The kit in the bathroom cabinet
Not everything that gets put off is a symptom. A good deal of it arrives in the post. There's the bowel screening kit, the letter inviting you for a smear test, the appointment for a mammogram, and the text about a health check. These are easier to ignore than a mole, because nothing is wrong. You feel fine, and the envelope goes on the side, then into a drawer.
Here's what the main programmes in England are, as the NHS describes them.
Bowel cancer screening is offered to people aged 50 to 74, every two years. It's a test you do at home. You collect a small sample and post it off, and the laboratory looks for traces of blood that you couldn't see. The NHS says it can help find cancer early, before you have any symptoms, which may mean it's easier to treat.
Cervical screening is offered to women and people with a cervix aged 25 to 64, every five years. The NHS describes it as a test to check the health of the cervix and help prevent cervical cancer.
Breast screening uses X-rays called mammograms to look for cancers that are too small to see or feel.
The NHS Health Check is a free check of the heart and blood vessels for people aged 40 to 74 who don't already have certain conditions. People should be invited every five years. It looks at your risk of problems such as heart disease and stroke, and you discuss how to lower it.
Add to those the dental check-up and the eye test, which you have to arrange yourself.
I need to say something here that a more one-sided book might leave out. Screening isn't a pure good, and deciding against a particular test is a legitimate choice. Every screening test produces some false alarms, which means anxious weeks and further tests for people who turn out to be fine. Some programmes also find slow-growing conditions that would never have caused trouble, and those then get treated. That's why the invitations come with information about benefits and risks, and why the programmes are offered as a choice. They aren't an obligation. A person who reads the leaflet, thinks it over and decides that a given test isn't for them has made a decision, and I've no quarrel with it.
That isn't what happens with the kit in the bathroom cabinet, though. Nobody read the leaflet and weighed the risks. The envelope went in the cabinet in June because opening it meant thinking about bowel cancer for ten minutes, and that's uncomfortable. It's the third kind of fear from chapter 8. There was every intention, and then a flinch away from the subject. In effect a decision has been made, because the test isn't getting done, but nobody made it.
This book is aimed at that kind of drift. People who consider a test and refuse it aren't my concern. So my suggestion for each outstanding invitation is to make it a real decision. Open the envelope and read what it says about benefits and risks. If you have questions, ask your GP surgery or ring the number on the letter. Then decide. If the answer is yes, book it or do the kit this week. If the answer is no, that's your right, and you can throw the letter away with a clear mind and stop feeling guilty every time you open the cabinet. The one thing not to do is carry on as you are, which gives you neither the test nor any peace about it.
I'd expect that most people who look at it properly will decide to do it. The home bowel kit in particular asks very little. It's a few minutes in your own bathroom and a walk to the post box. The main obstacle is that you have to think about the subject while you do it, and chapter 8 was about getting through those few minutes.