🔑 Key Learning
- Cervical Cancer: HPV-based smear screening from ages 25 to 64.
- Breast Cancer: Mammography from ages 47 to 73 every 3 years.
- Bowel Cancer: FIT for ages 60–74 every 2 years and 1 off flexisig at 55 yrs
- AAA: One-off ultrasound for men at 65.
- Other screening includes liver disease, diabetes complications, and genetic disorders.
➡️ Cervical Cancer Screening
🧬 Overview
- Offered to all women aged 25–64 years.
- 25–49 years: every 3 years.
- 50–64 years: every 5 years.
- Test: Cervical smear → HPV testing.
👀 Process
- If HPV positive: Cytology.
- If abnormal cytology: Colposcopy.
- Management depending on cytology and HPV status: treatment, re-screening after 1/3/5 years, or repeat colposcopy.
➡️ Breast Cancer Screening
🧬 Overview
- Offered to women aged 47–73 every 3 years.
- Women >70 can self-refer via GP.
- Test: Mammography.
👀 Special Circumstances
- MRI for young women at high familial/genetic risk (BRCA/TP53 mutations).
⚡ Screening Outcomes
- Triple assessment for abnormal results.
- Ductal carcinoma in situ (DCIS) detected and treated as cancer.
- False negative rate ~10%.
➡️ Bowel Cancer Screening
🧬 Overview
- Offered to men and women aged 60–74 every 2 years.
- Test: Faecal Immunochemical Test (FIT).
👀 Screening Pathway
- Positive FIT → Colonoscopy.
- Colonoscopy outcomes:
- Clear → Resume 2-year FIT cycle.
- Cancer → Treatment.
- Polyps → Removed and stratified:
- Low risk: Continue FIT screening.
- Medium risk: Colonoscopy every 3 years.
- High risk: Colonoscopy at 12 months, then every 3 years.
➡️ Abdominal Aortic Aneurysm (AAA) Screening
🧬 Overview
- Men aged 65 offered one-off abdominal ultrasound.
📊 Diagnosis & Monitoring
- AAA = Aortic diameter ≥3.0 cm.
- Small (3.0–4.4 cm): Annual scan.
- Medium (4.5–5.4 cm): 3-monthly scan.
- Large (≥5.5 cm): Surgical referral.
⚡ Surgical Management
- Open surgical repair or endovascular aneurysm repair (EVAR) considered for large AAAs or rapid expansion (>1 cm/year).
➡️ Other Regular Screening Examples
🧬 Liver Screening
- HCC: 6-monthly abdominal US + AFP in chronic liver disease.
- Varices: Surveillance endoscopy every 1–3 years if varices present.
- Cholangiocarcinoma: Annual US + CA19-9 in PSC.
🧬 Renal Screening
- ADPKD: US surveillance for first-degree relatives.
🧬 Diabetes Screening
- Foot screening: Annual.
- Retinopathy screening: Annual retinal photographs.
🧮 Summary Tables
📋 UK National Cancer Screening Programmes
| Cancer Screening | Target Population | Test | Frequency | Purpose |
|---|---|---|---|---|
| Breast Cancer | Women 47–73 years | Mammography | 3-yearly | Early breast cancer (inc. DCIS) detection |
| Cervical Cancer | Women 25–64 years | Smear + HPV test | 3–5 yearly | Detection of abnormal cells |
| Bowel Cancer | Men & women 60–74 years | FOBT | 2-yearly | Detection of occult blood in stool |
📝 Exam Clues & Clinchers
- Cervical screening starts at 24.5 years.
- Bowel screening starts at 60 years.
- Breast cancer screening begins at 47 years (not 50!).
- HCC screening = US + AFP every 6 months for cirrhotics.