Why has NHS stopped inviting me for cancer screening now I’m 71?

The admirable decision by King Charles to reveal he has cancer sparked a huge rise in the number of people seeking information about the disease. In the 24 hours following the news, Cancer Research UK saw a 33 per cent increase in visits to its information pages.

As the King is 75, it is inevitable that many of us who are older should have heightened awareness.

We are right to be alert to our level of risk. More than a third of new cancer cases are diagnosed in people aged 75 and over. But for concerned older people, there are some surprises in store.

I’m 71 and one of those for whom the news of King Charles’s cancer was a wake-up call. Unlike our monarch, I am not a paragon of healthy living. I used to smoke, I drink alcohol and I’m a bit overweight.

I thought I should get myself checked out. I suddenly realised I hadn’t been invited for my regular cervical screening or a mammogram. I assumed this had something to do with the pandemic, but I was wrong.

At my GP’s surgery, I was told I was now over the age limit to receive routine invitations for the breast or cervical cancer screening programmes (which have cut-off ages of 70 and 64, respectively in england). A nurse at the surgery told me that I was not entitled to either, even if I asked.

He WASN’T quite right. I checked online and discovered that, while I’d no longer receive automatic invitations from the nhs, I could request screening for breast cancer after 71, but not cervical cancer.

I also discovered that, when I reach 74, I will be removed from the bowel cancer screening programme (which starts at 60). After 74, you can request a bowel cancer test kit every two years.

But should I ask for these tests? I was especially concerned about not being called for cervical screening, because I had an abnormal smear and ensuing laser treatment 30 years ago.

I also wondered what happens in other countries. Is the cut-off date lower in the UK because our nhs is short of money, or is it determined by the latest knowledge of cancer statistics?

With breast cancer screening, 71 feels to be a random age. Why not 70 or 75? Why not until the day I die, as it would seem logical that regular screening for cancer would help delay that day. surely it is ageist to deny older women potentially life-saving screening?

Let’s start with breast screening. In women aged 50 to 70, who are offered screening once every three years, about 1,300 lives are saved in the UK each year by finding breast cancer early.

According to the nhs, routine breast screening stops at 70 because there’s no evidence screening older women brings more benefit than harm.

however, there is currently a massive study involving four million women being carried out by Oxford University, in which women between the ages of 47 to 49 and 71 to 73 are being screened, to assess the benefits and the risks of extending the age groups.

And other countries already screen to 74, including the U.s., Canada, Australia and most of the eU.

But before I called my local breast cancer screening service, I studied the statistics, and found there is a real risk I could end up having an unnecessary operation.

And I am all too aware how horrible breast surgery is. two close family members had surgery to have breast lumps removed, which turned out to be benign. these were traumatic operations under general anaesthetic.

When you get older, the risk is that screening spots a small cancer which would grow so slowly, it would never threaten your life.

A U.s. study in the journal Annals of Internal Medicine last August suggests there is a substantial risk of overdiagnosis, with routine screening for women in their 70s or over. the researchers found that cancers were detected in six out of 100 women who were screened after 70, and four out of 100 in those who weren’t — but there were no differences in the number of more advanced cancers diagnosed, which would be more likely to result in death. nor were there more deaths in the unscreened group.

so screening is not the life-saver you think — although there are likely to be some exceptions. Plus, surgery when you are older carries risks.

I’ve had operations as an older woman, including a knee replacement. It took months to recover. I also don’t want to have surgery on my breast unless I really need it. Just thinking about having some of my breast removed distresses me.

there has been debate swirling recently about the cut-off date for cervical cancer screening.

the disease is caused almost exclusively by the human papillomavirus — hPV — which is generally contracted through sexual activity. Cervical screening ends at 65 in the UK. But according to Cancer Research UK, there are 600 cases a year in women over 65, nearly a fifth (18 per cent) of the newly diagnosed cases.

Although I had an abnormal smear decades ago, apparently my risk of cancer has returned to the average.

But should I still be screened? the argument here is similar to that for breast cancer. It takes a long time for the virus to develop into cervical cancer.

however, we read a lot about the changing sex lives of older women and the resulting rise in stDs in this group. Women are more likely to divorce and start new relationships than a generation ago. But the cancer researchers I talked to said there was no evidence this had resulted in increased levels of cervical cancer in older women.

Yet in Australia they take a different attitude. there, women aged 70-74 are told they should have an ‘exit’ cervical screening test and, if no cancer is found, cease testing at that point. While charities here, such as Jo’s Cervical Cancer trust, advocate more research about the upper age cut-off, there is a safety net in the UK: if your last cervical screening was abnormal, you will be invited to the next one, even if you’re over 65, and will continue to be invited until you become hPV negative.

Also, a woman over 65 can request a smear if she’s never had one or not had one since she was 50.

And finally, bowel cancer screening. I was relieved to find that in all the countries I checked, the upper age limit was the same as ours: 74.

Cancer researchers say the recommended age ranges for screening programmes will be amended as more data is analysed.

As nicola smith, senior health information manager at Cancer Research UK, told me: ‘this is an evidencebased process and new research is constantly being reviewed.’ But, she added, and this is the key bit: ‘If you would like to be screened but are older than the age range, you can talk to your GP about your risk, or call the relevant screening helpline to ask to be screened.’

WhY did that nurse at my GP surgery not tell me that? he just said I couldn’t be screened. I didn’t feel my risk as an individual was even considered.

Yet while it’s important to question the ages for screening, less attention is paid to the fact that around a third of people never take up the offer, according to the Cancer in the UK Report 2024.

And, of course, the figure we should pay most attention to is that four in ten cancers are preventable.

smoking, drinking too much, being obese — they are the things we should worry about most.

I gave up smoking at 32. Big tick. And I try to keep within the 14 units of alcohol a week guidance and watch my diet. My cancer risk is down to me — not the Government.

having started this process quite cross about being left out by ‘ageist’ screening policy, I can now see the point of it.

I suspected the nhs was just trying to save money, but I think it was genuinely trying to save me from unnecessary treatment.

however, I’ve decided I would like to have one more mammogram and one more smear test. Just to be sure.