10 vital health checks (screening tests)
Screening means having tests to prevent diseases, or picking them up early. Doctors can do more for you if we can see you early in the disease process.
We will now describe 10 of the most important screening tests.
1. Abdominal aortic aneurysm (AAA) screening
AAA screening is a way of checking if there is a aneurysm (bulge or swelling) in the aorta.
What’s involved?
The screening test involves an ultrasound on your stomach. It is very quick, painless and reliable.
Why is the test important?
The aorta is the main blood vessel in the body. It pumps blood from the heart around the body. If a swelling in the aorta is left to get bigger it could burst, causing a life-threatening bleed inside the stomach. AAAs do not usually have symptoms – so the test can pick up an AAA before it bursts.
How often should you get checked?
AAA screening is offered to men during the screening year (1 April to 31 March) that they turn 65 to detect abdominal aortic aneurysms (a dangerous swelling in the aorta). Men over 65 can self-refer for AAA screening if they think they may might need one.
2. Blood pressure test
Blood pressure is the force that your blood exerts on the walls of your arteries. Normal blood pressure is 130/70 or below. High blood pressure is usually ‘silent’ – i.e. rarely has noticeable symptom. But it can weaken your heart and damage the walls of your arteries, increasing the risk of heart attack heart failure, stroke and kidney disease.
What’s involved?
Your pharmacist, practice nurse or GP, will use a cuff that fits around your upper arm and is inflated until it becomes tight. The test is quick and painless and only takes a minute. You can even buy a monitor to use at home. ‘A&D’ is a good make.
Why is the test important?
Around 30% of adults in England have high blood pressure, but many do not realise as they have no symptoms.
What happens next?
If your results fall outside of the normal range you will need to have it checked several more times. If your blood pressure is found to be consistently high (above 140/90), your GP will talk to you about how to lower it.
You may be offered a blood test to check the functioning of your kidneys and a test to check your risk of developing diabetes.
Treatment may include lifestyle changes, and if these are not successful or your blood pressure is still high, you will be prescribed medication.
3. Bowel cancer screening
Bowel cancer screening does n0t diagnose cancer, but it can detect potential problems before a person has cancer.
What’s involved?
The testing kit, called a Faecal Immunochemical Test (FIT), is sent through the post along with instructions. You use it to collect a stool sample, which you then send to a laboratory for analysis. You should receive the results of the test within 2 weeks.
Screening is offered every 2 years to all men and women aged 60 to 74 years – but it is also gradually being rolled out to people over the age of 50 years, so you might get a test before you are 60. People over 75 years, can also request a screening kit by calling the freephone helpline 0800 707 60 60.
Why is the test important?
Bowel cancer is the 4th most common cancer in the UK and the sooner it is detected, the easier it is to treat and the better your chance of surviving it.
What happens next?
The test looks for traces of blood. If there is any sign of that, you will be asked to discuss the possibility of more tests. This does not mean that you have bowel cancer, but you may need a bowel examination called a colonoscopy to rule out this possibility. A small percentage of people will have an abnormal result and will need follow-up tests.
4. Breast cancer screening
Regular breast cancer screening is a good way to pick up breast cancer early – and the earlier it is found the easier it is to treat. The main risk is that breast screening sometimes picks up cancers that may not have caused any symptoms or become life-threatening. So you may end up having unnecessary extra tests and treatment.
What’s involved?
An x-ray of each breast, called a mammogram, is done. Each breast is placed in turn on the x-ray machine and is gently but firmly compressed with a clear plate. The compression only lasts a few seconds, but some people do find this slightly uncomfortable.
Why is the test important?
Around 1 in 8 women in the UK are diagnosed with breast cancer during their lifetime.
How often should you get checked?
You will receive your first invitation to attend your local breast screening unit sometime between your 50th and 53rd birthdays. Ring your local breast service at your local hospital, if this does not happen,
In some areas, you will be invited from the age of 47 and until the age of 73 as the NHS is in the process of extending the screening programme as a trial. From then on, you will be invited every 3 years until your 70th birthday.
Although you might not receive an invitation for screening once you reach 70, you can request a screening every 3 years. You can contact your local breast screening service directly to request an appointment.
What happens next?
The results will be sent to you and your GP, usually 2 weeks after the screening. Most people receive a normal result but some may be asked to go to an assessment clinic for further tests.
5. Cervical cancer screening
Cervical cancer screening, also known as a ‘smear test’, is a method of preventing cancer by detecting abnormalities in the cervix which, if left untreated, could lead to cervical cancer.
What’s involved?
A doctor or nurse inserts an instrument called a speculum to open the vagina and uses a small soft brush to sweep around the cervix. Most people say it is slightly uncomfortable but not painful.
Why is the test important?
About 3,000 cases of cervical cancer are diagnosed each year in the UK. Since the screening programme was introduced in the 1980s, the number of cervical cancer cases has decreased by about 7% each year.
How often should you get checked?
All women aged 25-64 years should have cervical screening test every 3-5 years. Women over 65 years, are not usually invited for screening unless they have not been screened since the age of 50, or have had an abnormal result in any of their 3 most recent tests.
What happens next?
Most screening results are normal. But if you are recalled, this doesn’t necessarily mean that you have cancer. For around 1 in 20 women, the test shows some abnormal changes which will require further investigation and treatment.
6. Cholesterol blood test
Cholesterol is a type of fat that is carried around the body in the blood. High levels of cholesterol can build up in the arteries and increase your risk of a heart attack or stroke.
What’s involved?
You can have your blood cholesterol level measured by visiting your GP or local pharmacist. It involves either a blood test or a finger-prick test.
Why is the test important?
High cholesterol does not cause any symptoms, so you could have it without knowing. The only way to find out is to have a test.
What happens next?
If you have high cholesterol you can lower it by changing your diet, maintaining a healthy weight and taking regular exercise. If you already have heart disease or are at risk of developing it, your GP may prescribe cholesterol-lowering medicines such as ‘statins’.
7. Diabetic eye screening
Diabetic eye screening is a test to check for eye problems caused by diabetes. It can prevent blindness.
What’s involved?
Pictures are taken of the back of your eyes to check for any changes.
Before the test. Plan how you will get to and from the test – do not drive, as your sight may be blurry for a few hours afterwards; bring all the glasses and contact lenses you wear, and sunglasses; everything can look very bright for a few hours after the test; eat and drink as normal. You might want to bring someone with you, or ask someone to collect you after the test.
During the test. You will be asked to read some letters on a chart first. Drops are then put in your eyes. These may sting for a few seconds. The drops make your sight blurry after about 15 minutes. When the drops start working, you will be asked to look into a camera. The camera will not touch your eyes. Pictures are taken of the back of your eyes. There will be a bright flash when a picture is taken. Your appointment will usually last about 30 minutes.
Why is the test important?
Eye problems caused by diabetes are called diabetic retinopathy. This can lead to blindness if it is not found early.
The diabetic eye screening test can find problems before they affect your sight.
If you have diabetes and you’re aged 12 or over, you’ll get a letter asking you to have your eyes checked at least once a year.
What happens next?
You can go home when the test is finished.
For up to 6 hours after the test: your sight may be blurry – do not drive until it goes back to normal; everything can look very bright – wearing sunglasses can help.
You will not get your test result on the day. You will get a letter about your result within 6 weeks.
Diabetic eye disease
8. NHS health check
The NHS Health Check is a free check-up of your overall health. It can tell you whether you are at higher risk of getting certain health problems, such as heart disease, diabetes, kidney disease and stroke.
What’s involved?
An NHS Health Check takes about 20-30 minutes.
The health professional will ask you some simple questions about your lifestyle and family history, measure your height and weight, and take your blood pressure and do a blood test – often using a small finger prick test. You may get other blood tests, e.g. kidney function looking for CKD.
Why is the test important?
Based on the results of your questions and blood test, your health professional will be able to give you an idea of your chances of getting heart disease, stroke, kidney disease and diabetes.
If you’re over 65 years, you’ll also be told the signs and symptoms of dementia to look out for.
You will then receive personalised advice to lower your risk.
When will I be invited for an NHS health check?
You will be invited for a free NHS Health Check every 5 years if you are between 40 and 74 years of age and do not already have heart disease, stroke, diabetes, kidney disease or high blood pressure.
If you are registered with a GP surgery that offers the NHS Health Check, you should automatically get an invitation. Do not worry if you have not been invited yet – you will be over the next 5 years.
Alternatively, your local authority (council) will send you an appointment letter explaining where you have to go for your NHS Health Check.
If you a #re not sure if you are eligible for an NHS Health Check and would like one, or if you are eligible but have not had an invite for an NHS Health Check in the last 5 years, ask your GP surgery for an appointment.
9. PSA blood test
There is currently no national screening programme for prostate cancer in the UK because the PSA test is not always accurate.
The PSA test is a blood test to help detect prostate cancer. But it is not perfect and will not find all prostate cancers.
The blood test, which can be done at your GP surgery, measures the level of prostate-specific antigen (PSA) in your blood.
PSA is a protein made only by the prostate gland. Some of it leaks into your blood, but how much depends on your age and the health of your prostate.
You have a higher risk of prostate cancer if you:
- Have a family history of prostate cancer
- Are of black ethnic origin
- Are overweight or obese.
What’s a raised PSA level?
The amount of PSA in your blood is measured in nanograms of PSA per millilitre of blood (ng/ml). If you are aged 50 to 69, raised PSA is 3ng/ml or higher.
A raised PSA level in your blood may be a sign of prostate cancer, but it can also be a sign of another condition that’s not cancer, such as:
- An enlarged prostate
- Prostatitis
- Urinary tract infection.
How accurate is the PSA test?
Research has shown around 3 in 4 men with a raised PSA level will not have cancer, and around 1 in 7 men with prostate cancer would have a normal PSA result. So it is not simple.
Pros and cons of the PSA test
Pros:
- It may reassure you if the test result is normal
- It can find early signs of cancer, meaning you can get treated early
- PSA testing may reduce your risk of dying if you do have cancer
Cons:
- It can miss cancer and provide false reassurance
- It may lead to unnecessary worry and medical tests when there’s no cancer
- It cannot tell the difference between slow-growing and fast-growing cancers
- It may make you worry by finding a slow-growing cancer that may never cause any problems
Before having the test
If you’re having a PSA test, you should not have:
- Ejaculated in the past 48 hours
- Exercised heavily in the past 48 hours
- A urinary infection
- Had a prostate biopsy in the past 6 weeks
Each of these may give an inaccurate PSA reading.
Digital rectal examination (DRE)
Your doctor may also perform a digital rectal examination (DRE) to feel for any changes to your prostate gland. A DRE is done by inserting a gloved, lubricated finger into your bottom. A DRE on its own is not enough to detect cancer.
Biopsy
If you have a raised PSA level, you may need other tests, such as a biopsy. This involves taking small samples of your prostate and checking them for cancer.
Biopsies can miss prostate cancers and sometimes cause complications. The most common are bleeding and infections.
If you have prostate cancer
If you have prostate cancer, your specialist will discuss your options with you. Possible treatments include:
- Watchful waiting
- Regular tests (active surveillance)
- Radical prostatectomy (surgery)
- Radiotherapy
Side effects of some treatments can include problems with erections, loss of fertility and incontinence.
10. Skin check (on moles)
Whether you check yourself or visit a specialist clinic, keeping an eye on moles can help you to spot the early signs of skin cancer. Most moles are harmless, but sometimes they can develop into a rare form of skin cancer called malignant melanoma.
What’s involved?
If you notice a change in the colour, size or shape of an existing mole ask your GP to look at it and, if necessary, refer you for further testing.
Why is the test important?
Melanoma is the fifth most common cancer in the UK with around 16,000 new cases diagnosed each year; and as with all cancers, early detection and treatment increases your chances of surviving it.
How often should you check your body?
You should check all your moles every few weeks and see your doctor if you notice any changes.
What happens next?
If you find a suspect mole, you will be referred for further tests and to see a specialist (called a dermatologist) to decide to cut the mole out. If it is found to be a melanoma you will need further tests (e.g. a CT) to check that the cancer has not spread.
Summary
We have described 10 vital health checks, which are screening. Make sure you have them.
