Screening programmes

Question 1

Breast screening programme

• ages
• what offered

Answer 1

• 47-73 years
• Women are offered a mammogram every 3 years
• After the age of 70 years women may still have mammograms but are ‘encouraged to make their own appointments’

Question 2

Colorectal screening programme

• ages
• what used

Answer 2

• screening every 2 years to all men and women aged 60 to 74 years in England, 50 to 74 years in Scotland. Patients aged over 74 years may request screening
• eligible patients are sent Faecal Immunochemical Test (FIT) tests through the post
• a type of faecal occult blood (FOB) test which uses antibodies that specifically recognise human haemoglobin (Hb) used to detect, and can quantify, the amount of human blood in a single stool sample
• advantages over conventional FOB tests is that it only detects human haemoglobin, as opposed to animal haemoglobin ingested through diet
• only one faecal sample is needed compared to the 2-3 for conventional FOB tests
• whilst a numerical value is generated, this is not reported to the patient or GP, who will instead be informed if the test is normal or abnormal
• patients with abnormal results are offered a colonoscopy

Question 3

Cervical cancer screening programme

• ages

Answer 3

A smear test is offered to all women between the ages of 25-64 years

• 25-49 years: 3-yearly screening
• 50-64 years: 5-yearly screening
• cervical screening cannot be offered to women over 64 (unlike breast screening, where patients can self refer once past screening age)

Question 4

What about cervical cancer screening in:

• pregnancy
• women who have never had sex

Answer 4

• cervical screening in pregnancy is usually delayed until 3 months post-partum unless missed screening or previous abnormal smears
• women who have never been sexually active have very low risk of developing cervical cancer therefore they may wish to opt-out of screening

Question 5

How is cervical cancer screening programme performed?

Answer 5

There is currently a move away from traditional Papanicolaou (Pap) smears to liquid-based cytology (LBC). Rather than smearing the sample onto a slide the sample is either rinsed into the preservative fluid or the brush head is simply removed into the sample bottle containing the preservative fluid.

Advantages of LBC includes

• reduced rate of inadequate smears
• increased sensitivity and specificity

It is said that the best time to take a cervical smear is around mid-cycle. Whilst there is limited evidence to support this it is still the current advice given out by the NHS.

Question 6

Screening of aortic aneurysm

• age
• interpretation

Answer 6

Screening for an abdominal aortic aneurysm consists of a single abdominal ultrasound for males aged 65