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This publication is available at https://www.gov.uk/government/publications/leaflet-thinking-of-having-a-private-screening-test/private-screening-important-facts
If you live in England, there are some important facts you need to know before you make a decision.
Good health is something we all value and many of us take positive steps to stay as healthy as we can – perhaps through a balanced diet, regular exercise or stopping smoking.
We can also have health checks, called ‘screening’, to spot problems before they get too serious and before symptoms develop.
The NHS offers a number of screening tests throughout our lifetime, from pregnancy and birth right through to retirement. Private companies offer health screening too – sometimes called ‘health MOTs’, ‘health checks’ or ‘preventative tests’.
1. Screening pros and cons
People need information about the condition being screened for and the whole screening pathway before deciding whether or not to accept the test. This is because even the best screening test may not be 100% accurate. Tests may not always give clear-cut answers and the results could even be confusing.
1.1 False positive results
These suggest you have a problem when in fact you don’t. They can result in further tests and procedures that you don’t need and a lot of unnecessary worry.
1.2 False negative results
These miss a problem altogether. You may go away feeling relieved, and brush aside any signs of trouble later on – thinking that everything must be fine.
2. NHS screening – balancing benefit with risk
The NHS has thought very carefully about these issues, taking advice from a group of experts called the UK National Screening Committee (UK NSC). We only run screening programmes when good evidence shows that the benefits outweigh any risks. Some screening tests are very good and can be useful in preventing or reducing the risk of disease. However, other screening tests can do more harm than good. The NHS does not offer screening when it can do more harm than good.
The NHS also offers a complete service, not just a test – making sure you understand why you’ve been offered screening, what the outcomes might be, if there are any down sides and what your options are for each outcome. We make sure that any care or treatment you may need is in place. There are 11 national screening programmes in England.
3. What is screening?
It can be helpful to think of screening like a sieve. In the diagram above, a large group of people are invited for the test. The screening test is represented by the sieve. Most people who decide to accept the offer of being screened pass through the sieve. This means they are at low risk of having the condition that the test is looking for.
The people left in the sieve are identified as high risk and are therefore offered further investigation. This may mean they have the condition being screened for but further (diagnostic) tests may be needed to confirm.
In antenatal screening, a high risk screening result could mean that the mother, father or the unborn baby has the condition being tested for. Following a high risk result, options may include further tests, treatment, advice and support. In NHS screening programmes, people are given clear information to help them make their own choices at each stage.
If you’d like to find out more, try the Making Sense of Screening guide from Sense About Science.
4. Private screening
Private companies offer a wide range of health checks, from simple blood tests and physical examinations to full body scans and screening for serious conditions like aneurysms or heart failure. Some of the tests offered by private companies are not recommended by the UK NSC because it is not clear that the benefits outweigh the harms. If you’re thinking about paying for any of these checks, it’s worth asking the following questions first.
4.1 What do I hope to gain from this test?
Very importantly, screening is not for people with symptoms. If you have any symptoms, go to your doctor.
If you don’t have any symptoms you’re probably looking for peace of mind. Are you sure this test is going to offer that? For example, an ‘MOT’ is limited in what it covers, so can’t really offer a clean bill of health. Look for clear, balanced information on what’s being tested, including the potential harms. If you already know that you should take some exercise and cut down on alcohol or cigarettes, will this test tell you anything new?
4.2 Can I get the information I need another way?
4.3 Can I get this test on the NHS?
Some companies offer screening for conditions already covered by a free NHS programme. Ask yourself how the private test differs and try to compare the whole service, not just the test itself.
4.4 Is the screening company properly regulated?
It is a legal requirement that all providers of screening services in England are registered with the Care Quality Commission.
4.5 What does the fee cover?
Make sure you understand what you’re paying for. Will the company charge extra to follow up your results? If so, how much will it cost?
4.6 Can the test do more harm than good?
Some tests carry a risk in themselves (such as CT scans, which use radiation). Has the company provided balanced information about the risk? Is this outweighed by the benefit of the test? Pros and cons can be hard to judge, so ask for the facts in writing and make sure the company offers you the chance to discuss any concerns with a professional.
4.7 What if the test picks something up?
The obvious selling point for screening is that if you can catch a problem early, you can do something about it. Make sure this is really true for the test you’re considering. If it picks up a problem, is there a treatment available that is also acceptable to you? If the answer is ‘no’, you might prefer not to have the test at all.
4.8 What if there are no clear results?
If there’s a chance that you’ll need more tests, ask what they might involve, how much they cost and who will be doing them.