Bowel Cancer
The next item of business is a members’ business debate on motion S4M-05656, in the name of Sandra White, on bowel cancer—don’t take a chance, take the test. The debate will be concluded without any question being put.
Motion debated,
That the Parliament welcomes the launch of the campaign to encourage people between the ages of 50 and 74 to participate in bowel screening; understands that bowel cancer is the third most common cancer in Scotland with early detection resulting in nine out of 10 people surviving the cancer; further understands that Glasgow has the highest rate of deaths from bowel cancer in Scotland; welcomes what it sees as the success of other campaigns such as the breast cancer campaign, part of the Scottish Government’s £30 million detect cancer early drive, which aims to increase the early detection of cancer by 25%, and hopes that the bowel screening campaign will be as successful in raising awareness and early detection of bowel cancer.
12:32
I thank my fellow MSPs for supporting this members’ business debate. Without their support, we would not be having the debate, so I thank them very much. I also thank those who have been able to stay behind to take part.
Some 3,400 new cases of bowel cancer are diagnosed in Scotland each year. We know that increasing the number of people who live healthy lifestyles would cut that number and prevent bowel cancer. I know that some of my colleagues will use and speak about the facts and figures, but I want to keep my remarks to the bowel cancer—don’t take a chance, take the test screening, as this is a fantastic opportunity to bring that to the fore.
I attended the launch of the campaign at the Centre for Contemporary Arts in Glasgow. The Scottish Government launched it as part of the detect cancer early programme, which is backed by NHS 24 and the Scottish cancer coalition.
It is true to say that the campaign has certainly raised some eyebrows. It features Ford Kiernan in a very visual situation on television and in a very good voiceover on the radio, and it does not leave a lot to the imagination. I am sure that members have seen it. I think it is absolutely brilliant. Some people have said that it is designed to shock, but certainly it brings to people’s attention exactly what bowel cancer is.
The campaign’s aim is to bring home bowel cancer, particularly to men and particularly to men on the west coast. As we know, men find it particularly difficult to talk about their health and certain illnesses. In the case of bowel cancer, many men do not just find it difficult to talk about it but are very embarrassed and would not take the time to go to the doctor.
Bowel cancer is the third most common form of cancer in men, so anything that makes people sit up, take notice and take the test can only be a good thing. When we announced the campaign and that I was going to lodge a motion on it, it was obvious that some people who had seen the video were quite embarrassed and shocked by it. However, as I said, I thought it was brilliant. If it makes people sit up and take notice, it is a very good thing.
A couple of weeks ago, I had a conversation with Jackson Carlaw about the test. A number of us in Parliament will have received the test and not used it, set it aside or put it in the bin. I am not saying that Jackson Carlaw did that, but we did have a conversation about it.
The test kit is aimed at 50 to 74-year-olds and I appeal to people: when the kit lands on their doorstep, they should please take the test. It comes through the door every two years, it is very effective and simple to use, and the diagnosis is excellent. People can start treatment if bowel cancer is caught early enough, and if people do not have signs of bowel cancer but are worried about it, those worries could be completely gone after taking the test. That plea is the reason why I lodged the motion—I am sorry about the pun. People have to take the test because it can save so many lives.
It is really important that bowel cancer should be caught early. With early detection, nine out of 10 people can survive bowel cancer. As the motion says, Glasgow has the highest rate of bowel cancer deaths in Scotland, so it is imperative that people take part in the screening initiative. I thank Beating Bowel Cancer, Bowel Cancer UK and Cancer Research UK for their work and the magnificent job that they have done of highlighting the issue.
At the launch at the CCA, I met Lynn Faulds Wood, a broadcaster whom many people know. She is Scottish but now works and lives in London and she is a survivor of bowel cancer, which she had in her early 20s. Not only older people get bowel cancer. Lynn is such a good ambassador for this campaign; she speaks very highly of the people who have worked on it and says how important it is that people take part in it.
I also spoke to other survivors and people who are receiving treatment. They are very positive in their outlook, while recognising the real challenges that lie ahead. I will not name the person, but not so long ago I lost a very dear friend and colleague to bowel cancer. Six weeks before he was diagnosed, he had been playing squash, running and leafleting up and down tenements in Glasgow. If he had thought about taking the test, he might still have been with us here today. There are many other examples.
The message that I want people to take out of the debate is that bowel cancer is treatable if caught early enough. Help is there: there is a website and a hotline that people can phone if they happen to have thrown their kit in the bin. I make a plea, particularly to men who think that they do not need to take the test because bowel cancer will not happen to them and who would be embarrassed to talk about it: they should listen to the radio campaign, watch the video on TV and take the test. If nine out of 10 people survive a positive diagnosis, one of those nine could be any of them.
Thank you for giving me the opportunity to debate the motion, Presiding Officer. I thank members for supporting it.
12:39
I congratulate Sandra White on lodging this motion and think that we should also congratulate the Scottish bowel screening campaign, particularly its leader Professor Bob Steele, who has led it from the beginning. I remember meeting him about 10 years ago when he was piloting the programme in Tayside, and we were very pleased that he attended last night’s meeting of the cross-party group on cancer to talk about cancer surgery.
Although bowel cancer is the second most common cancer in men and the third most common in women, a very welcome fact is that deaths from the group that accepts screening have fallen by 30 per cent over the programme’s very short life. There is a very good reason for that. Of those who go to the doctor with symptoms, only 8 per cent are diagnosed with stage A, the first of the four stages of bowel cancer, whereas 49 per cent of those who are diagnosed through screening have stage A. That is very important, because more than 90 per cent of those diagnosed at the early stage—stage A—go on to survive for five years whereas only 7 per cent of those diagnosed at the fourth stage survive.
That emphasises the importance of the detect cancer early initiative. I congratulate the Scottish Government on that great initiative, which is particularly necessary for bowel cancer, for which the uptake of screening is about 55 per cent, which is much less than the uptake of screening for bowel cancer, for example.
We all know that there are particular challenges with certain sections of the population and, as a result, specific initiatives are important. In its briefing for the debate, Bowel Cancer UK talks about a project that it has been running and which has been successful in increasing uptake among those with learning disabilities, and I am sure that the Government will want to look at that and any other good examples.
Of course, screening is not a panacea; other messages about bowel cancer have to be sent. For a start, as people can get what are called interval cancers, they still have to watch out for symptoms between screenings. There are also the key messages about prevention, which are mainly about diet and exercise.
I will be interested to hear from the minister whether there are any plans to build on the screening programme, because I think that it might be possible to improve what is already a very good programme. In its briefing, Cancer Research UK mentions an alternative called the faecal immunochemical test, which, I am told, is more accurate and less complicated. I have to say, though, that I have never found the test to be particularly complicated, having taken it several times since I turned 50—which is unfortunately quite a long time ago.
The other possible development is the flexible sigmoidoscopy procedure. It is regarded as an even better test because polyps, which are always the precursor to cancers, can be removed. I am told that there might well be a pilot in that respect in Scotland—I believe that it might be in Tayside, which is once again leading the way—and the minister might wish to mention that. Of course, that raises the whole question of capacity not just for sigmoidoscopy but for colonoscopy, which is required for those who get a positive result in a faecal occult blood test. The news has highlighted controversies about capacity in that respect, including here in Lothian. However, this is not a debate about complaining; instead, it is about celebrating the success of the screening programme and the possibility of building on it to make it even more successful.
I have already mentioned Bowel Cancer UK, which I think is a great campaigning organisation. Indeed, I was pleased to sponsor a recent event that it had in the Parliament. The chief executive, Deborah Alsina, whom I recommend people follow on Twitter as her tweets contain an awful lot of useful information about bowel cancer, gave a very inspiring speech in which she emphasised the importance of taking account of patient experience; of improving access to various bowel cancer treatments, including some of the drugs that we have heard about in other contexts; and, crucially, of early diagnosis, which of course is the subject that we are discussing and whose successes we are celebrating.
12:44
I am from a generation brought up on “Carry On” comedies. My favourites are “Carry On Screaming”, “Carry On Doctor”, “Carry On Cowboy” and “Carry On Camping”, but I will never forget Charles Hawtrey as Dan Dann the Lavatory Man in “Carry On at your Convenience”.
Part of our character in this country is our tendency to laugh at what we think to be uncomfortable, and what we think to be uncomfortable is anything to do with the bowels—so much so that if that topic ever came up in any of the films, one could rely on Kenneth Williams to look full on at the camera and say, “Matron.” Basically, that is most people’s response before moving on. For a number of men who are asked anything about the nether regions, the traditional response is to look the inquirer in the eye and say, “Church of Scotland,” before moving on to a different subject. We must recognise that while we have in Scotland an excellent screening programme, we do not have an excellent record on bowel cancer.
I congratulate Sandra White on securing the motion. In the cancer debate a few weeks ago, I confused the subject with breast cancer—I was getting my breasts and my bowels confused—but I absolutely agree with the sentiment of and everything underpinning the motion.
My father-in-law died of bowel cancer in his early 60s. Bowel cancer will be detected in 4,000 Scots a year, which is one of the highest incident rates in the UK. We also have one of the lowest survival rates across the European Union—25 per cent of those who are identified with bowel cancer will die. Crucially, 90 per cent of those whose cancer is detected early through screening will survive for five years, while only 7 per cent of those who are detected late will survive for five years. Early screening is crucial. That is what the motion seeks to promote and what my remarks have been directed towards.
The campaign is aimed at people in their 50s. I know that for some people in their 50s anything beyond Brylcreem and Old Spice is to be thought about only by those who work in the theatre or the BBC; they do not want to talk about grooming. However, the next generation of younger men are more on the ball about health issues, as are the younger generation of children.
I must say to men in their 50s that they are no longer on the pull. I know that they think that they are still an icon, the glass of fashion and the mould of form, but I am sorry to say that they are in fact past that. Older women are looking for younger toyboys and younger women are interested only in those with a lot of money and, to be frank, that will not be anyone who lives in Scotland. The primary concern of men in their 50s ought to be their survival. If a screening programme is available every two years, for goodness’ sake, take advantage of it and be part of the 90 per cent of those unfortunate to be detected with bowel cancer who have a genuine chance of surviving it.
Therefore, my message to younger men and to children who have a father in their 50s who is part of the recalcitrant generation in relation to their health is to be aware that the screening programme exists. Tell Dad, “It ain’t pretty, but get over it.” Tell him that he must have the screening done, and ensure that for himself, his family and his generation, he does what will ensure that he is part of the 90 per cent who survive.
12:48
I congratulate Sandra White on securing this important debate and on her compelling contribution. I add my support to the tributes paid to charities such as Beating Bowel Cancer, Bowel Cancer UK and Cancer Research UK. We owe them all a debt of gratitude for their work, day in, day out, on behalf of people with bowel cancer.
It has been mentioned that Scotland has the highest incidence of cancer and bowel cancer in the UK. As Sandra White reminded us, bowel cancer is the third most common cancer in Scotland. Therefore, there is a huge responsibility on us all to do what we can to raise awareness; to educate ourselves in how to recognise the symptoms of the disease; and to disseminate throughout the general population the vital information that everyone needs if we are to obtain back the testing kits that can help people to detect the disease and ensure that they go on to access appropriate treatment.
Early detection and treatment of the disease are vital. Malcolm Chisholm highlighted the reduction in mortality rates that we have seen in recent years. If bowel cancer is detected early, nine out of 10 people go on to survive. That is an impressive statistic, but it is too easy to forget that a human story lies behind each of those statistics—perhaps that of a son who survives bowel cancer and goes on to live a fulfilling and productive life, or of a mother who survives bowel cancer and is able to enjoy a happy retirement with her grandchildren.
The Scottish Government is to be commended for extending the bowel screening campaign from April of this year. The latest public awareness campaign carries the message, bowel cancer—don’t take a chance, take the test. The chief medical officer for Scotland, Sir Harry Burns, has said:
“I hope that this campaign will get people talking about bowel screening, and show that screening is the most effective way of detecting bowel cancer early.”
Scotland has led the way by starting screening at the age of 50 rather than 60, as is the case in England. However, there is no room for complacency, because our survival rates and outcomes lag behind those of the rest of the UK and, as the motion outlines and as has been stated, Glasgow has some of the worst mortality rates in the country.
Only yesterday, the chief executive of Beating Bowel Cancer, Mark Flannagan, wrote in The Scotsman:
“There are some reasons to be optimistic about Scotland’s efforts to tackle bowel cancer. Scots now have the lowest screening age in the UK, thanks to the government’s understanding that early treatment saves lives.”
Currently, men and women between the ages of 50 and 74 are invited to participate in screening every two years and, in the future, those who are over the age of 74 will be able to self-refer every two years. However, it is important to remember that bowel cancer is not confined to the over-50s. Although it is rare, men and women in their 20s, 30s and 40s can also get bowel cancer.
Therefore, it is essential that we all overcome our natural reticence to talk about our vital bodily functions and that we all learn to recognise the symptoms of bowel cancer. That point was made with characteristic eloquence and humour by Jackson Carlaw. The symptoms of bowel cancer can include a change in your bowel habit, bleeding from the bottom or blood in your poo. We are going to have to overcome the taboo surrounding bowel cancer and get used to talking about bowels and bottoms, blood and poo.
The important message from today’s debate is that bowel cancer is a killer disease, but it can be beaten and is survivable. The bowel cancer screening programme has a vital role to play as part of the detect cancer early initiative. The evidence is clear: early detection saves lives. Each year, more than a quarter of the people who are diagnosed with bowel cancer in Scotland will die from the disease, yet bowel cancer can be beaten if it is diagnosed early. More than 90 per cent of patients who are diagnosed with early-stage bowel cancer will survive five years from diagnosis, whereas less than 7 per cent of patients who are diagnosed with late-stage disease will do so.
In the public debate on bowel cancer, we are where we were with breast cancer 20 years ago. Then, no one talked about breast cancer and it was seen as a death sentence. Today, it is no longer a common cancer killer but a disease that people talk about, get tested and treated for and—most important—survive. That is the position that we want to be in for bowel cancer, so let us have that ambition for Scotland.
I have had a late bid to speak from Nigel Don.
12:53
Thank you very much, Presiding Officer. As you will realise, I was in the chamber to listen and had not intended to contribute to the debate, but I would like to make a few remarks.
First, I congratulate Sandra White on bringing her motion before the chamber. Secondly, I will take any opportunity that I get to congratulate Professor Bob Steele, who has been instrumental in raising awareness of bowel cancer.
I would also like to pick up on Jackson Carlaw’s comments. I think that he got it absolutely right. Men of a certain age, of whom I am one, can be pretty reticent—although I am not sure that the flowers who are in the chamber are especially reticent—to talk about such things, so it is hugely important that we make the point to our families and the rest of the population that they must pester us. I agree with Malcolm Chisholm—I am struggling to see how any future test could be any easier. I did not think that the test was a problem, but if someone can make it easier, that is fine. It is that reticence that we must get folk to overcome. Quite frankly, if we need some children’s pester power, so be it.
12:54
Like other members, I congratulate Sandra White on securing time for a timely debate that coincides neatly with the publicity campaign that we are running on taking the test for bowel cancer.
I have no doubt that every member in the chamber knows someone who has been affected by cancer and I recognise that people hold a deep fear about the possibility of being diagnosed with cancer because of the consequences and difficulties that can arise from that. It is only natural that people tend to be reluctant or reticent to be tested for the possibility of having cancer. We must balance that issue with the need to inform people that if they do have cancer, then the earlier it is diagnosed the more likely that it can be effectively treated. That is exactly what the bowel cancer screening programme intends to do.
Cancer is a key priority for the Scottish Government and for the National Health Service in Scotland and it is essential that we make progress by detecting cancer at a much earlier stage. A number of members referred to the detect cancer early programme, which is a four-year, £30 million programme that is a key part of progressing earlier intervention and prevention. The programme is ambitious, because we are dealing with deeply held cultural views about going to the doctor and getting medical advice and checks at a much earlier stage. Nonetheless, the programme is extremely important and that is why the Cabinet Secretary for Health and Wellbeing, when he launched the campaign to raise awareness of the Scottish bowel screening programme last month, emphasised the point that detecting cancer earlier will, quite literally, save lives. That is why participating in the programme is extremely important for those who are of an age—of which I am not, as yet—to be invited to participate.
In their contributions, Sandra White and Jim Eadie highlighted the fact that if bowel cancer is detected early then nine out of 10 people can expect to survive, which is fantastic news. As Jim Eadie illustrated, there is a human story behind those statistics and they highlight how treatable the condition is if it is detected at an early stage.
Jackson Carlaw and other members highlighted the fact that Scotland continues to lag behind other European countries on cancer survival rates, and with an aging population we expect to see an increasing number of cancer instances. Clearly we must do more and that is why all men and women aged between 50 and 74 have been invited to participate in the Scottish bowel screening programme every two years, and why, as of April, those who are over 74 will be able to request a screening kit every two years through the Scottish bowel screening helpline.
I hope that the campaign, which several members referred to, will help to empower people to talk about things much more openly and frankly. I witnessed the campaign a few weeks ago when I was at Firhill watching Partick Thistle. The campaign team was there on the concourse, mixing with the fans and providing them with information about the screening programme. The club also made some announcements during the course of the half-time break. Obviously, as a fan I am biased about the club, but I congratulate Partick Thistle on participating and on working with the screening programme to progress the campaign. I encourage other football clubs to do that because it is a very good way of reaching a key group, particularly men of the age groups that can participate in the programme.
The important thing is that a person diagnosed with bowel cancer will receive the best possible services and treatment available. We have made progress in those areas. In his speech, Malcolm Chisholm asked about future developments. He referred to two particular areas. One was the faecal immunochemical test—FIT—that has been developed. We are carrying out some work on that in Scotland as part of the screening programme. The FIT is a more costly test and we need to evaluate it to determine whether it would be effective as a first-line test. We are currently carrying out some pilot work to find out how effective it could be, because it has the potential to detect some forms of bowel cancer that the existing test may not identify.
The second point that he made concerned flexible sigmoidoscopy—I am told that the short term is flexi sig. That screening programme has other benefits, and we have provided some £2 million to run a pilot over the next two years to determine whether that test could be used in Scotland to continue to make progress.
We have been making progress and we need to make further progress in the years to come. The public awareness campaign has an important part to play in breaking down some of the existing barriers and encouraging people to participate in the testing scheme. That can help to improve people’s survival of bowel cancer should they be diagnosed with it.
I encourage all members to continue to do what they can in their constituencies to encourage their constituents to participate in the screening programme. I have no doubt that all the members who are in the chamber will join Prostate Cancer UK in trying to raise awareness of another cancer that, if diagnosed early, can be treated effectively. That charity is lobbying the Parliament today to try to raise awareness among men about getting treated early for prostate cancer.
13:01
Meeting suspended.
14:30
On resuming—