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NHS bowel cancer screening programme promotion: money down the toilet

27 April 2009
By David McDermott
Director of ltd which will launch later this year
Appeared in BioNews 505
Upon collecting a prescription from my local pharmacy, I was surprised to be handed a key ring with a small plastic toilet attached (1). The NHS bowel cancer screening programme promotion is, apparently, all about toilets! It is time to ask the members of the NHS Committee, who gave their seal of approval to a visual image meant to be a memorable centrepiece of this worthy campaign, to stand up and be counted, to ensure that they are never given the authority to invest public money again in a toilet idea. Their actions are not only crass and crude but also immoral.

Pee, po, belly, bum, drawers (2)

 Toilets conjure up images of turds and skid marks and, depending on how misspent your youth, puke. Toilets are where you wipe your bottom or your arse, depending on your lexicon. They are places where lazy boys piss on the seat.

Anxiety, desperation, repulsion

 There are anxious times, when in desperate need, we cannot find a toilet, embarrassing moments when we cannot get to one in time and occasions when we get to one, generally of the traditional public variety, and the length of the visit is governed by how long you can hold your breath.

Vulnerability, indignity and embarrassment

 Toilets are places where we run the risk of getting caught with our trousers down and our pants round our ankles. We have to make sure that we have 'adjusted our dress before leaving' and don't wander round for the rest of the day with our flies open or our skirt tucked into our knickers. And, they are places from which we emerge sheepishly when we have made a smell.

Funny ha ha?

 In short, toilets are associated with crap, whether it's the substance or the experience. Why then, with all these negative connotations, was the toilet seen as a fit and effective motif for this vitally important campaign. Is it meant to lighten a dark subject with scatological humour (from the Greek skat, meaning excrement, you know), of which the British are apparently fond? Is there some amusing cultural subtext which I've missed? I don't know, but is cancer really a laughing matter? Toilets and their business are things we talk about reluctantly, intrinsically they have little or no appeal, and there's not much which is uplifting, redeeming or life-affirming about them.

What's a camel?

 So just what took place in the NHS Committee meeting with their advertising agency? Just what was the basis for approving this crass and crude motif? What is intended with this puerile reference to the porcelain? Perhaps, toilet is a euphemism for poo - i.e. your poo is the main way to discover if you've got bowel cancer? I think we should be told because it isn't clear. It isn't engaging. In fact, it's repulsive.

So, what's the real message?

 If you're confused about the message, and after you've got over your annoyance about the immoral waste of your taxpayers' money and loss of opportunity, take a moment to consider just what is the message and how do you get it across?

Well, the message must be 'talk about health, talk about pain, talk about worrying symptoms even if they are embarrassing'. Talk with family, friends and your GP. Learn about risk of illness through family history and illness through lifestyle, diet and environment. Talk helps overcome the fear of ill-health and the worry and embarrassment of symptoms with the reassurance that early diagnosis and treatment can mitigate the effect of illness and in some cases avoid it altogether. And, with early diagnosis, bowel cancer has very high recovery rates.

It's in your super, soaraway Sun (3)

 In partnership with Cancer Research UK, Stephanie Moore, widow of England World Cup winning team captain, Bobby Moore, who died of bowel cancer, diagnosed too late, has organised an exemplary campaign for Bowel Cancer Awareness Month in collaboration with the Team England Football charity, which features household-name Premiership footballers, stripped to the waist to reveal stunning images depicting anatomical views of the bowel. The 'There is Moore to know' campaign uses aspirational icons from popular culture, newsworthy in themselves, in combination with arresting imagery which cleverly avoids distracting scatological references and the parts of our body associated with the toilet. The subject matter is powerful, dignified and ultimately effective because it provides something worthy of discussion.

'Those who cannot remember the past are condemned to repeat it' (George Santayana)

 However, the NHS Bowel Cancer Screening Programme, which focuses on the 60+ population, would have been too late for Bobby Moore, who died of cancer at the age of 51. It would have been too late for me too, as this was when I was diagnosed with bowel cancer. I survived because I talked to my doctor about a change in bowel habit before it was too late but my grandmother didn't and nor did my cousin, who both died in their 40s. My surgeon told me that there may be a genetic risk and advised my kids had screening from the age of 40, and my siblings and their kids, and my cousins and their kids, and their kids, and their kids...

But how could this life-saving advice be passed down the generations? Who would do the remembering, the reminding? I concluded that we had to create a family vault for this vital information and with the help of my other cousin, also a cancer survivor, we are creating, which will be the first website of its kind in the world: a safety deposit box for your family's health history, accessible any time of day or night no matter where you or your family may be in the world. And it incorporates an automatic reminder system, so you can look after your kids even when you're not around.

National Family History day

Extensive research in the US has so clearly shown that talking to your family about its health history has such a positive effect on its general health awareness, that the US Surgeon General has designated Thanksgiving as National Family History day. Do you think such an idea would have been a better way of promoting the NHS Bowel Cancer Screening Programme? Discuss.

1) Toilet Keyring, NHS Bowel Cancer Screening Programme Promotion picture
|  27 October 2021
2) 'Pee, po, belly, bum, drawers' (Flanders & Swann)
|  27 October 2021
3) The Sun, 'England stars in bowel cancer awareness ad'
The Sun |  23 April 2009
31 October 2011 - by Dr Rebecca Robey 
The NHS must take steps to prepare for a revolution in genetics-based medicine, according to a new report by the independent think tank, the Foundation for Genomics and Public Health (the PHG Foundation). The Foundation says that rapid advances in technology will soon make it possible for individuals to have their entire genome analysed affordably, and this will have a major impact on many aspects of healthcare...
7 June 2010 - by Dr Sophie Pryor 
US scientists have identified a region of DNA, which may contain a novel gene responsible for the progression and spread of colorectal (bowel) cancer....
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