Screening

Question 1

What is screening?

Answer 1

Screening is a way of identifying apparently healthy people who may have an increased risk of a particular condition

Question 2

What are the important criteria of screening?

Answer 2

The WILSON Criteria:

• Important health problem
• Natural history of the condition should be understood
• Recognisable latent or early symptomatic stage
• Should be a test that is easy to perform and interpret, acceptable, accurate, reliable, sensitive and specific
• Should be an accepted treatment recognised for the disease
• treatment should be more effective if started early
• there should be a policy on who should be treated
• diagnosis and treatment should be cost-effective

Question 3

What are the benefits of screening?

Answer 3

• 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 chance of a health problem can help people make better informed decisions about their health.
• Screening can reduce the chance of developing a condition or its complications.
• Some deaths from abdominal aortic aneurysms, bowel cancer, breast cancer and cervical cancer can be prevented.

Question 4

What are the risks of screening?

Answer 4

• Screening tests are not 100% accurate. “false positive” and “false negative”
• Some screening tests can lead to difficult decisions. For example, if a pregnancy screening test tells you your baby has a higher chance of having 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.
• Anxiety.
• Even if your screening test result is normal or negative (meaning you are not at high risk), you could still go on to develop the condition.

Question 5

Colorectal Cancer

Answer 5

Bowel cancer is the 4th most common type of cancer

Home test kit, called a faecal immunochemical test (FIT)

Everyone aged 60 to 74 who is registered with a GP and lives in England is automatically sent a bowel cancer screening kit every 2 years.

If you’re 75 or over, you can ask for a kit every 2 years by phoning the free bowel cancer screening helpline

If blood on test → proceed to colonoscopy

Question 6

Breast Cancer

Answer 6

Invite for breast screening (mammogram) between 50 and 53. Then you’ll be invited every 3 years until you turn 71.

If you’re a trans man, trans woman or are non-binary you may be invited automatically, or you may need to talk to your GP surgery or call the local breast screening service to ask for an appointment.

Over 71, you can still have breast screening every 3 years if you want to.

Question 7

Cervical Cancer

Answer 7

Smear test, cytology

It’s not a test for cancer, it’s a test to help prevent cancer.

All women and people with a cervix aged 25 to 64 should be invited by letter.

checked for certain types of human papillomavirus (HPV) that can cause changes to the cells of your cervix.

Question 8

AAA Screening

Answer 8

Screening for AAA is offered to men during the year they turn 65.

USS scan.

Small AAA (3cm to 4.4cm) → scan every year

Medium AAA (4.5cm to 5.4cm) → scan every 3 months

Large AAA (5.5cm or more) → referred to a specialist surgeon within 2 weeks