Question 1

What has to be true before a screening programme is justified?

Accepted Answer

Briefly, the condition must be an important health problem with an understood natural history and a recognisable early stage, the test must be simple, safe, precise and acceptable with an agreed cut-off, and the programme must have an effective intervention, trial evidence that it reduces mortality or morbidity, benefit that outweighs harm, value for money and quality assurance. The UK NSC sets this out in full as 20 criteria.

Question 2

What is the difference between lead-time and length-time bias?

Accepted Answer

Lead-time bias is the apparent lengthening of survival caused simply by diagnosing earlier, with the date of death unchanged. Length-time bias is the tendency of screening to preferentially detect slowly progressive disease, because fast-growing disease appears and presents between screening rounds. Overdiagnosis is related but distinct, since it concerns disease that would never have caused symptoms or death.

Question 3

Which adult screening programmes run in England?

Accepted Answer

Cervical screening for women and people with a cervix aged 25 to 64 every 5 years, breast screening every 3 years up to the 71st birthday, bowel screening with a FIT kit every 2 years from 50 to 74, a single AAA scan for men in the year they turn 65, and diabetic eye screening. Targeted lung screening for people aged 55 to 74 at high risk runs through lung health checks in some areas. Each nation sets its own policy, so ages can differ.

Question 4

Is prostate cancer screened for in the UK?

Accepted Answer

Not at population level, because screening is more likely to cause harm than good across the whole population. Since March 2026 the UK NSC recommends targeted PSA testing every 2 years for men aged 45 to 61 with a pathogenic BRCA2 variant and a family history of breast, ovarian, pancreatic or prostate cancer, and no targeted screening for other risk groups.

UK Screening Programmes

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