Key Takeaways
- Your risk of developing cancer is affected by diet and lifestyle, genetic factors and age
- Screening tests are used to find cancer or cell abnormalities that might develop into cancer, in people who have no symptoms
- It’s important to attend screening tests so cancer may be caught early, and before it has spread
- The NHS offers four types of screening tests – cervical, breast bowel and lung
- It’s important to continue attending screening appointments for as long as you are eligible
Your risk of developing cancer can be affected by many things, including your diet, lifestyle, and genetic factors. Your risk for certain cancers can also vary simply with age. This is where screening comes in. Screening tests are used to find cancer or cell abnormalities that might develop into cancer, in people who have no symptoms. Regular screening gives you the best chance of finding cell abnormalities and cancer early. In the UK, the NHS offers four screening tests – cervical, breast, bowel and lung. This article examines each of these in detail, including the age at which you’ll be invited for screening.
Cervical screening
About cervical cancer
Cervical cancer is cancer of the cervix – the opening from the top of the vagina to the womb. The main cause of cervical cancer is a virus called high-risk human papillomavirus (HPV), which can cause abnormal cell changes that may develop into cervical cancer. At the early stage, cervical cancer may not cause any symptoms and is usually found and treated because of cervical screening tests, which save an estimated 2,000 lives each year.
Who can get cervical cancer?
Anyone with a cervix – that is women and people assigned female at birth who have a cervix. Most cervical cancer cases are diagnosed in those aged 30 to 45, but cervical cancer can occur at any age if the cervix is present. Risk drops after 65 if screening has been regular and the results normal. Those who have had persistent HPV or not been vaccinated against HPV are at higher risk.
99.8% of cervical cancer cases in the UK are preventable
Cancer Research UK
About cervical screening
During a cervical screening test (also called a smear test) a small sample of cells is taken from the cervix. Rather than testing for cancer itself, cervical screening tests for HPV, which may turn into cancer if left untreated. All eligible people automatically receive a letter from their GP inviting them to attend for screening.
You will usually be invited for screening every five years between ages 25–64. After this age, screening will not routinely be offered.
Cervical cancer symptoms
Visit your GP if you experience any of the following symptoms:
- Unusual vaginal bleeding, including after the menopause, after sex, or between regular periods
- Changes to vaginal discharge
- Pain or discomfort during sex
- Unexplained pain in your lower back or pelvis
Useful resources
Cervical screening (Macmillan)
Breast screening
About breast cancer
Breast cancer is cancer that starts in the breast tissue. It’s the most common cancer in the UK, affecting one in seven women during their lifetime. The earlier breast cancer is diagnosed, the better the chance of successful treatment, so it’s important to check your breasts regularly and to see your GP if you notice a change.
Who can get breast cancer?
Most breast cancers (80%) occur in women over the age of 50. The older you are, the higher your risk but younger women can be affected too, so it’s important to be breast aware whatever your age.
Men can also get breast cancer, but this is rare. Most men who get breast cancer are over 60. There’s no breast screening programme for men, so it’s important to be chest aware.
Breast screening programmes prevent around 1,300 women in the UK dying from breast cancer every year
Breast Cancer Now
About breast screening
Breast screening uses a breast X-ray called a mammogram to look for cancers when they’re too small to see or feel. In the UK, women aged 50 to 71 are invited for a mammogram every three years as part of a national breast screening programme. Breast screening is more frequent, and begins at an earlier age, for women who have been assessed as having a moderate or high risk of developing breast cancer by a specialist in genetics or cancer. Above age 71, screening is by request only.
The NHS breast screening programme offers screening to trans women, and also to trans men who have not had top surgery. However, you’ll only be automatically invited for screening if you are registered as a female with your GP.
Breast cancer symptoms
See your GP if you notice a change to your breast that’s new or unusual for you.
- A new lump or area of thickened tissue in either breast
- A change in the size or shape of one or both breasts
- A discharge of fluid from either of your nipples
- A lump or swelling in either of your armpits
- A change in the look or feel of your skin, such as puckering or dimpling, a rash or redness
- A rash (like eczema), crusting, scaly or itchy skin or redness on or around your nipple
- A nipple change, for example it has become pulled in (inverted)
Useful resources
Benefits of breast screening (Macmillan)
Breast screening for women with a high risk of breast cancer
Bowel screening
About bowel cancer
Bowel cancer, often called colorectal cancer, affects the large bowel, which is made up of the colon and rectum. Most bowel cancers develop from pre-cancerous growths, called polyps, but not all polyps develop into cancer, and they can be removed early to prevent them becoming cancerous. Bowel cancer is the fourth most common cancer in the UK and the second biggest cause of cancer death. However, in the UK, bowel cancer survival has more than doubled in the last 40 years.
Who can get bowel cancer?
Slightly more men than women develop bowel cancer, and, while most of those diagnosed are older, bowel cancer rates in younger adults are rising. If you have a family history of bowel cancer, your risk is higher, however, only 5–10% of bowel cancer cases are thought to be inherited.
If diagnosed early, more than 90% of bowel cancer cases can be treated successfully
NHS
About bowel screening
As part of the NHS Bowel Cancer Screening Programme, eligible people are sent a home testing kit every two years to collect a small sample of poo to be checked for tiny amounts of blood which could be caused by cancer. Regular colonoscopies are recommended for people who have an increased risk of developing bowel cancer because of either their family history of the disease or genetic conditions they’ve inherited.
For most people the bowel screening programme will begin at 50 and you will be called every two years until you are 74. After this you won’t receive the routine appointments but you can request to continue with screening. These may be slightly different in the other nations of the UK. You can find out more here.
Bowel cancer symptoms
Visit your GP if you experience any of the following symptoms:
- Bleeding from your bottom and/or blood in your poo
- A persistent and unexplained change in bowel habit
- Unexplained weight loss
- Extreme tiredness for no obvious reason
- Pain or a lump in your tummy
Useful resources
Understanding bowel cancer screening (Macmillan)
Lung cancer screening
About lung cancer
Lung cancer is cancer that starts in the lung tissue, the windpipe or the bronchus (the airway that takes air from the windpipe into the lungs). Lung cancer is the world’s most common cancer, and the 4th most common cancer in the UK.
Who can get lung cancer?
Lung cancer mainly affects older people. The most significant risk factor for lung cancer is smoking, with 70% of cases caused by smoking. However, people who have never smoked can also get lung cancer. Long-term exposure to second-hand smoke, air pollution and chemicals, such as asbestos, have also been identified as some of the contributing factors to lung cancer in non-smokers.
Almost 65% of people with stage 1 lung cancer will survive their cancer for 5 years or more
Cancer Research UK
About lung cancer screening
Lung cancer screening is currently offered for eligible people in some parts of England. If you live in one of these areas, are aged 55–74 and are a current or former smoker, you may be invited for a free lung health check by your GP. If you’re invited, you’ll have an initial appointment in person, on the phone or online, to assess your lung cancer risk. After that you might be referred back to your GP or for a low-dose CT scan of your lungs.
Lung cancer screening is expected to be available across England by 2030 (check whether lung checks are available in your area here). Wales and Scotland have committed to pilot screening programmes, beginning in 2027. Northern Ireland has yet to implement a screening plan.
Lung cancer symptoms
- Having a new cough or a cough most of the time
- Getting out of breath doing the things you used to do without a problem
- Coughing up phlegm (sputum) with blood in it
- Having an ache or pain in the chest or shoulder
- Chest infections that keep coming back or a chest infection that doesn’t get better
- Losing your appetite
- Feeling tired all the time (fatigue)
- Losing weight
It’s important to have anything different or new checked by your GP.
Useful resources
Lung cancer screening (Roy Castle Lung Cancer Foundation)
How important is screening for those who have a family history of certain cancers?
Dr Vishakha Tripathi, Consultant genetic counsellor
When an individual is at an elevated risk for cancer, for example if they have a family history of the disease, access to regular evidence-based screening offers the opportunity for early detection and maximises options around treatment. If you have concerns about a genetic risk for a certain cancer, and there is either no screening programme for it or you haven’t yet been invited because of your age, you should have a conversation with a clinical expert, such as a genetic counsellor or clinical geneticist. This will help you to understand the evidence behind the screening options and the ages at which they’re available. It can also help you to understand other strategies to manage the risk that might be available to you. You can be referred to a genetic counsellor through your GP or a specialist hospital team.
When an individual is at an elevated risk for cancer, for example if they have a family history of the disease, access to regular evidence-based screening offers the opportunity for early detection and maximises options around treatment.
Dr Vishakha Tripathi, Consultant genetic counsellor
While we have ensured that every article is medically reviewed and approved, information presented here is not intended to be a substitute for professional medical advice, diagnosis, or treatment. If you have any questions or concerns, please talk to one of our healthcare professionals or your primary healthcare team.
References
https://www.cancerresearchuk.org/
https://camdencarechoices.camden.gov.uk/