Where screening for cancer is possible it is an essential tool in detecting abnormalities at an early stage, allowing treatment when the cancer is most likely to be curable, or in some cases, even before it develops.
National cancer screening programmes exist for breast, bowel and cervical cancer. We remain committed to introducing new screening programmes as and when they are proven to be both clinically and cost-effective.
What is breast screening?
Breast screening is a method of detecting breast cancer at an early stage. The first step involves an x-ray of each breast – a mammogram – which is taken while carefully compressing the breast. The mammogram can detect small changes in breast tissue which may indicate cancers too small to be felt either by the woman herself or by a GP.
Who is eligible?
Women aged between 50 and 70 are routinely invited for breast screening every three years. Women over the age of 70 do not currently receive screening invitations, but are encouraged to make their own appointments. This age range will extend to cover women aged 47-73 by 2012.
Genetic risk/familial breast cancer
Some women may have an increased risk of developing cancer because of a family history of breast or other cancers.
Even if you have one or more relatives who have, or have had, breast cancer, it does not necessarily mean that breast cancer runs in your family. However, familial breast cancer may be a possibility if there have been more cases in one family than would normally be expected or if there are other cancers in your family that are related to breast cancer, such as ovarian cancer or certain other cancers that develop at a young age.
The National Institute for Health and Clinical Excellence (NICE) has issued clinical guidelines about the care of women with breast cancer in the family (familial breast cancer). NICE have also produced a booklet for the public explaining the care and treatment options that should be available in the NHS for women with breast cancer in the family.
If you are concerned about your risk of breast cancer, first talk to your GP.
Cervical screening is not a test for cancer. It is a method of preventing cancer by detecting and treating early abnormalities which, if left untreated, could lead to cancer in a woman’s cervix (the neck of the womb).
What is cervical screening?
In cervical screening a sample of cells is taken from a woman’s cervix by a doctor or nurse using a spatula. The head of the spatula is then broken off or rinsed into a small glass vial containing preservative fluid. The sample is sent to a laboratory where a special piece of equipment deposits a thin layer of the cells on to a slide. The slide is then examined under a microscope by a cytologist.
Who is eligible for screening?
Women aged 25 to 49 are invited for cervical screening every three years, and women aged 50 to 64 every five years. Women over can be screened if their previous three tests were not clear or if they have never been screened.
Cervical cancer is very rare in women under 25. Evidence has shown that screening women under the age of 25 may produce a false positive result which may suggest they have cervical abnormalities when in reality it is just their cervix still developing. This can lead to unnecessary investigations, which may damage the cervix and lead to premature births later in life. Screening women from the age of 25 helps reduce anxiety and the number of unnecessary investigations and treatment in younger women.
We want to ensure that the policy on starting screening at age 25 remains in the best interests of young women and is based on the latest available clinical evidence. That is why the Advisory Committee on Cervical Screening reviewed the evidence at a specially convened meeting on 19 May 2009, and concluded unanimously that the starting age for screeing should remain at 25.
Human Papilloma Virus (HPV) Immunisation Programme
Bowel cancer screening aims to detect bowel cancer at an early stage, in people with no symptoms, when treatment is more likely to be effective. Bowel cancer screening can also detect polyps. These are not cancers, but may develop into cancers over time. They can easily be removed, reducing the risk of bowel cancer developing.
The NHS Bowel Cancer Screening Programme is currently being rolled out nationally, with full national coverage expected by December 2009. As the programme is rolled out, details of implementation will be sent to local GPs and announced in the local press.
What is bowel screening?
Men and women eligible for screening will receive an invitation letter explaining the programme and an information leaflet. About a week later, a self-sampling kit (the Faecal Occult Blood test) will be sent out along with step-by-step instructions for completing the test use in the privacy of your own home. The kit is then returned by post to a regional laboratory, where it will be processed and the results sent within two weeks. Men and women with a positive test will be invited for a bowel scope (colonoscopy) to see if cancer or polyps are present.
Who is eligible?
The NHS Bowel Cancer Screening Programme offers screening every two years to all men and women aged 60 to 69. People over 70 can request a screening kit. From 2010, the programme will be extended to men and women aged 75.
The prostate is only found in men. It is very important for a man’s sex life, producing some of the fluid in semen. It is found below the bladder and is about the size of a walnut. It surrounds the tube that carries urine from the bladder.
There is currently no national screening programme for prostate cancer. However, the Government is committed to introducing a national screening programme for prostate cancer if and when screening and treatment techniques are sufficiently well developed.
Men who have close relatives (a father, brother, grandfather or uncle) who have had prostate cancer are slightly more likely to develop it themselves.
Prostate Specific Antigen Testing (PSA)
The PSA test measures the level of PSA in a man’s blood. However, it is not a perfect test. Some men with prostate cancer do not have raised levels of PSA, and two thirds of men with raised levels of PSA do not have prostate cancer. Also, the PSA test cannot distinguish between men with slow-growing prostate cancer and those who have a more aggressive disease.
Prostate Cancer Risk Management Programmes (PCRMP)
The PCRMP was established to ensure that men considering a PSA test are given information concerning the benefits, limitations and risks associated with having a test. Materials have been produced (including a leaflet) to help men make an informed choice about the PSA test and have been sent to all GPs in England.
If a man still wants a PSA test after consultation with his doctor and consideration of the leaflet, he can have one free on the NHS.
