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Case/Article Review 13


​You have two minutes to read the enclosed article, and you will subsequently be asked a range of questions by the interviewer. You may wish to make notes, however please note you will not be allowed to refer to your notes or the article during the discussion.

​
Half of people in England sent a home-testing kit for bowel cancer in 2015 did not use it, according to research in the European Journal of Cancer. Fewer men than women returned the kits, which are designed to detect the disease before symptoms appear. The current screening kit requires small stool samples to be posted for screening in specially sealed envelopes.

Cancer Research UK said it was very concerned by the figures. In 2015, only 49% of people aged 60-64 who received a home test kit for the first time returned their samples, down from 53% in 2010. Anne Parmenter, 63, from south London, received a bowel cancer testing kit in the post on her 60th birthday. "I wasn't going to do it but, in the end, I thought it was daft not to and sent it back.  "The following Tuesday I received a letter asking me to go to hospital for more tests.  "I had no symptoms before and didn't feel unwell, so I feel that kit saved my life," she says.

She was diagnosed with bowel cancer and had surgery and chemotherapy.  "The cancer has changed how I look at life because none of us know what is around the corner.  "Three years ago, I had no idea of what was to come but I am now slowly recovering and getting back to normal."
The research, from University College London, looked at data from 4.4 million men and women sent the bowel cancer screening kits over five years in England.

Those living in poorer areas were less likely to take part than those in wealthier areas. Among women, 56% returned samples, compared with 47% of men. Cancer Research UK said people were missing out on a test that could reduce their risk of dying from bowel cancer by up to 25%.


(Adapted from: https://www.bbc.co.uk/news/health-45411114)

 Outline the main issues raised.
​


Average Candidate Response
This article discusses the issues with screening programmes, in particular poor compliance in bowel screening and how this is resulting in more people dying from bowel cancer.
​
Excellent Candidate Response
​
The key issue detailed in this article, is that an increasing proportion of the population above the age of 60 is declining the opportunity to undergo screening for bowel cancer; this is particularly prevalent in areas of a lower socioeconomic status. 

On the one hand, one could argue that each individual has their own autonomy to make a decision to not undergo screening, which should be respected; there are many factors that may discourage individuals from taking part in this testing. One example is a limited understanding of the benefits of screening. Members of the public may believe that no symptoms correlates with no disease, and that if there are no explicit signs of the cancer, there is no need for testing. Furthermore, a lack of awareness – particularly in ‘less educated’ communities - may influence this decision. Through mediums such as social media campaigns, many people recognise the importance of early diagnosis of breast cancer, for example, as it is one of the most common forms of cancer in the UK. Bowel cancer, on the other hand, is much less publicised, resulting in the public not fully understanding the dangers of this disease. 

However, it could be disputed that some patients may not have the capacity to make such a decision regarding the screening process, as a result of this lack of education. Furthermore, the beneficence of these individuals must be considered – undergoing testing reduces the likelihood of suffering from bowel cancer, as the disease can be diagnosed and treated at an early stage. Therefore, it must be argued that, to ensure the well-being of these patients, screening must be encouraged with wider societal education and health promotion. 
​

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