Screening: What you need to know

  • Cancer screening is the process of testing samples from healthy people with no symptoms.
  • Common cancers like breast cancer, bowel cancer and cervical cancer are all screened for by the National Screening Service of Ireland.
  • By taking up a screening appointment when you are invited to attend, you can stay on top of your health and detect cancer in it’s earliest stages. 

Testing for cancer, or for conditions that may lead to cancer, in people who have no symptoms is called screening.

In some cases, cancer can begin to develop without the person experiencing any symptoms. By carrying out screening on people that appear to be healthy, we can help to detect and treat pre-cancerous and cancer in its earliest stages, drastically improving the survival rates and treatment options for those diagnosed. 

In Ireland, our national screening service provides free screening programmes for breast, cervical and bowel cancer through their BreastCheck, CervicalCheck and BowenScreen services. 

If results acquired from screening services return as abnormal, those tested are then referred on for further testing, treatment, or support to ensure every aspect of care is catered for. 

Not all cancers are screened for. Screening is recommended only for those cancers where screening has a proven life-saving effect that substantially outweighs the potential harm of examining very large numbers of people who may never have the target cancer. 

How is cancer screened for?

Breast cancer:  Breast cancer screening uses an X-ray image called a mammogram to check the breasts for signs of cancer. It can help detect cancers that are too small to be felt and therefor works to detect cancer in its earliest stages. The earlier a breast cancer is found; the more effective treatment may be. Screening does not prevent breast cancer from developing, but it may find  it sooner, when the chance of successful treatment is higher. 

Cervical cancer: Cervical screening is used to detect early abnormalities that, if left untreated, could lead to cervical cancer. According to the European Cancer League, 9 out of 10 invasive cervical cancer can be prevented by screening. Screening in conjunction with the rolling out of HPV vaccines [link to vaccine page] could help to reduce your risk of dying from cervical cancer considerably. 

There are two tests used to screen for abnormalities in the cervix – an internal Pap test which takes samples of cells from the surface of the cervix for further testing, and the newer model, the HPV test. 

HPV testing is used to check for infection of HPV as almost all cases of cervical cancer are caused by high risk strains of HPV. As of March 2020, the Irish government are rolling out HPV testing as a form of screening for cervical cancer. Everyone registered for CervicalCheck will first undergo HPV testing to see if there is HPV in your system. 

If the test comes back positive, those tested will be screened for abnormal cells. By testing for the presence of HPV first, and if the infection is detected early, those tested can be monitored and offered treatment in an effort to eradicate cervical cancer.

Bowel Cancer: The BowelScreen home kit aims to detect bowel cancer (or conditions that can lead to bowel cancer) at an early stage, when there is a good chance that treatment will be successful. The FIT test, or faecal immunochemical test works to detect microscopic drops of blood in the stool that can indicate the early development of bowel cancer.  

If this test comes back positive for blood in the stool, you may be referred on for a colonoscopy for further investigation. A colonoscopy is a medical procedure in while a thin flexible camera is inserted through the anus into the bowel to take a closer look for signs of cancer such as polyps. When detected early, bowel cancer has a 90% survival rate five years after diagnosis.

What is the age of eligibility for screening services in Ireland?

Breast cancer: BreastCheck, Ireland’s, breast cancer screening service is available to women aged between 50 to 69Those on the BreastCheck registry will be invited to take part in routine mammograms at regular intervals. You can join the breast check register here or freephone 1800 45 45 55.

Cervical cancer: CervicalCheck offers free smear testing at regular intervals to women aged between 25 and 65. You will receive your invitation to take part in CervicalCheck by mail if you are on the registry. To check or sign up to the registry, click here or freephone 1800 45 45 55. 

Bowel Cancer: BowelScreen offers their free at home FIT kit to those between the ages of 60-69. Those on the BowelScreen register will be sent the home kit along with step by step instructions on how to administer the test at home. The test is then sent back for testing. You can check that you are signed up to the BowelScreen registry here or freephone 1800 45 45 55. 

Is screening mandatory?

In Ireland, cancer screening is not mandatory, but it is highly recommended you take up your invitation to screening when it arrives. Screening works by creating opportunities from those that fall into a certain age bracket to help monitor health and reduce the risk of receiving a late stage or terminal cancer diagnosis when early detection is possible. 

Does screening reduce your risk of developing cancer? 

Breast Cancer: Mammography is the best available screening method for finding small cancers that you cannot feel yourself, but it may not pick up cancer in its smallest form. Therefore it is important receive screening regularly when invited. The risk of missing a cancer during a screening depends on a woman’s age and the density of her breasts. The risk is higher for younger women or women under 40 because breast tissue is usually more dense  and so mammograms are not recommended for this age group. However, this does not mean if you notice changes to your breast you should allow them to go unchecked. If you have any concerns, speak to your GP without delay. 

Cervical Cancer: If you undergo screening regularly, you are unlikely to develop a cancer since almost all cervical changes that could develop into cancer will be detected and treated in time. Nine out of 10 invasive cervical cancers can be prevented by regularly undergoing screening and by receiving the HPV vaccine. Refer back to HPV page……

Bowel Cancer: While BowelScreen is not 100% reliable , the newer faecal immunochemical test (FIT) have shown far more consistent results and fewer cancers are missed. The FIT test tests for microscopic blood traces in the stool that cannot be seen with the naked eye, not the presence of cancer so further testing is required to determine the presence of cancer. 

Cancer is a slow developing disease, so many of these cancers can be detected at the next screening test or examination, hence the importance of regular participation in screening. 

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