Warning: this post contains references to the magical world of bowel cancer screening and all the glitter and fluff that comes with it.
One of the best gifts you can receive on turning fifty is an invitation to have your colon analysed. As if it’s not bad enough having to start the second (and almost certainly final) half of your life, you also have the indignity of having a stranger poking their noses into the delicacies of your rectum. I’m not entirely sure there will be any literal poking of noses but I think you get my point. It’s not that I’m not grateful for the attention, especially if it will help me avoid a long, slow, agonising death, much of which will no doubt be spent sitting on a cushion that looks like a large ring doughnut, it’s just that it seems a bit harsh to finally reach your half century only to be told that, hey, fun’s over pal, now get ready for some real pain.
The perils of aging are one of God’s most reliable ways of telling us he doesn’t exist; creating us just to watch us get old, tired and miserable doesn’t make any sense whatsoever. And the alternatives are hardly cheerful: war, famine, suicide, freak accidents, childhood illness, cot death, drugs, booze, boredom – each one drenched it it’s own particular, tragic gravy. In fact, now I think about it, if those are the alternatives perhaps it’s better to count some blessings and be grateful to be fifty at all. Fifty, as happy as life will allow and still in charge of enough of my mental faculties to know that my mental faculties aren’t quite as sharp as they used to be and that there is almost nothing I can do about it (sudoku and blueberries will only get you so far). So there is suddenly something quite refreshing about setting off on the mysterious journey towards the end by having someone else ponder the virtues of my arsehole. And beyond!
The nice thing about the NHS in 2026 is that you don’t have to trudge to the GP or some damp, collapsing hospital ward to find out how many things are trying to kill you from the inside out. Since they have been astute enough to realise that it takes weeks to get a doctors appointment unless you phone up and say your lungs have just dropped out of your nose, and that technically speaking having people dying in hospital corridors from a virus they have picked up in the same hospital is not good for business, it is better instead to deal with as many problems as possible from the other end of a very long, very shitty stick. And this is why I can have the contents and wellbeing of my bowels assessed remotely, by someone I will probably never meet; unless it’s really bad news and I ask them to double check.
So, I’ve been sent a letter inviting me to take part in a spot of bowel cancer screening. It’s all the rage. I can tell I’m in good company because the handy booklet that came with the letter has a photo on the front of a nice multi-ethnic, cross gender group of fifty-plus year olds, all smiling away. I assume they’re smiling because they’ve just been sent the same invitation and feel valued as a result. Or maybe they’re smiling because they can’t wait for their free bowel cancer screening kit to arrive. Or maybe it’s because they’ve just been told that they almost certainly don’t have bowel cancer yet (but will be invited to do another test every two years until they turn 76, at which point they will probably have something even worse than bowel cancer to smile about anyway, and bowel cancer on top).
Now, I don’t want you to get all jealous (which you won’t if you’re already part of the happy, smiley, NHS bowel cancer screening programme) but you really do get sent a free NHS bowel cancer screening programme testing kit through the post. You would think the free NHS bowel cancer screening programme testing kit would arrive at the same time as the letter inviting you to take part in the NHS bowel cancer screening programme, but for some reason it doesn’t. This may be a matter of common logistical sense or it might be so it doesn’t all come as one great big shock to the system – it’s clearly enough of a surprise to get invited to take part in the NHS bowel cancer screening programme without being simultaneously ordered to send in your sample immediately, upon (potentially) pain of death. So it’s rather thoughtful that they give you a couple of weeks to let it all sink in before the testing kit arrives. I suppose it also gives you a bit of time to build up a nice big sample too.
My NHS bowel cancer screening test kit arrived in a neat little box the other day, by which time I’d caught my breath. The box wasn’t particularly subtle, but then neither, I guess, is finding out you have stage four bowel cancer, especially when diagnosed late because you’ve chosen to opt out of the NHS bowel cancer screening programme. By this point I had read all about bowel cancer in the booklet with the smiley people thinking about bowel cancer on the front and was raring to go. But if you think that taking part in the NHS bowel cancer screening programme is as easy as doing a poo into an envelope and popping it in the post then you’d be very much mistaken. First you have to get your timings right, then prepare carefully for the magic moment and then hope everything goes smoothly (that’s as much detail as you’re going to get – if you want to know more then I suggest you enter the NHS bowel cancer screening programme and find out for yourself). A bit of privacy is also recommended.
Of course, it would be easier if you could just select a poo that doesn’t have cancer in it but that, sadly, isn’t quite how it works. Instead you just have to take pot luck and even then you only send in a tiny amount, because the NHS already have enough shit to be dealing with. What is particularly interesting (I’m using that last word very loosely) is that the little card envelope the NHS bowel cancer screening people send you to put your poo in is clearly labelled as destined for your designated NHS bowel cancer screening programme hub and so on a daily basis the postal service is handling what must eventually add up to literally tons of human excrement every day. No wonder the Royal Mail is struggling – I packaged my sample up with the precision of a watchmaker and the sort of hygiene standards you’d find in a pharmaceutical cleanroom, but I imagine some aren’t quite so diligent, so your average postie must be forgiven for displaying some reluctance to being asked to walk that round for too long.
Anyway, it’s all sent and done, and I have a faint sense of pride in knowing that by committing a tiny window into the general health of my colon to science I am keeping someone at the NHS bowel cancer screening programme hub (Nottingham University Hospital branch) in a job. It’s an interesting vocation and certainly not for everyone, but then there are lots of jobs that most people would turn their noses up at: masseur for the morbidly obese, halitosis tester, being a guest on Sunday Brunch. Now all I have to do is wait a couple of weeks for the results. They say that 97% of screening tests are negative (which in turn, confusingly, is positive) and that being in the other 3% doesn’t mean you definitely have bowel cancer but, rejoice, you may just need to go in for further tests and a colonoscopy, which sounds about as much fun as having a plastic tube shoved up your arse. My fingers are crossed, as are my buttocks. There’s no need to shit myself just yet then, though at least if they needed another sample I’d be one step ahead.
G B Burton. 20.08.2026
Ps, I did offer to write the next NHS bowel cancer screening programme information booklet, but they haven’t got back to me yet.
On stupidity......and other causes for concern. 