Screening for life

What is Screening?

Screening looks for early signs of disease or a condition in adults and children who do not have symptoms. Finding early signs of disease early is very important as it gives you the best chance of having early treatment and survival. You may feel well even if you have signs of a condition. However, it is important to remember that no screening is 100% accurate and some conditions may be missed. If you have any questions about screening, contact your GP or your local screening office.

Taking part in screening is your choice. However, it is important to know the benefits and risks of screening before you consent to take part.

When is screening not beneficial?

Let us take the following (imaginary) example, which was developed by the Max Planck Institute for Human Development in Berlin. The diagram below shows two groups of people who all died of cancer at the age of 70 – regardless of whether or not they had done screening tests. In the group that did not have screening, the cancer was detected at the age of 67, three years before their death. In the group that had screening, on the other hand, the cancer was already detected at the age of 60.

If you only look at the number of people who were alive five years after their cancer was diagnosed, screening seems to be highly effective. In reality, however, all of the people died at the age of 70 – with or without screening. So having a screening test did not make them live longer, they just learned that they had cancer earlier. This means that it increased the time they spent living as cancer patients by several years.  

If the screening tests had been effective, the people who had screening would have lived longer, so they would have died when they were older than 70, or their cause of death would have been something other than the disease that was detected through screening. Apart from that, screening might also have other benefits, such as an improvement in quality of life. The important thing is that screening should have benefits that outweigh the risks.

How are the benefits of screening tests assessed?

Researchers use different scientific methods to evaluate screening tests. For example, they do studies to find out:

- How reliable the test is

- Whether a patient benefits from starting treatment earlier rather than later

- Which groups of people benefit from early diagnosis and treatment

- How the benefits compare to the risk

Balance of benefits and harmful effects...

To be able to assess the advantages and disadvantages of screening, as well as the balance of benefits and harmful effects, the screening test itself needs to be tested in studies. Here it is not only the accuracy of the test that is of interest, but, more importantly, whether the people who have screening also have benefits to their health as a result.

The benefits and harmful effects of a screening test can only be weighed up if researchers do randomized controlled trials in which participants are observed throughout the entire screening chain – starting with the first test and continuing during the following tests and treatments.

Here one group regularly has screening tests, while the other group does not. At the end of the study the results of the two groups are compared, for example in terms of their disease-specific life expectancy and the number of treatments and complications they had.

Available Screening -

- Antenatal Screening - Mother blood tests and ultrasound

- Newborn Blood- Spot Screening - Heel- Prick test - babies 5 days old

- Newborn Hearing Screening - Babies 0-2 weeks

- Anyone over the age of 12 with diabetes - Diabetes screening eye tests

- Women, Cervical screening - smear test, aged 25 - 64 years old

- Breast screening, breast x- ray - anyone 50 - 70, Men can also get breast cancer... ( over 70 if you ask)

- Bowel Screening, home testing kit - Age 60 -74

- Abdominal aortic aneurysm screening one-off ultrasound - Aged 65 (Over 65's - if you as)

Antenatal Screening

- You will be offered antenatal screening tests during your pregnancy to check your health and the health your baby.

- A midwife will explain the different tests you can have as part of your routine antenatal care.

- Screening may involve ultrasound scans, blood test and Down's syndrome screening. These test will be offered at different stages during your pregnancy.

- If your screening suggests a problem, you may be offered more tests and scans.

Newborn Blood-spot Screening

- Newborn blood-spot screening identifies babies who may have rare but serious conditions.

- You will offered screening for baby usually 5 days after you have given birth.

- A sample of blood is collected by pricking your baby's heel.

- Most babies will have normal results. These results will be available within 6 to 8 weeks of the sample being taken. Your health visitor will discuss the results with you and answer any questions you may have.

- If your baby has an abnormal screening result for any of these conditions, they will need more tests to confirm whether they have the condition.

- If any conditions are found, your baby will receive early specialist care and treatment.

Newborn hearing screening

- Newborn hearing screening identifies if your baby has a hearing loss that could affect their speech and language development.

- You will be offered screening for your baby once your baby has been born.

- Screening is offered either in hospital, a few days after your baby's birth, or a week or two later, usually in a local clinic.

- The screening test does not hurt of harm your baby and most test results are normal.

- The screener will tell you the results of the test straightaway, and explain if another test if needed. This will be done by an audiologist (hearing specialist) at a local clinic.

Cervical Screening

- Cervical screening (a smear test) can save lives by preventing cancer from developing in the cervix (the neck of the womb)

- Women aged 25 to 49 are invited for screening every 3 years. Women aged 50 to 64 are invited every 5 years.

- A smear test involves taking sample of cells from the cervix using a soft brush.

- A smear test is carried out at GP surgeries or at some sexual health clinics.

-Your sample will be sent to a laboratory for testing.

- You will receive results by post within 4 weeks of your test.

- If changes are found, you may need a test called a colposcopy which looks at your cervix in more detail. The test will be done at your local hospital clinic.

Breast screening

- Breast screening can save lives through finding breast cancer early.

- Women over 70, are invited for a breast X-ray every 3 years.

- If you are over 70, you can ask for a breast screening appointment by phoning Breast Screening Wales.

- You will be screened at a breast screening mobile unit or at a breast screening centre.

- You will receive you results by post within 3 weeks.

- You may need more tests if changes are seen on your X-ray. If breast cancer is found, you will receive treatment at your local hospital.

Bowel Screening

- Bowel screening can save lives through finding bowel cancer early.

- Men and women aged 60 to 74 are invited to take part in screening every 2 years.

- The test looks for hidden blood in your stool sample.

- Bowel Screening Wales will automatically send out a screening test, which you can do at home.

- They will send you your results by post within 2 weeks of receiving your your completed test.

- If blood is found, you may need to have a colonoscopy. A colonoscopy. A colonoscopy is where a flexible camera is inserted into your back passage (bottom) to look at the lining of your bowel. This test will be offered at your local hospital.

Abdominal aortic aneurysm screening

- AAA screening can save lives by finding a swelling (aneurysm) of the aorta (mail blood vessel) in the abdomen.

- Men who are over 65 years old will be invited for one-off screening test. If you are over 65, you can ask for an appointment by phoning your local screening centre.

- AAA screening involves a simple ultrasound scan and the best way of finding AAA.

- AAA screening is carried out in community clinics.

- You will be given your results at the time of the test.

- If your aorta is bigger than normal, you will be offered regular scans to check its size. If your AAA is large, you will see a specialist team who will talk to you about your care. You may need to have an operation.

Diabetic eye screening

- Eye screening can prevent sight loss by finding retinopathy (a complication of diabetes) at an early stage.

- All people aged 12 and over with a diagnosis of diabetes and who are registered with a GP in Wales, are invited for a regular screening.

- Digital photographs of your retina (the 'seeing part' of the eye) are taken and examined for signs of diabetic retinopathy.

- Screening is carried out in local health care clinics and mobile units.

- You (and your GP) will be sent your results by post within 4 weeks of screening.

- If you need more tests you will be offered an appointment with your local hospital eye specialist.

Things you can do to keep healthy...

Move more:

- Being active helps you feel better and can reduce your risk of developing a serious illness.

- Aim to be active for at least 2 and a half hours a week.

Drink less

- Drinking alcohol can increase your risk of disease, cancer and liver damage.

- If you want to keep the risks low, drink no more than 14 units a week.

- If you want to cut down, have several drink free days a week.

Eat well

- Eating fruit and vegetables may help reduce your risk of developing serious disease such as cancer and disease.

- Try to eat at least 5 portions of fruit and vegetables every day.

For more information on keeping healthy, visit:

www.change4lifewales.org.uk

Don't Smoke

- Stopping smoking will improve your health

-Stop Smoking Wales offers free, local NHS support.

For more information about stopping smoking, visit:

www.stopsmokingwales.com

Thank you for reading and stay safe x