What would you do if your cancer test came back positive?

The thousands of Scots who do nothing - and the city researchers trying to understand why

Professor David Weller of Edinburgh University will lead the study

Tens of thousands of people living in the Lothians are playing a form of Russian roulette. There’s no pistol, no bullet loaded in one chamber. Just the possibility that, for some of them, a genetic timebomb is tick-tick-ticking…

The numbers of people failing to take a simple, free test in the privacy of their own home appears hard to explain when the consequences could literally be the difference between living and dying.

However the fact is that one in four of the 950,000 Scots invited to take part in screening for bowel cancer each year simply do not respond or participate. That’s more than 200,000 people in Scotland - likely around 30,000 in the Lothians - not taking a few minutes for a simple process that could save their lives.

More worryingly, even amongst the tiny number who do test and get a positive screening result around a quarter – somewhere around 4500 people in Scotland - never attend for the follow-up investigation to determine whether they do have bowel cancer (and we should stress that - in most cases - a positive does not mean the person has cancer).

Yet the truth remains that bowel cancer, the second largest cause of cancer deaths in Scotland, can be very successfully treated in most cases where it is caught early enough – with survival rates as high as 90 per cent. When it is not detected until the cancer is metastatic the prognosis is much gloomier, with the chance of surviving five years or beyond at around ten per cent.

Research to save lives

That stark difference is why a national bowel cancer screening service was established in the UK – after being pioneered in Scotland - and research has shown that it is preventing around 2500 bowel cancer deaths across the UK each year. It is offered, free, to people aged 50-74.

Yet another concern is that many of those who do not engage are actually in groups that have a higher risk - in terms of links to socio-economic status and levels of deprivation.

Now a team from the University of Edinburgh’s Department of General Practice is to carry out research which, it is hoped, will help more GPs and health professionals better understand the barriers that deter some individuals from participating in an already successful national bowel cancer screening programme and, in the process, help save more lives.