UK screening programmes

Before and after birth

• Antenatal blood tests at booking: HIV, hepatitis B and syphilis, with sickle cell and thalassaemia screening offered ideally by 10 weeks.
• Combined test for Down's syndrome: nuchal translucency with hCG and PAPP-A, from 11+2 to 14+1 weeks. The quadruple test is used from 14+2 to 20+0 weeks if a woman books too late.
• A higher chance result is 1 in 150 or higher. She is offered NIPT, or a diagnostic test (CVS at 11 to 14 weeks, amniocentesis from 15 weeks).
• Anomaly scan: 18+0 to 20+6 weeks.
• Gestational diabetes: an OGTT at 24 to 28 weeks for women with risk factors (BMI over 30, a previous baby of 4.5 kg or more, a first-degree relative with diabetes, high-risk family origin), and early in pregnancy after previous gestational diabetes.
• Newborn physical examination (NIPE): within 72 hours and again at 6 to 8 weeks: eyes, heart, hips and testes.
• Newborn blood spot: on day 5 (days 5 to 8), for sickle cell disease, cystic fibrosis, congenital hypothyroidism and six inherited metabolic diseases.
• Newborn hearing screening is offered to every baby.

Hips, eyes and testes at the newborn check

• Abnormal hip examination: hip ultrasound by 2 weeks of age.
• Hip risk factors (breech at or after 36 weeks, or a first-degree family history): hip ultrasound by 6 weeks.
• Absent or abnormal red reflex: ophthalmology within 2 weeks.
• Both testes impalpable: senior paediatric review within 24 hours.

Cancer screening

• Cervical: people with a cervix aged 25 to 64. The sample is tested for high-risk HPV first. In England, HPV-negative people aged 25 to 49 are invited every 5 years (since July 2025), and 50 to 64 every 5 years.
• HPV positive with abnormal cells: colposcopy. HPV positive with normal cells: repeat in 12 months.
• Breast: women aged 50 up to their 71st birthday, every 3 years, by mammogram.
• Bowel: a home FIT kit every 2 years from 50 to 74.
• Lung: targeted lung screening with low-dose CT for people aged 55 to 74 who smoke or used to, being rolled out across England.
• Prostate: there is no population programme. In 2026 the UK National Screening Committee recommended targeted screening only for men aged 45 to 61 with a BRCA2 variant and a family history of related cancers, with a rollout in England planned from 2027. Other men aged 50 or over can ask for a PSA test after an informed discussion.

Other adult programmes

• Abdominal aortic aneurysm: a one-off ultrasound for men in the year they turn 65.
• 3.0 to 4.4 cm: scan every year.
• 4.5 to 5.4 cm: scan every 3 months.
• 5.5 cm or more, growth over 1 cm a year, or symptoms: refer to the vascular service.
• Diabetic eye screening: from age 12, every year, or every 2 years for people whose last two screens were normal.
• NHS Health Check: adults aged 40 to 74 without existing heart disease, diabetes or kidney disease, every 5 years.

The principles behind screening

• A screening test is offered to people without symptoms. Anyone with symptoms is investigated, not screened, whatever their age or last screen.
• Sensitivity is true positives divided by all with the disease; specificity is true negatives divided by all without it.
• Positive predictive value falls when the condition is rarer, so a screening programme in a low-risk group produces more false positives.
• Lead-time bias: survival looks longer because the diagnosis is made earlier, not because death is delayed.
• Length-time bias: screening finds more slow-growing disease, which has a better outlook anyway.
• The UK National Screening Committee advises ministers on which programmes the NHS offers.

Traps

• Screening a patient who has symptoms. Postmenopausal bleeding, a breast lump or rectal bleeding needs the NICE referral pathway, not the next screening invitation.
• Pregnancy and cervical screening: a pregnant woman who is due for screening has it about 12 weeks after the birth, unless there are symptoms.
• AAA screening is for men at 65. Women are not invited. An older man who missed his scan can ask to be screened.