Sections | Questions |
---|---|
Section 1: About You | Have you ever been diagnosed with cancer? |
Do you have 2 or more close relatives who have been under the age of 50 when diagnosed with cancer? | |
Please give your height in Feet and Inches / Centimetres Please give your weight in Stones and Pounds/Kilos | |
Did you receive your bowel screening kit in the post? If yes, did you send it back? | |
Have you been invited for a cervical smear test? If yes, did you attend? | |
Have you been invited for your breast screening test? If yes, did you attend? | |
Section 2: Your Lifestyle | Do you smoke? If yes, On average How many cigarettes a day do you smoke |
Are you exposed to another person’s smoke on a regular basis? | |
Do you drink alcohol? If yes, on average How many units of Alcohol do you drink each week? | |
On average, how many hours a week do you exercise in total, adding up any daily amounts? | |
How often do you eat 5 portions of fruit and vegetables in a day? | |
Section 3: Your Health | Do you have a cough that won’t go away? If yes, do you bring up blood when you cough? |
Have you noticed any unusual lumps on your body (e.g. breasts, testicles, armpits, groin)? | |
Have you noticed a change in how your skin looks (e.g. change to a mole, freckle or patch of skin)? | |
Do you have a sore or ulcer in your mouth that will not heal? | |
Have you noticed a change or any blood in your poo? | |
Do you have any problems when peeing? | |
Do you have any unexplained bleeding (e.g. blood in your pee, bleeding from your bottom, vaginal bleeding during /after sex or in between periods)? | |
Do you have difficulty swallowing? | |
Have you been losing weight without trying to? | |
Have you noticed any unexplained change in your appetite? | |
Do you feel tired most of the time? | |
Do you have an unexplained pain that won’t go away? |