Health – and longevity – is unevenly distributed across socioeconomic status. Persons of lower income, education, or occupational status experience worse health, and die earlier than do their better-off counterparts.
These disparities can be lessened by being active not passive in terms of decisions about your health, and the medical care you seek. This article is about making active decisions, with a focus on NHS screening – and some other non-screening things you can do.
Broadly speaking there are two ways of preventing disease, and living longer: screening and non-screening. Though it is true that many diseases are affected by genetic/racial factors (and luck), beyond your control.
Nonetheless, you (with the help of the NHS) can help with both screening and non-screening methods. Both are partially under your control. And you can chase the system, if things are not happening. Health, and preventative medicine, need to be actively sought. This includes lifestyle choices you can make as well.
We will now explain how to live longer – by making active not passive decisions. And we will go through ten top tips that are examples of how you can do that.
These are free tests offered by the NHS automatically once you reach a certain age. The tests check for signs of a disease. You should receive a letter directly from the screening programme or via your GP.
If you do not receive an invitation, contact your GP (or the relevant place, e.g. the nearest breast unit for mammograms). To get these services you need to be registered with a GP and have an NHS number.
1. Cervical cancer. This test checks the health of your cervix (the base of the uterus, or womb) and helps to prevent cancer. Cervical screening starts from the age of 25 years through to the age of 64. The test is very quick and usually painless. If you are not called up, contact your GP surgery.
2. Breast cancer. Mammograms are x-rays used to look for early breast cancer that you cannot feel. Any female registered with a GP, will be invited for a mammogram every 3 years between the ages of 50 and 71 years. Again, the test is very quick, and testing centres are usually in easily accessible places like your local supermarket carpark. Chase them by contacting your local hospital’s breast unit, if you are not called up for one. They are not organised through your GP.
3. AAA (abdominal aortic aneurysm). An AAA is a widening of the main blood vessel in the abdomen, the aorta. You should be invited for a screening from the age of 64, or soon after your 65th birthday. Again, chase it, if nothing happens.
4. Bowel cancer. Do a home screening test. This test is for everyone aged 60 or over (and 56 year olds). You will be sent a home test kit, called a faecal immunochemical test (FIT). You then need to collect a small sample of poo and send it to a lab.
The sample is checked for tiny amounts of blood (which can be a sign of growths in the bowel called polyps, or bowel cancer). If the test finds anything unusual, you might be asked to have further tests to confirm or rule out cancer, e.g. a colonoscopy or CT.
It is easy not to do this test as its a ‘bit yucky’. Again, be active and do it – and engage with the available system.
5. NHS Health Check. You should automatically be invited for an NHS Health Check if you’re aged 40-74 years and you have not had a stroke, or do not already have a pre-existing health condition. If not, contact your GP surgery. Some pharmacies do these checks as well.
6. Lung cancer. Targeted Lung Health Check (TLHC) programme – this is a trial at present in some parts of England. People aged 55-75 who have ever smoked will be invited to a free lung check. Following the lung health check those assessed as high risk will be offered a scan. If you think you might be at risk, why not discuss it with your GP and see if you can have one?
[Hint: Never assume that no news is good news. Always chase up results if you don’t receive them within two weeks.]
These are things its a good idea to keep on top of, but there are not currently NHS screening programmes for.
7. Other ways of preventing cancer. Examples include:
Breast cancer – from the age of 16 years, women should feel for lumps by examining their own breasts and armpits at least once a month in the shower or bath. Men get breast cancer too, so should do the same.
Skin cancer – avoid excessive sun exposure, and use high factor sunscreens – especially when abroad in hot countries. Wear a hat and long sleeves shirts. If any mole changes significantly, ask your GP to look at it. And if they are not sure, see a skin specialist (dermatologist).
8. Diabetes and high blood pressure
To prevent these two ‘silent killers’, eat healthily, exercise and keep your weight down – try to keep your BMI under 30.
Form the age of 30 years, check your own blood pressure every six months. From the age if 40, take it every three months. All homes should have a blood pressure machine. A&D is a good make. They are quite cheap.
Type 2 diabetes is an inherited disease. It is especially important to start looking for ‘early diabetes’ if either of your parents has diabetes; by having a blood glucose (sugar) test every six months, from the age of 30 years. This is especially true if you are Black or Asian.
9. Don’t smoke – to prevent smoke-related disease
10. Don’t drink alcohol excessively – to prevent alcohol-related disease
I know we sound a bit preachy here – doctors can be like that. But this is because we want our patients to live long and healthy lives. To do that you need to be active in decision making, not passively waiting until the system chases you. And is important to make time for fun too: parties, holidays, good food, and alcohol … in moderation.
We have explained how to live longer by NHS screening. We hope you have found it helpful.