Screening Dr Helen Raison Consultant, Public Health Royal Borough - - PowerPoint PPT Presentation

Screening

Dr Helen Raison Consultant, Public Health Royal Borough of Kingston

What is screening?

Screening is a process of identifying apparently healthy people who may be at increased risk

• f a disease or condition. They can then be offered information, further tests and appropriate

treatment to reduce their risk and/or any complications arising from the disease or condition.

UK Population Screening Programmes

Antenatal and Newborn

• sickle cell and thalassaemia
• fetal anomaly
• infectious diseases in

pregnancy

• newborn and infant physical

examination

• newborn blood spot
• newborn hearing

Have to meet strict criteria to be introduced as a managed screening programme by National Screening Committee

Young Person and Adult

• diabetic eye
• abdominal aortic aneurysm
• breast cancer
• cervical cancer
• bowel cancer

Antenatal And Newborn Screening Programmes

Adult Screening Programmes

Adult Screening

Programmes

Diabetic Retinopathy Screening Programme

• Diabetes can lead to diabetic eye disease.
• Early identification and treatment of diabetic

eye disease can reduce sight loss.

• The main treatment for diabetic retinopathy is

laser surgery.

• All people with known type 1 and type 2

diabetes aged 12 or over are invited for screening

• People already under the care of an
• phthalmology specialist for the condition are

not invited for screening.

• The programme offers pregnant women with

type 1 or type 2 diabetes additional tests because of the risk of developing retinopathy

• 79.4% of those offered a test attended and

had digital screening

Abdominal Aortic Aneurysm Screening Programme

• https://www.gov.uk/guidance/abdominal-aortic-aneurysm-screening-

programme-overview

Breast Cancer Screening Programme

• Women age 50-70 automatically invited every

3 years

• Some older and younger women are invited

as part of a screening study

• Women over 70 can continue to have breast

screening every 3 years but have to request it

• Finds small cancers which cannot yet be seen
• r felt
• Main risk is that some women will be

diagnosed and treated for a breast cancer that would never otherwise have been found or caused them harm

• 66.2% eligible women screened in last 3 years

in South West London. Lower than target of 70% coverage

• Screening leaflets

https://www.gov.uk/government/collections/ breast-screening-information-leaflets.

Bowel Cancer Screening Programme

• Offered every 2 years to all men and women

aged 60 to 74

• Information letter sent, followed by

posted faecal occult blood sampling kit. The kit includes simple instructions for taking sample at home and sending to lab

• The sample is then processed and the results

sent to the individual within 2 weeks.

• Colonoscopy for those with abnormal

screening result (to look at bowel lining)

• 53.9% eligible people been screened in past

2.5 years in SWL. Working to increase this.

• A bowel scope screening programme is being

introduced for all men and women in England aged 55

Cervical Cancer Screening Programme

• https://www.gov.uk/guidance/cervical-screening-programme-
• verview

Why some screening tests are not run as screening programmes?

• National Screening Committee makes recommendations on 109

conditions

• Reviews every 3 years
• Uses evidence to decide if population screening should be

introduced, changed or stopped

• Examples of conditions where NSC has recommended ‘no’ in 2017

include:

• Asymptomatic bacteriuria
• Antenatal carriage of Group B streptococcus
• Ovarian Cancer
• Duchenne Muscular Dystrophy

Prostate Cancer – PSA screening test

• Second leading cause of cancer-related death in UK men
• Risk of prostate cancer increases with age, family history, in black men, in overweight

and obese men

• NSC does not recommend universal screening (2016)
• Slow growing prostate cancer is common, may not cause symptoms or shorten life
• Abnormal PSA test may mean a man has cancer, but it may mean he does not (3 in 4 men wont)
• PSA test cannot distinguish fast-growing from slow-growing cancers
• Prostate cancer screening can reduce prostate cancer deaths by 21% but it can also lead to major

harms caused by treating men who incorrectly testing positive. NSC concluded that harms outweigh the benefits.

• Work is ongoing to increase the accuracy of the PSA test
• Information on PSA test: https://patient.info/health/prostate-and-urethra-

problems/prostate-specific-antigen-test-psa

• NHS/PHE Prostate Cancer Risk Management Programme – guidance for GPs and

patients to decide whether to do a PSA test

Who is who in screening ?

Royal Borough Kingston Public Health Team assures local programmes, holds PHE/NHSE to account, supports work to reduce inequalities in access to screening Helen Raison, Screening Assurance Lead UK National Screening Committee advises ministers and the NHS in the 4 UK countries about all aspects of screening and supports implementation of screening programmes PHE Screening and NHSE England PHE lead the national population screening programmes, and advise NHSE Screening Commissioners who commission the programmes NHS, GPs, Hospitals deliver the screening programmes at screening centres, maternity units, GP surgeries, local clinics