Screening services

Screening for Life

Screening is a process of identifying apparently healthy people who may be at increased risk of a disease or condition. You can then be offered information, further tests and appropriate treatment to reduce your risk and/or any complications arising from the disease or condition. 

Adult Screening Programmes

Abdominal Aortic Aneurysm (AAA)

Why Screen?

The aorta is the main blood vessel that supplies blood to the body. Sometimes the wall of the aorta in the abdomen can become weak and stretch to form an aneurysm. When this happens, there is a risk that the aorta may split or tear (rupture).
 
A ruptured AAA can lead to serious blood loss that will need immediate emergency treatment.
 
Not every AAA will rupture, but if it does the chances of getting to hospital and surviving surgery are very poor. It is estimated, that around 85 per cent of people with a ruptured aneurysm will die, and that many of these will die before reaching a hospital. Even for those who reach hospital alive, around 30-75% of people with ruptured aortic aneurysm will die as a result.

Who is screened?

Men aged 65 are invited if they live in Wales and are registered with a GP practice. If a man is over 65 and has never been for an NHS AAA screening scan, they can ask for a scan by contacting the screening programme on 01443 235 161
 
Men are six times more likely to have an AAA than women, and this becomes increasingly common with age. A ruptured AAA is less common in women and on average happens 10 years later than in men. The National Screening Committee does not recommend offering women screening for AAA. Women who have a family history of AAA should speak to their GP, who will be able to advise them.
 
How is the screening done?
An ultrasound scan measures the size of your abdominal aorta. It is the best way of detecting an AAA. The ultrasound scan for AAA screening only takes a few minutes and is painless. About 95 out of every 100 men screened are told that they have a normal screening result and are not offered any further tests. In the other 5% an enlargement to some degree will be found.
If you have a small AAA (3 to 4.4 cm wide) or a medium AAA (4.5 to 5.4 cm wide) we will invite you to come back for a monitoring scan:
 
  • Every year if you have a small AAA, or
  • Every three months if you have a medium AAA. 
  • The AAA nurse will recommend that you make an appointment to see your GP to check your blood pressure and discuss health and lifestyle issues.

If you have a large AAA (one that measures 5.5cm or more) we will refer you to a specialist team within a day of your scan. You should be seen by a member of the specialist team within two weeks. You will be offered further investigations and probably an operation to repair the AAA.

More information on the Welsh Abdominal Aortic Aneurysm Screening can be found at: www.aaascreening.wales.nhs.uk

Bowel Cancer

Why Screen?

  • Bowel screening reduces your risk of dying from bowel cancer.
  • Bowel cancer is more common as you get older.
  • You may feel well even if you have early bowel cancer.
  • Finding cancer early gives you the best chance of survival.

Who is screened?

  • We invite men and women aged between 60 and 74, and who are living in Wales, for bowel screening every two years.

How is screening done?

The screening test involves a home testing kit that is sent to you. The test kit does not tell you if you have bowel cancer. The results will tell you if you need further tests such as a colonoscopy (a camera inserted into your bottom).  You will receive your results within 2 weeks.

More information on bowel cancer screening can be found at: www.bowelscreening.wales.nhs.uk

Breast Cancer

Why Screen?

If we find breast cancer at an early stage, treatment has the greatest chance of being successful.

Who is screened?

The breast screening programme is only for women aged over 50. This is because the risk of developing breast cancer increases with age.  Breast cancer affects one in nine women in Wales at some time in their lives. Screening is offered:

  • Women aged between 50 to 70 are invited automatically.
  • Women may be 52 years of age by the time they receive their first appointment.
  • Breast Test Wales aims to offer screening every three years.
  • Women over 70 may ask Breast Test Wales for an appointment every three years by getting in touch with their local screening centre.

How is screening done?

We use mammography to detect breast cancer.  This means that radiation (x-rays) is passed through your breast to form a picture (mammogram). Although x-ray radiation in itself can cause cancer, the risk from mammography is very low with the benefit far outweighing the radiation risk. 

More information on breast cancer screening can be found at: www.breasttestwales.wales.nhs.uk/

Cervical Cancer

Why Screen?

The cervical screening programme has three main aims:
 
  1. To reduce the number of cases of cervical cancer (incidence) by picking up cell changes before they become a cancer.
  2. To reduce the number of deaths from cervical cancer (mortality) by stopping cancer from developing, or picking it up at an early stage.
  3. To reduce the effects of cancer or cancer treatments on health (morbidity) by stopping cancer from developing, or picking it up at an early stage when it is much easier to treat.

Who is screened?

We will invite you for cervical screening if you are aged 25-64 and you are registered as female with a GP surgery.

  • Women aged 25-49 are invited every three years.
  • Women aged 50-64 are invited every five years.
  • Women who need follow-up after cell changes will be invited even if under the age of 25 or over the age of 65.
  • Women with Human Immunodeficiency Virus (HIV) are advised to be screened every year until the age of 65.
  • If you are 65 or over and have never had a smear test, then you are entitled to have one.

How is screening undertaken?

Cervical screening is also called the smear test. A sample of cells is taken from the cervix using a soft brush. The sample is put into a pot of liquid and sent to the cervical screening laboratory. At the laboratory, the sample is first tested for high-risk types of  human papillomavirus (hrHPV). This is because the cell changes that lead to nearly all cases of cervical cancer are caused by hrHPV.

If high-risk HPV is not found in the sample, then the cells do not need to be looked at. This happens in nearly 9 out of every 10 samples. If hrHPV is found in the sample, the cells are put onto a slide. The cells are then looked at under a microscope by a screener. If the cells are normal, a repeat cervical screening test will be done after 12 months to see whether the high risk HPV is still present. If it is still there, the cells will be checked again. If the cells show any changes, then some further investigations will be needed.

More information on Cervical Cancer Screening cna be found at: www.cervicalscreeningwales.wales.nhs.uk

Diabetic Eye Screening

Why Screen?

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

Who is screened?

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

How is screening undertaken?

Digital photographs of the 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 6 - 8 weeks of screening. If you need more tests you will be offered an appointment with your local hospital eye specialist.

More information on Diabetic Eye Screening can be found at: phw.nhs.wales/diabetic-eye-screening-wales

Maternal and Newborn Screening

Antenatal

During pregnancy there are several different types of screening tests offered. The tests are:

  • Ultrasound scans at around 12 weeks and 20 weeks of pregancy.
  • Blood tests usually before 14 weeks of pregnancy.

More information on all the different Antenatal Screening tests can be found at: www.antenatalscreening.wales.nhs.uk

Newborn Bloodspot

Newborn bloodspot screening is when a small sample of blood is taken from the baby’s heel, on day five of the baby’s life. This blood sample is screened for rare but serious diseases that can cause serious illness or even death if not treated early.  The screening test is carried out by a midwife and is part of routine post natal care.

In Wales all babies are offered screening for the following conditions:
 • Inherited metabolic disorders
     - Medium-chain acyl-CoA dehydrogenase               deficiency (MCADD)
     - Phenylketonuria (PKU)
     - Maple syrup urine disease (MSUD)
     - Isovaleric acidaemia (IVA)
     - Glutaric aciduria type 1 (GA1)
     - Homocystinuria (HCU)
• Congenital hypothyroidism (CHT)
• Cystic fibrosis (CF)
• Sickle cell disorders (SCD)
 
More information on Newborn Bloodspot Screening can be found at: www.newbornbloodspotscreening.wales.nhs.uk

Newborn Hearing

One or two babies in every 1000 are born with a hearing loss that may affect their speech and language development.  Newborn hearing screening helps to find those babies and offers help and support from the start. 

Hearing screening tells us which babies may have a hearing loss. The screening test shows us which babies need more tests to decide if they have a hearing loss. Screening does not detect all hearing loss or prevent future hearing difficulties.
 
The screening test is usually done whilst you are still in hospital following birth. If however you are discharged before this can be done you will have the test done at home.
 
More information on Newborng Hearing Screening can be found at: www.wales.nhs.uk/sitesplus/980