Screening

CERVICAL SMEARS

These are undertaken by the Practice Nurse and appointments can be booked online or via telephoning our appointments line 01442 250117. It is preferable to take the smear during the middle of your cycle. Recall rate is :

aged 25 to 49 – every 3 years
aged 50 to 64 – every 5 years
over 65 – only women who haven’t been screened since age 50 or those who have recently had abnormal tests

If you have had any unexpected bleeding between periods, or any other unexpected bleeding it may be advisable to see a doctor.

For more information on Cervical Smears go to: www.patient.co.uk

BREAST SCREENING

This is organised by our local breast screening service

This is NOT arranged by the surgery.

The Beds and Herts Breast Screening Service is part of the National Breast Screening Programme and provides a free breast screening service for well women aged between 50 and 70, serving residents in all of Bedfordshire and most of Hertfordshire. You will be invited every 3 years until you are 70.

If you’re over the age of 70, you’ll stop receiving screening invitations. However, you’re still eligible for screening and can arrange an appointment by contacting the beds and herts breast screening unit directly.
They aim to provide and promote an efficient and effective, high quality breast screening service, to all eligible women within a caring environment.

Breast screening aims to find breast cancer at an early stage, often before there are any symptoms. To do this, x-rays are taken of each breast (mammogram). Early detection may often mean simpler and more successful treatment.

PSA TESTING

This is such a controversial subject I thought I’d summarise what we know to date. Remember this is screening ASYMPTOMATIC men, not those with symptoms. If you notice that
• your flow rate deteriorates
• the number of times you have to urinate during the day or night increases
• or if you notice blood in your urine

then see your GP who will check your PSA and examine your prostate

PSA testing has more than doubled the incidence of prostate cancer, identifying tumours that would never have otherwise come to clinical attention. This would tend to make you think that PSA testing is a good idea, so why don’t we screen for PSA levels

At autopsy in men who have died from other diseases (not prostate cancer) occult prostate cancer is common:

30% of men aged >50yrs
70% of men aged >70yrs

This suggests that indolent prostate cancers may be a ‘normal’ part of ageing.

We are still not able to differentiate between aggressive prostate cancer and prostate cancer that very slowly progresses in the background ( so called indolent prostate cancer)

PSA testing does NOT reduce the death rate from prostate cancer
There have now been 5 large long-term randomised trials which have looked at prostate cancer mortality in screened and
unscreened populations.
At best, using the 11y follow-up data from the ONE screening study that showed some benefit, for every 1000 men screened and followed up for 11years, we will prevent 1 prostate cancer death at the expense of treating 37 additional
men.

• The test is unlikely to prevent you from dying from prostate cancer over 10–15y or to help you to live longer.
• Elevated PSA values are common and lead to tests that have harms.
PSA tests find many cancers that will never cause health problems.

Once we find a cancer, it is difficult not to treat it.

• Treating men with clinically unimportant cancers exposes them to harm.
• Over one-third (36%) of men report moderate/severe symptoms after prostate biopsy.
• Treatments have harms which can be serious and may persist and yet have very little if any benefits.

Remember – this ONLY relates to asymptomatic men

BOWEL SCREENING

More information on bowel screening is available here
This is available if you’re over 55. From age 60-75 you will be offered a stool test every 2 years. Remember if you have recurrent blood in your stool you should see your GP and not wait for screening.

AORTIC ANEURYSM SCREENING

This is available to men only and you will receive an invite on turning 65. If you are a man over 65 and you’ve never been sent this, phone 01727 897719 to discuss how to arrange screening.