cancer screening

Question 1

screeningrpgrams available?

Answer 1

Screening Division manages:–Breast Cancer Screening–Cervical Screening–Bowel Screening–Newborn Hearing Screening–Hosts Antenatal Screening Clinical NetworkWill manage :–Abdominal Aortic Aneurysm Screening–Newborn Bloodspot Screening

Question 2

uknsc?

Answer 2

UK National Screening Committee (UK NSC)––Assesses all programmes against published criteria Review and advises to continue or introduce new programmes Advises UK Health Departments (in Wales: Wales Screening Committee )

Question 3

special limitations?

Answer 3

false positive results (wrongly reported as having the condition) and false negative results (wrongly reported as not having the condition).

Question 4

btw?

Answer 4

Breast Test Wales is a single organisation responsible for all aspects of breast screening in Wales–service delivery–QA–training–evaluation

Question 5

breast screening policy?

Answer 5

Breast screening offered every three years to all women aged 5070 Women aged over 70 can self refer but are not invited Women aged under 50 cannot self refer BTW screens around 100,000 women per year Breast screening reduces deaths from breast cancer by at least 15%•BUT some women attending for screening will be harmed–anxiety–Over diagnosis–false reassurance

Question 6

mammography?

Answer 6

Sensitivity 85%:percentage of those with the disease who are correctly identified by the test Specificity 90%:percentage of those with no disease who are correctly identified by the test Positive predictive value 20%:percentage of those identified by the test as having the disease who actually do have it UK-screen 3 yearly•based on results of UKCCR trial 1990–randomised women to annual or three yearly screening–difference in breast cancer mortality not statistically significant

Question 7

cervical screening program?

Answer 7

Aim–To reduce the incidence of and mortalityfrom invasive cervical cancerMethod–By detection and possible treatment ofpre-invasive cervical diseaseCurrent test–Cytological examination of exfoliated cellsfrom cervix. Pre-invasive phase:Cervical Intraepithelial Neoplasia -CIN-1/2/3Third of CIN 3 progresses to cancer if untreated in 10-15 years

Question 8

hpv?

Answer 8

16 and 18 as carcinogensEstimate >70% of sexually activepeople exposed to HPVPeak infection rate inyoung (20-24)

Question 9

cervical all wales screening policy?

Answer 9

ztarget age range: 20-64 years(25-64 in England and Northern Ireland)first invitation is issued before age 21routine recall is every 3 years(in England and Northern Ireland, 3-yearly 25-49 then 5-yearly to 64)CSW screens around 210,000 samples per year

Question 10

bowel screening wales?

Answer 10

Randomised Controlled Trial evidence-mortality reduction 15%•Screening Programme –October 2008 •Men and women aged 50-69 every two years. Increased now to 74 year olds•Faecal Occult Blood (FOB) test kits sent to home.•Test not 100% accurate•2% positive –offered colonoscopy