NHS Screening Programmes

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.

Cervical cancer

Patient groupAgeFrequency
People with a cervix25 – 64Every 3 years
50 – 64Every 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).

Result Outcome
HPV negativeRoutine recall (according to age group)
HPV positive, no abnormal cellsRepeat test in 1 year
HPV positive, abnormal cells presentReferred for colposcopy
Inadequate sampleRepeat test in 3 months

Breast cancer

Patient groupAgeTest
Registered with their GP as female50 – 70Offered 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”. 

Bowel cancer

Patient groupAgeTest
All patients60 – 74Offered 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)

Patient groupAgeTest
Registered with their GP as maleDuring the screening year (1 April to 31 March) when they turn 65Offered a one-off ultrasound scan 
66 + Can self-refer for ultrasound scan
Result (diameter)Outcome
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

NHS screening

UK National Screening Committee – GOV.UK

Familial breast cancer: classification, care and managing breast cancer and related risks in people with a family history of breast cancer | Guidance | NICE 

Guidelines for the management of hereditary colorectal cancer from the BSG /ACPGBI/UKCGG – The British Society of Gastroenterology 

Written by Dr Grace Howson (GP)

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