Evidence-based screening in the UK: the national programmes explained

The UK National Screening Committee advises governments in the four nations on whether populations should be screened for particular conditions. It reviews evidence on the natural history of the condition, test accuracy, treatment effectiveness, harms and cost. Because screening healthy people can cause harm through false alarms and overtreatment, the bar for recommendation is high. Many tests that seem sensible do not meet it.

• Cervical screening: tests for human papillomavirus in cervical samples, with invitation ages and intervals set nationally.

• Breast screening: mammography invitations for women in an older age range, every few years.

• Bowel screening: home test kits for blood in stool, with the starting age being lowered in England.

• Abdominal aortic aneurysm screening: a one-off ultrasound offered to men in the year they turn 65 in England.

• Diabetic eye screening for people with diabetes.

• Antenatal and newborn screening for a range of conditions.

• Lung screening for people in a defined age range with a smoking history, being rolled out in England.

Prostate-specific antigen testing has not been recommended for population screening because it can detect cancers that would never have caused harm and lead to treatment with side effects. Ovarian cancer screening trials did not show a clear benefit in lowering deaths. Whole-body scans and multi-cancer blood tests have not been shown to reduce deaths. Each case reflects balance of benefit and harm, not oversight.

Private providers offer tests that fall outside national programmes or earlier than recommended ages. Some can be reasonable for people at higher risk, for example with strong family history or a known genetic variant, where tailored surveillance is recommended by specialists. For average-risk people, benefits are less certain and harms remain. If you are considering private screening, discuss with your GP first.

People with strong family histories of breast, ovarian or bowel cancer, or known genetic variants, may be offered earlier or more frequent surveillance through NHS genetics and specialist services. Ask your GP whether referral is appropriate. These pathways are different from population screening and are based on specific risk.

Screening is a choice. Information is provided so you can decide. If you receive an invitation, read the leaflet, consider benefits and limitations and attend if you wish. If you miss an invitation, you can usually book another. Screening does not guarantee that cancer will be found or that you will be unaffected, and you should still report symptoms, whatever your screening history.