The NHS offers several screening programmes, following recommendations set by the UK National Screening Committee. They are designed to aid early detection of serious conditions (such as cancers) in asymptomatic patients. Although screening is run at a national level, when patients have questions or worries they will often direct them to their GP. This quick reference guide should help you answer those queries.
Please note that screening in pregnancy, newborn screening and diabetic eye screening are not covered here.
|People with a cervix||25 – 64||Every 3 years|
|50 – 64||Every 5 years|
The cervical cells are first tested for the presence of human papillomavirus (HPV). HPV 16 and 18 are the highest risk types. If the sample is positive for HPV, it is then examined under a microscope for the presence of abnormal cells (dyskaryosis).
|HPV negative||Routine recall (according to age group)|
|HPV positive, no abnormal cells||Repeat test in 1 year|
|HPV positive, abnormal cells present||Referred for colposcopy|
|Inadequate sample||Repeat test in 3 months|
|Registered with their GP as female||50 – 70||Offered a mammogram every 3 years|
|70 +||Can self-refer for a mammogram every 3 years by calling local breast screening service, contact details available on NHS website|
Younger people may ask about screening if they are concerned about a family history of breast cancer. Guidance is available in these cases: NICE CG164, linked in “Further Reading”.
|All patients||60 – 74||Offered a faecal immunochemical test (FIT) every 2 years, looking for traces of blood in the stool|
|75 +||Can request a kit every 2 years by phoning the free bowel cancer screening helpline available on the NHS website|
98% of people have a normal (negative) result, while the remaining 2% are contacted to discuss further investigation with colonoscopy. It is important to note that screening uses a higher cut-off (80-150 μg/g) than we do (10μg/g). Therefore, in patients presenting with symptoms consistent with bowel cancer, do not be reassured by a recent negative FIT test if it was done via bowel screening – you should repeat the FIT test yourself.
Younger people may ask about screening if they are concerned about a family history of bowel cancer. There is guidance available from the British Society of Gastroenterology for these cases, linked in “Further Reading”.
Abdominal aortic aneurysm (AAA)
|Registered with their GP as male||During the screening year (1 April to 31 March) when they turn 65||Offered a one-off ultrasound scan|
|66 +||Can self-refer for ultrasound scan|
|Normal (<3cm)||No follow-up required (this is the case for >98%)|
|Small AAA (3 – 4.4cm)||Repeat ultrasound annually|
|Medium AAA (4.5 – 5.4cm)||Repeat ultrasound 3 monthly|
|Large AAA (5.5cm or more)||Referral to vascular surgeon|
Always remember that screening tests, like any test, can produce false negative results. Screening is not intended to investigate symptomatic patients, but to diagnose asymptomatic patients early in their disease, when the prognosis is likely to be better. Any patient presenting with symptoms should be fully assessed and investigated, whether they have a recent reassuring screening result or not.
Further Reading / References
Written by Dr Grace Howson (GP)
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