.

Screening for conditions is designed to detect problems early and before they are causing symptoms. This means that treatment can be done earlier and can prevent the disease progressing. So cancer screening can either detect cancers at an early stage or often before the cancer has developed. No test is perfect and screening tests are carefully designed to get the best balance between identifying as many people as possible with the condition and having positive tests for people who actually don’t have the condition. This means that there are only certain diseases where screening works well and where there are national screening programmes. With prostate cancer for example the test is not yet good enough to justify a national screening programme, but it is possible that things may change over the next few years. Lung cancer screening may soon be put in place too.

Women have been invited for cervical screening and for breast screening for many years and men are now invited for aortic aneurysm screening. Both men and women are invited for bowel screening. There is a national programme for people with diabetes to have their eyes screened which goes beyond the general advice for us all to ensure that we check out our vision.

We will get invited to attend for screening appointments, just like we get a notification to renew our car tax and book an MOT.

Screening take-up locally is generally good, but it is important that we all take seriously the offer of screening. There aren’t the legal sanctions like an MOT, but It is in our own interests to check out screening.

Dr Tim Allison is NHS Highland’s director of public health and policy.

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