Screening is a way of finding out if people are at higher risk of a health problem, so that early treatment can be offered or information given to help you make informed decisions.
Making an informed choice
Before having any screening test, it's worth finding out about the test itself and what would happen next if you found out you have a higher risk of a particular condition.
Deciding whether or not to have a screening test is a personal choice and one which only you can make. When you are invited for screening, you will receive an information leaflet about the screening test. You can discuss any aspect of the screening test with your health professional and decide whether or not it's right for you.
Different types of screening have different benefits and risks. Some of these are listed below.
The benefits of having a screening test include:
- Screening can detect a problem early, before you have any symptoms.
- Finding out about a problem early can mean that treatment is more effective.
- Finding out you have a health problem or an increased risk of a health problem can help people make better informed decisions about their health.
- Screening can reduce the risk of developing a condition or its complications.
- Screening can save lives.
The risks and limitations of screening include:
- Screening tests are not 100% accurate. You could be told you have a problem when you don't – this is called a "false positive" and may lead to some people having unnecessary further tests or treatment as a result of screening. A screening test could also miss a problem – this is called a "false negative" and could lead to people ignoring symptoms in the future.
- Some screening tests can lead to difficult decisions. For example, if a pregnancy screening test tells you your baby has a higher risk of a particular condition, you may then be faced with a decision about having further diagnostic tests that involve a risk to your pregnancy. If the diagnostic test is positive, you may then need to decide whether to continue with your pregnancy.
- Finding out you may have a health problem can cause considerable anxiety.
- Even if your screening test result is normal or negative (i.e. you are not at high risk), you could still go on to develop the condition.
1. Abdominal aortic aneurysm (AAA)
2. Breast Cancer
3. Bowel Cancer
1. Abdominal aortic aneurysm screening
Abdominal aortic aneurysm (AAA) screening is a way of detecting a dangerous swelling (aneurysm) of the aorta – the main blood vessel that runs from the heart, down through the abdomen to the rest of the body.
An AAA usually causes no symptoms, but if it bursts, it’s extremely dangerous and usually fatal. Around 8 out of 10 people with a ruptured AAA either die before they reach hospital or don’t survive surgery.
Screening involves a simple ultrasound scan of your stomach (abdomen), which takes about 10-15 minutes.
If your abdominal aorta is not enlarged, you don’t ever need to be tested again, but if you have a small to medium aneurysm, you'll be regularly monitored to check it doesn’t get dangerously larger.
If you are found to have a large aneurysm, you'll be seen by a vascular surgeon (a specialist in blood vessels) within two weeks. They will advise on whether you would benefit from treatment to reduce the risk of it bursting.
Who is eligible?
As the swelling is far more common in men aged over 65 than it is in women and younger men, men are automatically invited for screening in the year they turn 65.
For men who haven’t had the screening done but would like to have it, you can self-refer by phoning the screening coordinators on 0151 706 4767 to have a test booked locally (you will need your NHS number).
If women wish to be screened they must contact the surgery to arrange for a referral. This is because women do not receive screening invites as AAA is much more common with men.
Why have AAA screening?
An AAA is sometimes picked up by chance – for instance, if you’re being tested for another condition.
In general, if you have an AAA, you won’t know. You probably won’t feel any pain or notice anything different, but if the aneurysm bursts, it’s a medical emergency, and most people either die before they reach hospital or don’t survive surgery.
Screening is a way of detecting an aneurysm early. If a large aneurysm is detected before it bursts it can be treated. Accepting the invitation to screening cuts the risk of dying from an abdominal aortic aneurysm by about half.
The NHS AAA Screening Programme was set up in England in 2009 and has been offered throughout the UK since the end of 2013.
What happens during AAA screening?
The screening test for AAA is a simple, pain-free ultrasound scan of the abdomen that usually takes about 10-15 minutes. The screening technician will ask you to lift up your shirt and then run a small ultrasound scanner on your abdomen, which will allow the thickness of your abdominal aorta to be measured on a monitor.
The technician will tell you the result straight away and your GP will also be informed.
What happens next depends on the size of your abdominal aorta:
- If it’s normal, you won’t ever be invited for another screening. An aneurysm grows so slowly that you’re unlikely to develop one after the age of 65.
- If you have a small to medium-sized aneurysm, you’ll be invited back for regular scans to check its size.
- If you have a large AAA, you’ll be referred to hospital to be seen by a vascular surgeon within two weeks. You will then be advised about treatment options but, generally, men with a large AAA are advised that the risk of a large aneurysm rupturing is more dangerous than having surgery to repair it.
2. Breast Cancer Screening
About one in eight women in the UK are diagnosed with breast cancer during their lifetime. There's a good chance of recovery if it's detected in its early stages.
Breast screening aims to find breast cancers early. It uses an X-ray test called a mammogram that can spot cancers when they are too small to see or feel.
Who is eligible?
As the likelihood of getting breast cancer increases with age, all women who are aged 50-70 and registered with a GP are automatically invited for breast cancer screening every three years. However, the NHS is in the process of extending the programme as a trial, offering screening to some women aged 47-73.
You may also be eligible for breast screening before the age of 50 if you there has been breast cancer in your family.
In the meantime, if you are worried about breast cancer symptoms, such as a lump or area of thickened tissue in a breast, don't wait to be offered screening – make a GP appointment.
Why is breast screening offered?
Most experts agree that regular breast screening is beneficial in identifying breast cancer early. The earlier the condition is found, the better the chances of surviving it.
You're also less likely to need a mastectomy (breast removal) or chemotherapy if breast cancer is detected at an early stage.
The main risk is that breast screening sometimes picks up cancers that may not have caused any symptoms or become life-threatening. You may end up having unnecessary extra tests and treatment.
What happens during breast screening?
Breast screening is carried out at special clinics or mobile breast screening units. The procedure is carried out by female members of staff who take mammograms.
During screening, your breasts will be X-rayed one at a time. The breast is placed on the X-ray machine and gently but firmly compressed with a clear plate. Two X-rays are taken of each breast at different angles.
After your breasts have been X-rayed, the mammogram will be checked for any abnormalities. The results of the mammogram will be sent to you and your GP no later than two weeks after your appointment.
Following screening, about one in 25 women will be called back for further assessment. Being called back doesn't mean you definitely have cancer. The first mammogram may have been unclear.
About one in four women who are called back for further assessment are diagnosed with breast cancer.
I recently turned 50 - why haven't I been invited yet?
The local Breast Screening Programme invites patients in every 3 years in groups according to their GP Practice.
This means that all eligible women registered with us will be called in at the same time every 3 years. The most recent screening for Northgate Village Surgery patients was in October 2017.
If you have turned 50 after this time then you will be called for screening in October 2020. In the meantime, if you do have any concerns about breast cancer, please book an appointment with the GP.
3. Bowel Cancer Screening
Bowel cancer is the fourth most common cancer in the UK. 1 in 12 people will develop bowel cancer in their lifetime. If it's detected at an early stage, before symptoms appear, it's easier to treat and there's a better chance of surviving it.
To detect cases of bowel cancer sooner, the NHS offers two types of bowel cancer screening to adults registered with a GP in England:
- All men and women aged 60-74 are invited to carry out a faecal occult blood (FOB) test. Every two years, they're sent a home test kit, which is used to collect a stool sample. If you are 75 or over, you can ask for this test by calling the freephone helpline on 0800 707 60 60.
An additional one-off test called bowel scope screening is gradually being introduced in England. This is offered to men and women at the age of 55. As of March 2015, about two-thirds of screening centres were beginning to offer this test to 55 year olds. It involves a doctor or nurse using a thin, flexible instrument to look inside the lower part of the bowel.
Taking part in bowel cancer screening reduces your chances of dying from bowel cancer, and removing polyps in bowel scope screening can prevent cancer. However, all screening involves a balance of potential harms, as well as benefits. It's up to you to decide if you want to have it.
Why does the NHS offer bowel scope screening?
NHS bowel scope screening helps to prevent bowel cancer. For every 300 people screened, it stops two from getting bowel cancer and saves one life from bowel cancer.
Who is eligible?
Bowel scope screening is a one-off test offered to men and women at the age of 55.
People aged 75 and older can still be screened for bowel cancer. They can request an FOB screening kit by calling the freephone helpline on 0800 707 60 60.
However, people younger than 60 are not eligible for the FOB screening test, but can have bowel scope screening. In the meantime, if you have symptoms, are worried about a family history of bowel cancer, or are worried about your bowel health in any way, speak to a GP.
Some health problems mean that it might not be possible for you to have bowel scope screening.
Please call the freephone helpline number on 0800 707 60 60 if you:
- have had all of your large bowel removed, or have a stoma bag to collect your poo
- are currently being treated for ulcerative colitis or Crohn’s disease in your large bowel
- are waiting for heart surgery or have had heart surgery in the last three months
- cannot walk more than 100 yards without resting because of a lung or heart problem
- think you may be too unwell to go for your appointment
What does the FOB screening test involve?
The home testing kit is used to collect tiny stool samples on a special card. The card is then sealed in a hygienic freepost envelope and sent to the screening laboratory, where it will be checked for traces of blood that may not be visible to the naked eye, but could be an early sign of bowel cancer.
You'll receive the results of your FOB test within two weeks of sending in the test kit. There are three types of result:
- Most people will have a normal result – no further tests are needed and you'll be invited to take part in screening again in two years (if you're still aged 60-74).
- A few people will have an unclear result – you'll be asked to repeat the FOB test up to twice more.
- A few people will have an abnormal result – you'll be offered an appointment to discuss colonoscopy at a local screening centre.
What does bowel scope screening involve?
Bowel scope screening is done by a specially trained nurse or doctor at an NHS bowel cancer screening centre.
The doctor or nurse will put a thin flexible tube into your bottom to look inside the lower part of your bowel and remove any small growths, called polyps, that could eventually turn into cancer.
You'll receive the results of your bowel scope screening test within two weeks of your appointment.
Most people will have a normal result.
Some people will have polyps,which may mean having another examination of the bowel (a colonoscopy).
Rarely, the test will find cancer.