Screening clinics

The first symptom of breast cancer most people notice is usually a lump in their breast. However, there are other key symptoms of breast cancer to look out for:

• thickening in your breast or armpit
• a change in size, shape or feel of your breast
• skin changes in the breast such as puckering, dimpling, a rash or redness of the skin
• fluid leaking from the nipple in a woman who isn’t pregnant or breastfeeding
• changes in the position of the nipple

The symptoms listed here are more often caused by other medical conditions. But if you have any of them it is important to make an appointment with your GP practice.

Breast cancer screening aims to find breast cancer early, when there is the best chance of being successfully treated. Screening involves having an x-ray of your breast called a mammogram. This will be taken by a female clinician.

Breast screening is for women and some trans or non-binary people between the ages of 50 and 71, every 3 years. All invitations for breast screening will soon be sent via the NHS App in the first instance (so please turn your notifications on). For those who don’t have the NHS App or do not respond, they will receive invitations either via text or by post.

You should get a letter with your results within 2 to 3 weeks. This will tell you what, if anything, you need to do next.

A mammogram is an x-ray of the breasts. It is a method of finding breast cancer at a very early stage. A female mammographer will compress your breasts – one at a time – between two x-ray plates to get clear images. The compression only lasts a few seconds and does not cause any harm to the breasts.

Any x-ray involves radiation, but mammograms only require a very low dose. The risk that such a low dose could cause a cancer is far outweighed by the benefits of early detection of breast cancer.

During the mammogram, the breast is tightly squeezed between two plates, which some women do find uncomfortable or mildly painful. However, this is necessary to get a clear image and only lasts for a few seconds.

Your results are usually sent by letter within 2–3 weeks. Your GP practice will also receive a copy.

If your images show no sign of cancer, you will be given the all clear and invited again for screening in 3 years’ time.

Some women will be called back for further assessment; approximately 4–5 in 100 women are invited for extra tests, which can include another mammogram, or an ultrasound and potentially a biopsy.

In most cases, further assessment does not lead to a cancer diagnosis.

Please use the links below for more information:

• Breast screening (mammogram) – NHS
• Breast care and screening: and easy read guide
• NHS breast screening video: what happens during a mammogram  https://www.youtube.com/watch?v=9XHLNd7wO78

Early cervical cancers and pre-cancerous cell changes don’t usually have symptoms. However, the most common symptoms of cervical cancer include:

• unusual vaginal bleeding, e.g. bleeding in between periods or bleeding after sex
• pain or discomfort during sex
• vaginal discharge that is an unusual colour or odour
• pain in the area between the hip bones (pelvis)

Not everyone diagnosed with cervical cancer will have symptoms. That’s why it’s important to attend regular cervical screening.

Cervical screening is a way of preventing cancer. It tests for a virus called human papillomavirus (HPV). High-risk HPV can cause cervical cells to become abnormal. Virtually all cases of cervical cancer are linked to high-risk HPV.

The NHS cervical screening programme invites those eligible between the ages of 25 to 64 every 5 years. If HPV is detected, you may be invited more regularly.

A doctor or nurse will usually carry out your cervical screening test. You can ask for a female clinician. They will ask you a few questions about your period, if you have experienced any unusual bleeding, and if you are taking any hormonal medication.

You will undress from the waist down and lie on a couch; a speculum is gently inserted to access the cervix. A small brush takes a cell sample. The procedure takes under 5 minutes, with the whole visit lasting about 10 minutes.

This programme is for people without symptoms. If you experience unusual vaginal bleeding, discharge, or pelvic pain, regardless of age or your screening history, don’t wait for your screening invitation but contact your GP practice.

Human Papilloma Virus (HPV) is the main cause of cervical cancer. It can be passed on without anyone knowing they have it, which is why it is important that people take part in cervical screening when invited. It is important that family members support women to participate in screening.

Screening is for everyone regardless of marital or relationship status, or sexual orientation. It does not matter if you have not been in a relationship, are single or you are married to a single partner. The test will not affect virginity.

Results are now sent through the NHS App or by letter usually within 2 to 6 weeks. If your test indicates you do not have HPV, your next cervical screen will be in 5 years.

If your result indicates you have HPV, you may be invited in for more frequent tests or referred for further investigations.

Read more using the links below:

• Cervical screening – NHS
• Cervical screening video about how it is done: https://www.youtube.com/watch?v=OU7fZb_sTus
• Cervical screening: easy read booklet
• The Eve Appeal – The Leading UK Gynaecological Cancers Charity: https://eveappeal.org.uk/
• Macmillan Cancer Support: https://www.macmillan.org.uk/cancer-information-and-support/cervical-cancer

The symptoms of bowel cancer can include:

• bleeding from the back passage (rectum) or blood in your poo
• a change in your normal bowel habit, such as looser poo, pooing more often or constipation
• a lump that your doctor can feel in your back passage or tummy (abdomen), more commonly on the right side
• a feeling of needing to strain in your back passage (as if you need to poo), even after opening your bowels
• losing weight without trying
• pain in your abdomen or back passage
• tiredness and breathlessness caused by a lower-than-normal level of red blood cells (anaemia)

Bowel cancer screening aims to find bowel cancer early, when there is the best chance of being successfully treated.

Bowel cancer screening is available to everyone between the ages of 50 to 74 years.

All invitations to participate in bowel screening will soon be sent via the NHS App in the first instance (so please turn your notifications on). For those who don’t have the NHS App or do not respond, they will receive invitations either via text or by post.

A bowel cancer testing kit is sent in the post every 2 years to those who are eligible. You need to be registered with a GP to receive your screening invitations. The test is called FIT – Faecal Immunochemical Test (FIT) – and looks for invisible blood in the stool.

You do the test at home. The kit contains instructions of how to do the test and includes a prepaid envelope to send the sample to the laboratory for testing.

You should get the results within a few weeks. The letter will tell you what, if anything, you need to do next.

If you’re 75 or over and you wish to continue being screened for bowel cancer, you can ask for a FIT test kit every 2 years by phoning the free bowel cancer screening helpline on 0800 707 60 60.

No, the FIT kit test does not diagnose bowel cancer; however, the results of the test will show if there is any blood present in your sample.

Your results letter is usually sent within two weeks. If no trace of blood is found, you will simply get an all-clear with no further testing required. If there are traces of blood found in your sample, you will be invited in for further investigations, normally a colonoscopy.

Because most bowel cancers (over 90%) occur in people aged 50 and over, the bowel cancer screening programme focuses on this age group. However, anyone with symptoms—under 50 or older—should contact their GP practice promptly.

Check that your contact details at your GP practice are accurate and up to date.

If you are eligible and still yet to receive a kit, call the bowel cancer screening helpline on 0800 707 6060.

Here are some useful links:

• Bowel cancer screening – NHS
• Watch the bowel cancer screening test video with translated subtitles or British Sign Language on Vimeo

There are many different signs of lung cancer. Some lung cancer symptoms, such as a persistent cough or shortness of breath, are more common and easier to recognise than others.

It is really important to be aware of the symptoms of lung cancer – regardless of whether you have smoked or not. Lung cancer can happen to anyone so if you are experiencing any of the following, you should contact your GP practice:

• A persistent cough (that lasts for three weeks or more)
• Feeling breathless for no reason
• Repeat chest infections or chest infections that haven’t improved after having treatment
• Losing weight and/or loss of appetite
• Coughing up blood or blood in your phlegm (spit)
• A cough that changes or gets worse
• Unexplained tiredness or lack of energy
• Chest or shoulder pain

Less common symptoms include: back pain, wheezing, a hoarse voice, finger clubbing (where the tips of your fingers swell around your nail), difficulty swallowing, or a swelling in your face or neck

There are often no signs or symptoms of lung cancer at an early stage. Lung cancer screening can find lung cancer at its earliest stage when it is easier to treat, often before you have any symptoms.

Lung cancer screening can help diagnose lung cancer as early as possible.

Screening is currently being rolled out across England and is available for eligible people aged between 55-74 years old who smoke or used to smoke and are registered with a participating GP practice.

Of those picked up through the Lung Cancer Screening Programme, 75% are diagnosed with stage 1 and 2 when treatment can be more successful.

There are two parts to lung cancer screening:

1. Lung health check: After you receive a letter inviting you to take part, a patient care advisor (a non-medical professional) will call you to carry out a lung health check assessment over the phone, which takes around 15 minutes. They will ask you a series of questions about your overall health, your lung health and your smoking history. Your risk of lung cancer will be calculated and this will decide next steps.
2. In person appointment: If your assessment finds that you meet a certain level of risk, you will be offered an in person appointment with a nurse and, if suitable, a CT scan of your chest. This will take place at a local mobile unit or NHS hospital.

Many people with early-stage lung cancer have no symptoms. One of the main aims of this programme is to detect lung cancer at the earliest opportunity when it is easier to treat.

We strongly recommend you take up the invitation for lung cancer screening even if you feel well.

Lung cancer screening is being offered only to current or former smokers aged between 55-74 because the risk of lung cancer and the benefits of early detection through screening outweigh any potential risks or harms for this specific group.

If you are not eligible for screening but have any symptoms or concerns about your lung health, you should contact your GP practice to arrange an appointment.

People with a history of smoking are at a higher risk of lung disease or lung cancer than people who have never smoked. However, anyone can get lung cancer so if you have any concerns or are experiencing symptoms, contact your GP practice.

No, people who smoke or used to smoke any tobacco product, including cigarettes, pipes, cigars, roll ups, hookahs or shishas, may also be eligible for free lung cancer screening.

To be invited for lung cancer screening, your GP practice needs to be participating in the programme and also needs to be aware that you have smoked and recorded this on your medical history.

If you think you are eligible, contact your GP practice to check your smoking record is up to date.

Please visit these useful links:

• Lung cancer screening – NHS
• Home – NW & SW London Lung Cancer Screening

Symptoms of prostate cancer do not usually appear until the prostate is large enough to affect the tube that carries urine from the bladder out of the penis (urethra).

Most men with early prostate cancer don’t have any signs or symptoms. That’s why it’s important to know about your risk. If you do notice changes in the way you urinate, this is more likely to be a sign of a very common non-cancerous problem called an enlarged prostate, or another health problem. But it’s still a good idea to get it checked out.

Possible symptoms of prostate cancer include:

• difficulty starting to urinate or emptying your bladder
• a weak flow when you urinate
• a feeling that your bladder hasn’t emptied properly
• dribbling urine after you finish urinating
• needing to urinate more often than usual, especially at night
• a sudden need to urinate – you may sometimes leak urine before you get to the toilet.

These symptoms should not be ignored, but they do not mean you have prostate cancer. You should always contact your GP practice to discuss your symptoms.

There is currently no routine screening programme for prostate cancer in England.

However, the UK National Screening Committee (UK NSC) has announced a draft recommendation for a targeted prostate cancer screening programme for men with a BRCA1 or BRCA 2 genetic mutation, as this puts them at higher risk of developing prostate cancer.

If you are worried about symptoms that may indicate prostate cancer, make an appointment with your GP practice to discuss your concerns.

A family history of cancer can also indicate a higher risk.

This can mean any first-degree relative with breast, ovarian or prostate cancer. However, this term can include different levels of risk, for example men with more than one relative who has had cancer, or men whose relatives had their cancer diagnosed at a young age. Those with a family history of cancer may be eligible for genetic testing.

If you have a family history of cancer and are experiencing symptoms of prostate cancer, or if you are worried about symptoms that may indicate prostate cancer, make an appointment with your GP practice to discuss your concerns.

Learn more here:

• Prostate cancer – NHS
• https://prostatecanceruk.org/prostate-information-and-support/prostate-tests/psa-blood-test