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Making cancer screening work for you

Sophie Brooks
by Sophie Brooks | In depth

9 April 2024

9 comments 9 comments

Two people sitting talking to a GP


The 3 UK screening programmes, for bowel, breast and cervical cancer, save thousands of lives each year. Screening can help diagnose cancer at an early stage, when there are more treatment options and treatment is more likely to be successful. And cervical screening can even prevent cancers from developing in the first place.

Across the UK, the proportion of eligible people completing screening in 2021/22 ranged from around 62-70% for bowel cancer, 62-77% for breast cancer, and 67-69% for cervical cancer.

Screening is always a personal choice, but it’s important that everyone who’s eligible for screening has the same opportunities to access it. While someone might decide that screening isn’t right for them, there are also people who might want to be screened but aren’t able to because something gets in the way.

So, let’s look at how we can make screening work for you.

From getting the invite in the first place, attending the appointment or doing the test itself, to receiving results, here are our top tips for making the screening process just a little bit easier.

Step 1: Getting your cancer screening invite

Let’s start at the very beginning – how do you get a screening invite?  

Well, first you need to make sure you are registered with a GP.  If you aren’t registered, you won’t receive an invite to cancer screening.  

Most people who are eligible for screening will receive their invite in the post automatically. This means for most people the invite will come to you when it’s time to consider screening, and there’s nothing you need to do beforehand. 

Just make sure your GP has your current home address – and let them know if this changes! If you have not been sent a letter, and think you should have been, contact your GP.  

But invites aren’t always automatic – so what then? 

Screening for transgender and non-binary people 

For some people, invites may not come automatically at all. For transgender or non-binary people, screening invites will be sent out based on the gender registered with their GP. But your sex assigned at birth, hormones, or surgeries you may have had, may impact what screening programmes are suitable for you.  

Your gender identity should not affect your access to screening, so speak to your GP or Gender Identity Clinic for advice. Our webpage on screening for trans or non-binary people helps to make sure you have the information you need. 

Step 2: Understanding your screening invite

Once that letter has landed on your doormat – open it, read it, and check that you understand the information.  

The letter inviting you to take part in screening contains information about the test or what happens at the screening appointment. 

Invites are available in different languages 

If the letter isn’t written in your first language, ask if your GP or the screening service can provide the information in a different language. You may also be able to find these online through Public Health England. Remember you could also ask a friend or relative to help you understand this information.  

A profile picture of Gem
Gem was diagnosed with cervical cancer after attending her screening appointment.

Check out other screening resources 

Cancer screening can be confusing. There are often words people may not recognise like, mammograms, FIT tests, and HPV testing. And while screening invites aim to be clear and simple, people often have lots of questions after reading the information.

So, if you have questions… that’s ok!  

There are lots of resources available to help. Our screening pages help with many of your questions, and we have individual for leaflets for breast, bowel and cervical cancer. We also have information about screening in easy read format, which can be useful for people who speak English as a second language, people who find it hard to read and write, and people with conditions that affect how they process information. 

I like to know what to expect. So before my first screening appointment I did some research online about what the appointment would involve and what the actual screening would be like.

This helped put my mind at ease. I was still nervous, but the image that you build up in your head is usually far worse than the reality.

- Gem, diagnosed with cervical cancer aged 28.

And remember, you can speak to your GP or local screening service with any questions you have about cancer screening. The number for the relevant screening service can be found on your screening invite.

Step 3: Deciding if you would like to take part

Whether or not you go for screening is your choice. And the information in your screening invitation can help you make an informed decision.  

But there are many things that may influence our decisions around cancer screening. Research is giving us an insight into some of the reasons people may not chose to attend screening. We might not think screening is for us, we might feel scared of getting the results, or we simply might not have enough time to attend the appointment. 

It’s important to recognise when these factors are acting as barriers to participation for people who do want to take part. At Cancer Research UK, we aim to raise awareness and remove barriers so everyone who wants to take part in screening can do so.

Cancer screening isn’t for me… is it?  

One common barrier to screening is people thinking that screening is not for them. That’s often because people perceive themselves as having a low risk of cancer, or because they don’t have any symptoms.

Picture of John and his great grandson, Levi.
John (left) was diagnosed with bowel cancer after screening even though he didn't have symptoms.

While it’s true that cancer is more common as we get older, anyone can develop cancer at any age. And screening programmes have been designed to target ages where the benefits of the programme outweigh the risks.  

Screening is for people without symptoms 

It’s common misconception that you need symptoms to complete cancer screening. But cancer screening is actually designed for people without symptoms, as it can help detect the early signs of cancer before symptoms appear.  

My initial thought on receiving the test kit was, 'what on earth do I need to be doing this for'. I didn't feel unwell, so I didn't think I needed to do it.

But after a week or so of it lying on the table, I was going to the toilet so just picked it up and did it.

- John, diagnosed with bowel cancer aged 60.

If you do have symptoms or notice something unusual for you – it’s important to speak to your doctor. Don’t wait for screening, and don’t put off talking to your doctor even if you have been screened.  

Most screening tests do not result in a cancer diagnosis 

Another barrier often cited is fear or fatalism. It’s important to know that most cancer screening tests do not result in a cancer diagnosis – and the majority require no further testing at all. But the ones that do give an indication that further tests are needed can go on to detect cancer at an earlier stage.  

And early diagnosis is key – spotting cancer at an early stage means treatment is more likely to be successful.   

Spotting cancer early can save lives 

More than 9 in 10 people with bowel cancer survive their disease for five years or more if it’s diagnosed at the earliest stage. This falls to around 1 in 10 people when bowel cancer is diagnosed at the most advanced stage.  

And it’s an even better picture for breast cancer: if breast cancer is diagnosed at the earliest stage, almost all women survive their disease for 5 years or more.  

I view cervical screening like I do going to the dentist. It's designed to pick up any problems before they get worse.

Catching my cancer early meant I was able to have less treatment and means I am still able to hopefully have children one day. I will always be thankful I chose to go to my screening the day I did. My life today could be very different if I didn't.

- Gem, diagnosed with cervical cancer aged 28.

Early diagnosis could help thousands more survive their cancer – and cancer screening is one important way to spot cancer early.

Step 4: Preparing for the appointment and screening test

Another reason for not completing screening can be our perception of the screening appointment or the test, and what it involves. Sometimes, this can cause people to delay screening, or not attend at all. So, what can we do to make this step a bit easier? 

Get the right appointment for you 

Preparing for a screening appointment can help it run more smoothly. And this can start with booking the appointment itself. For example, you might want to consider booking the first appointment of the day if you feel uncomfortable in waiting rooms, or perhaps the last appointment if you want to make sure you can head straight home afterwards.  

You might also want to consider telling your provider if you have found screening uncomfortable in the past or are feeling worried or anxious, or simply take the opportunity to ask them any questions you may have. This can help reassure you before the appointment. 

If you are struggling to get an appointment that works, ask if there are evening or weekend appointments available. If that doesn’t work, remember you can also have your cervical screening done at some sexual health or specialist clinics.  

For breast screening, you can go straight to your local breast screening service, rather than through your GP. Explore these options too if you’d prefer.  

Get to know about the screening test 

We’ll start with cervical screening because, let’s face it, questions about the test being uncomfortable, painful, or embarrassing are common. The test involves the use of a speculum so the nurse can see the cervix and take a sample of cells using a soft brush.  

I do remember feeling pangs of embarrassment before my first screening as they're looking at an intimate area, but I tried to remember, and still do, that they do this all the time and have probably seen thousands of people and to them it's just their day job.

The screening only takes a couple of minutes. It can be uncomfortable and you do feel a bit exposed but it's over before you know it.

For me the importance of getting checked out and catching any changes early has always overridden any fear or embarrassment I've felt about the screening.

- Gem, diagnosed with cervical cancer aged 28.

It is normal to feel self-conscious, nervous, or embarrassed, but it can be reassuring to know that most of these tests are done by practice nurses who are very experienced doing cervical screening.

When booking the appointment, you can ask for a man or woman to do the test, and for someone to be with you (this can be a friend or family member, or someone who works at the practice).  

Check out our cervical screening video for some more helpful information.  

When it comes to breast screening, the test involves having x-rays of the breasts called mammograms. These tests are performed by a specialist, and all mammographers are also female in the UK. So there’s no need to request this when making an appointment.

Our video of a breast screening appointment can give you an idea of what to expect during a mammogram.  

The third screening programme is a bit different. It doesn’t involve attending an appointment at all. 

Bowel cancer screening can be done in your own home and involves a simple and easy test. The test itself is called a Faecal Immunochemical Test, or FIT, and requires the collection of a poo sample.  

The instructions and the test kit were simple to follow, and returning it was easy. I'd recommend reading the instructions a few times before doing it.

The thought about collecting the sample wasn't nice, but the test costs nothing, and you might feel you lose a bit of dignity, but what's that for peace of mind.

- John, diagnosed with bowel cancer aged 60.

But remember, although you can do this privately in your own home, it doesn’t make the test any less important We have some simple tips to make the whole process a lot easier in our leaflet containing tips and guidance for collecting your sample. 

Step 5: Attending the appointment

We’ve now covered what the screening tests involve, but actually attending a screening appointment can still feel scary or a bit worrying. During your appointment, remember the nurse is there to support you throughout. Try to share how you are feeling: they will understand if you’re afraid or embarrassed, and sharing your concerns means they can recognise what kind of support you might need.  

Remember, whether it’s breast or cervical screening – you are in control. Don’t feel pressured to keep going. You can ask the nurse to stop at any point.  

Getting comfortable with cervical screening

Most people won’t experience pain from cervical screening, but sometimes the speculum can be uncomfortable. Speak with your doctor or nurse if you have concerns about this. There are ways to make this more comfortable, such as using a different sized speculum or moving into a different position.   

On the day of the appointment consider wearing a dress or skirt. This may help you feel more covered as you can keep it on during the test and only take off your underwear.  

Mastering the mammogram  

Breast screening mammograms can also be uncomfortable, but most people only feel mild discomfort, and it doesn’t last for long. If you do experience pain, speak to the mammographer. They’re trained to offer the support you need.  

For breast screening, consider wearing a top with a skirt or trousers, rather than a dress, which will make it easier to get undressed to the waist only. The nurse or mammographer will help to make you feel as comfortable as possible.  

There is lot of guidance and support out there for attending screening so consider taking a look at Jo’s trust cervical screening tips, or NHS guidance for what happens at your breast screening appointment 

Step 6: Receiving the results

Phew… the appointment is done or the sample in the post; time to forget about it? For some people it’s a simple as that, but for others the waiting can be an anxious time. But remember, most people that complete screening will have a normal result, meaning no further tests are needed. 

Waiting on your results

Screening results can take from around 2 to 6 weeks and are usually sent in the post. If you have been waiting longer than expected, call your GP surgery to find out if they have any updates. If there is a delay, try not to worry. It doesn’t mean that there’s anything wrong.  

Continue to listen to your body 

Most results mean that no further tests are needed. But this doesn’t completely rule out cancer. Whether you’ve been screened or not, it’s important to get to know your body and what is normal for you and speak your GP if you notice any unusual changes. You doctor will want to hear about any changes you are experiencing. 

Attend appointments for further tests 

If further tests are needed, these will be explained on the letter. You can read about some of the tests for breast, bowel or cervical cancer on our webpages. But you can also go to your doctor to ask any questions you might have. Needing further tests does not necessarily mean you have cancer, but it’s important that you continue with these next steps. Remember, if it is cancer, finding it at an early stage means treatment is more likely to work. 

Cancer screening is about you

So, from invite to results, we hope these tips will help make your cancer screening journey that little bit easier. There are lots of resources both online and as printed documents with helpful information about cancer screening. For more information on screening and to check your eligibility visit: https://www.cancerresearchuk.org/about-cancer/screening. And, remember, if you’re worried, concerned or have questions, speak to your GP or screening service.

Cancer screening is always a personal choice, and it’s important that every individual eligible for screening is given equal access to that choice. We hope this article helps make screening work for you, and gives you the best opportunity to make an informed decision.

    Comments

  • Robert Leigh
    10 May 2024

    My wife died from metastic breast cancer. She had conscientiously attended screening for many years, never delaying, and showed no visible symptoms nor had any lumps in the breast at the time of diagnosis. After mastectomy, chemotherapy and radiotherapy and being declared with a chance of being at least 99% sure of being cured, the cancer continued to spread to other parts of her body with various attempts to arrest progress but sadly she succumbed to the disease. Increasing the frequency of routine screening could increase the number of cures and reduce the amount of palleative treatment needed which is a great load on resources. Ensuring screening more frequently (I believe it used to be every 2 years) would save lives, and I imagine that examination of mammogram results is being automated more and more through AI, reducing the required human resource. We should be looking to return to biennial screening.

  • Margaret Watchman
    9 May 2024

    I am 74, am I able to request breast screening ( I missed my 70yr old one because of covid restrictions) & also bowel cancer screening ?

  • Maureen Sutton
    9 May 2024

    All very informative and helpful. Hope I receive a letter

  • Jill Clark
    23 April 2024

    Jacob
    Many thanks for your answer of 19th April, but in the case of bowel cancer screening, it does not seem to be very convincing. A more honest answer is that the UK does not have sufficient endoscopists to perform colonoscopies to diagnose bowel cancer, and younger people are given priority over older people. Does Cancer Research UK have any intention of promoting the bowel scope camera that you can swallow? More accessible, earlier and cheaper ways of diagnosis would help to make screening much more effective.

  • Pamela Hibbert
    20 April 2024

    Two things which people might find useful; I was diagnosed with breast cancer over ten years ago and still could not find a lump nor feel any symptoms even after the screening. Do please attend!
    Older women can have a three-yearly breast screening if they ask-so please do.

  • Jill Clark
    18 April 2024

    Bowel cancer screening is highly effective with about 90% of all cases identified by screening being at Stages 1 or 2 when treatment is most effective. Unfortunately, only about 8-12% of all bowel cancer case are caught via screening. (Stats from National Bowel Screening Audit 2023) A key reason for this is because screening becomes voluntary from age 74 (so very few people over 74 are screened) when the average age for contracting bowel cancer is about 72-74. This is in spite of the fact that catching cancers early is considerably cheaper for the NHS, and so many elderly people are diagnosed late. This is blatent age discrimination. Whether it is legal or not, I don’t know, but it is certainly discriminatory. What’s worse, although screening becomes voluntary at age 74, very little information is given about whether to volunteer for it, so informed content goes flying out of the window.

  • reply
    Jacob Smith
    19 April 2024

    Hi Jill,

    Thank you for your question.

    The UK’s national cancer screening programmes are effective tools to help spot cancers at an early stage, or even prevent them. We know that cancer screening saves thousands of lives each year. But no screening test is perfect. There are potential harms, such as false negatives or false positives, or picking up cancers that would not have gone on to cause any problems if they were never detected (overdiagnosis). That’s why cancer screening is offered at ages when the benefits are biggest, and the harms are smallest. 

    Eligibility for screening programmes is decided by an independent organisation called the National Screening Committee (NSC) based on the best scientific evidence and the balance of harms and benefits. You can read more about this here: https://www.cancerresearchuk.org/about-cancer/cancer-symptoms/spot-cancer-early/screening/what-is-cancer-screening

    Cancer risk does increase with age, this is because build-up of DNA damage within our cells over time. However, for people over the recommended screening age the overall balance of harms and benefits are less clear, and the risks of screening may be greater. If someone would like to be screened but is older than the age range, they can discuss their risk and the balance of benefits and risks with their GP, or in some nations call the relevant screening helpline to ask to be screened for breast or bowel cancer.

    It’s important to remember that screening is for people without symptoms. So whatever someone’s age, if they notice anything unusual for them, they should speak to their doctor.

    I hope this information is helpful.

    Jacob, Cancer Research UK

  • John Markey
    17 April 2024

    The more screening more lives will be saved

  • Julia D
    17 April 2024

    I believe invitations to breast screening stop at age 70 (?) but why do they stop
    when the risk of cancer increases with age?

  • reply
    Jacob Smith
    19 April 2024

    Hi Julia,

    Thank you for your question.

    The UK’s national cancer screening programmes are effective tools to help spot cancers at an early stage, or even prevent them. We know that cancer screening saves thousands of lives each year. But no screening test is perfect. There are potential harms, such as false negatives or false positives, or picking up cancers that would not have gone on to cause any problems if they were never detected (overdiagnosis). That’s why cancer screening is offered at ages when the benefits are biggest, and the harms are smallest. 

    Eligibility for screening programmes is decided by an independent organisation called the National Screening Committee (NSC) based on the best scientific evidence and the balance of harms and benefits. You can read more about this here: https://www.cancerresearchuk.org/about-cancer/cancer-symptoms/spot-cancer-early/screening/what-is-cancer-screening

    Cancer risk does increase with age, this is because build-up of DNA damage within our cells over time. However, for people over the recommended screening age the overall balance of harms and benefits are less clear, and the risks of screening may be greater. If someone would like to be screened but is older than the age range, they can discuss their risk and the balance of benefits and risks with their GP, or in some nations call the relevant screening helpline to ask to be screened for breast or bowel cancer.

    It’s important to remember that screening is for people without symptoms. So whatever someone’s age, if they notice anything unusual for them, they should speak to their doctor.

    I hope this information is helpful.

    Sophie, Cancer Research UK

  • Keith D
    17 April 2024

    It is a shame you did not include in your article the eligibility factors (e.g. age groups) for inclusion in these three screening programmes.

  • reply
    Jacob Smith
    18 April 2024

    Hi Keith,

    Thanks for your comment. For more information on screening and to check your eligibility for all three cancer screening programmes, visit: https://www.cancerresearchuk.org/about-cancer/screening

    I hope that helps,
    Jacob, Cancer Research UK

Tell us what you think

Leave a Reply

Your email address will not be published. Required fields are marked *

Read our comment policy.

    Comments

  • Robert Leigh
    10 May 2024

    My wife died from metastic breast cancer. She had conscientiously attended screening for many years, never delaying, and showed no visible symptoms nor had any lumps in the breast at the time of diagnosis. After mastectomy, chemotherapy and radiotherapy and being declared with a chance of being at least 99% sure of being cured, the cancer continued to spread to other parts of her body with various attempts to arrest progress but sadly she succumbed to the disease. Increasing the frequency of routine screening could increase the number of cures and reduce the amount of palleative treatment needed which is a great load on resources. Ensuring screening more frequently (I believe it used to be every 2 years) would save lives, and I imagine that examination of mammogram results is being automated more and more through AI, reducing the required human resource. We should be looking to return to biennial screening.

  • Margaret Watchman
    9 May 2024

    I am 74, am I able to request breast screening ( I missed my 70yr old one because of covid restrictions) & also bowel cancer screening ?

  • Maureen Sutton
    9 May 2024

    All very informative and helpful. Hope I receive a letter

  • Jill Clark
    23 April 2024

    Jacob
    Many thanks for your answer of 19th April, but in the case of bowel cancer screening, it does not seem to be very convincing. A more honest answer is that the UK does not have sufficient endoscopists to perform colonoscopies to diagnose bowel cancer, and younger people are given priority over older people. Does Cancer Research UK have any intention of promoting the bowel scope camera that you can swallow? More accessible, earlier and cheaper ways of diagnosis would help to make screening much more effective.

  • Pamela Hibbert
    20 April 2024

    Two things which people might find useful; I was diagnosed with breast cancer over ten years ago and still could not find a lump nor feel any symptoms even after the screening. Do please attend!
    Older women can have a three-yearly breast screening if they ask-so please do.

  • Jill Clark
    18 April 2024

    Bowel cancer screening is highly effective with about 90% of all cases identified by screening being at Stages 1 or 2 when treatment is most effective. Unfortunately, only about 8-12% of all bowel cancer case are caught via screening. (Stats from National Bowel Screening Audit 2023) A key reason for this is because screening becomes voluntary from age 74 (so very few people over 74 are screened) when the average age for contracting bowel cancer is about 72-74. This is in spite of the fact that catching cancers early is considerably cheaper for the NHS, and so many elderly people are diagnosed late. This is blatent age discrimination. Whether it is legal or not, I don’t know, but it is certainly discriminatory. What’s worse, although screening becomes voluntary at age 74, very little information is given about whether to volunteer for it, so informed content goes flying out of the window.

  • reply
    Jacob Smith
    19 April 2024

    Hi Jill,

    Thank you for your question.

    The UK’s national cancer screening programmes are effective tools to help spot cancers at an early stage, or even prevent them. We know that cancer screening saves thousands of lives each year. But no screening test is perfect. There are potential harms, such as false negatives or false positives, or picking up cancers that would not have gone on to cause any problems if they were never detected (overdiagnosis). That’s why cancer screening is offered at ages when the benefits are biggest, and the harms are smallest. 

    Eligibility for screening programmes is decided by an independent organisation called the National Screening Committee (NSC) based on the best scientific evidence and the balance of harms and benefits. You can read more about this here: https://www.cancerresearchuk.org/about-cancer/cancer-symptoms/spot-cancer-early/screening/what-is-cancer-screening

    Cancer risk does increase with age, this is because build-up of DNA damage within our cells over time. However, for people over the recommended screening age the overall balance of harms and benefits are less clear, and the risks of screening may be greater. If someone would like to be screened but is older than the age range, they can discuss their risk and the balance of benefits and risks with their GP, or in some nations call the relevant screening helpline to ask to be screened for breast or bowel cancer.

    It’s important to remember that screening is for people without symptoms. So whatever someone’s age, if they notice anything unusual for them, they should speak to their doctor.

    I hope this information is helpful.

    Jacob, Cancer Research UK

  • John Markey
    17 April 2024

    The more screening more lives will be saved

  • Julia D
    17 April 2024

    I believe invitations to breast screening stop at age 70 (?) but why do they stop
    when the risk of cancer increases with age?

  • reply
    Jacob Smith
    19 April 2024

    Hi Julia,

    Thank you for your question.

    The UK’s national cancer screening programmes are effective tools to help spot cancers at an early stage, or even prevent them. We know that cancer screening saves thousands of lives each year. But no screening test is perfect. There are potential harms, such as false negatives or false positives, or picking up cancers that would not have gone on to cause any problems if they were never detected (overdiagnosis). That’s why cancer screening is offered at ages when the benefits are biggest, and the harms are smallest. 

    Eligibility for screening programmes is decided by an independent organisation called the National Screening Committee (NSC) based on the best scientific evidence and the balance of harms and benefits. You can read more about this here: https://www.cancerresearchuk.org/about-cancer/cancer-symptoms/spot-cancer-early/screening/what-is-cancer-screening

    Cancer risk does increase with age, this is because build-up of DNA damage within our cells over time. However, for people over the recommended screening age the overall balance of harms and benefits are less clear, and the risks of screening may be greater. If someone would like to be screened but is older than the age range, they can discuss their risk and the balance of benefits and risks with their GP, or in some nations call the relevant screening helpline to ask to be screened for breast or bowel cancer.

    It’s important to remember that screening is for people without symptoms. So whatever someone’s age, if they notice anything unusual for them, they should speak to their doctor.

    I hope this information is helpful.

    Sophie, Cancer Research UK

  • Keith D
    17 April 2024

    It is a shame you did not include in your article the eligibility factors (e.g. age groups) for inclusion in these three screening programmes.

  • reply
    Jacob Smith
    18 April 2024

    Hi Keith,

    Thanks for your comment. For more information on screening and to check your eligibility for all three cancer screening programmes, visit: https://www.cancerresearchuk.org/about-cancer/screening

    I hope that helps,
    Jacob, Cancer Research UK

Tell us what you think

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