Statutory guidance

Population screening: risk factors, signs and symptoms, more information

Updated 19 March 2021

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This publication is available at https://www.gov.uk/government/publications/nhs-population-screening-support-for-carers/population-screening-support-for-carers-screening-programmes-overview

Below is an overview of the NHS population screening programmes with important information for carers.

1. Abdominal aortic aneurysm (AAA) screening

1.1 Risk factors

Men are 6 times more likely to have an abdominal aortic aneurysm (AAA) than women. The chance of having an aneurysm also increases with age, which is why the NHS only invites for screening men aged 65 or over. Other AAA risk factors include:

  • high blood pressure
  • chronic obstructive pulmonary disease
  • high blood cholesterol
  • a family history of AAA
  • cardiovascular disease, such as heart disease or a history of stroke
  • smoking or having previously smoked

1.2 Signs and symptoms

An AAA usually does not show any symptoms but in rare cases, they can include:

  • a pulsing sensation in the tummy (like a heartbeat)
  • tummy pain that does not go away
  • lower back pain that does not go away

If an AAA bursts, it can cause:

  • sudden, severe pain in the tummy or lower back
  • dizziness
  • sweaty, pale and clammy skin
  • a fast heartbeat
  • shortness of breath
  • fainting or passing out

It’s important to get any of these symptoms checked out. Do not wait until the person’s screening appointment.

1.3 Checklist of things to consider

When considering AAA screening for the person cared for, things to consider are:

1.4 More information

For information on AAA screening visit NHS.UK

This short video explains what normally happens during an AAA screening appointment.

AAA screening

2. Antenatal and newborn screening

There are 8 different sets of tests for pregnant women and newborn babies. They are:

The NHS recommends:

  • infectious diseases in pregnancy screening
  • diabetic eye screening for pregnant women with diabetes
  • newborn blood spot screening
  • newborn and infant physical examination
  • newborn hearing screening

This is because results from the above tests can help make sure people with diabetes, pregnant women and babies get urgent treatment for serious problems.

2.1 Checklist of things to consider

When considering antenatal and newborn screening for the person cared for, things to consider are:

2.2 More information

More information is available on:

You can also read:

3. Bowel cancer screening

3.1 Risk factors

Factors known to increase the risk of bowel cancer include:

  • age – the risk increases as people get older
  • diet – eating a lot of certain foods increases the risk, including red and processed meats
  • a family history of bowel cancer
  • a previous diagnosis of bowel cancer
  • smoking
  • drinking alcohol
  • being overweight
  • not doing enough exercise
  • digestive disorders – such as Crohn’s disease or ulcerative colitis
  • certain genetic conditions

3.2 Signs and symptoms

The 3 main symptoms of bowel cancer are:

  • a persistent change in bowel habit – which is usually having to poo more or poo becoming more runny
  • persistent blood in the poo which happens for no obvious reason or happens at the same time as a change in bowel habit
  • persistent lower abdominal (tummy) pain, bloating or discomfort that is caused by eating and may be associated with loss of appetite or significant unintentional weight loss

It is important to get any of these symptoms checked out. Do not wait until the person’s next scheduled screening test.

3.3 Checklist of things to consider

When considering bowel cancer screening for the person cared for, things to consider are:

3.4 More information

For more information on bowel cancer screening visit:

4. Breast screening

4.1 Risk factors

Factors known to increase the risk of breast cancer include:

  • age – the risk increases as women get older
  • a family history of breast cancer
  • a previous diagnosis of breast cancer
  • a previous non-cancerous (benign) breast lump
  • being tall, overweight or obese
  • drinking alcohol

4.2 Signs and symptoms

Breast pain is not usually a symptom of breast cancer. Women should see their GP if they notice any of these symptoms:

  • a change in the size or shape of one or both breasts
  • discharge from either nipple
  • a lump or swelling in either armpit
  • dimpling on the skin of the breasts
  • a rash on or around the nipple
  • a change in the appearance of the nipple, such as becoming sunken into the breast

More information on checking breasts for signs of breast cancer is available.

It’s important to get any of these symptoms checked out. Do not wait until the person’s next screening appointment.

4.3 Checklist of things to consider

When considering breast screening for the person cared for, things to consider are:

4.4 More information

For more information on breast screening visit:

The Do The Test – Go For It! short film features women with learning disabilities encouraging others not to be scared of screening and to have the test if they want to.

5. Cervical screening

5.1 Risk factors

Almost all cases of cervical cancer are caused by the human papillomavirus (HPV). HPV infection is very common – most women will have HPV at some point in their lives. However, HPV infection rarely leads to cervical cancer.

Additional risk factors that may affect a woman’s chance of developing cervical cancer include:

  • smoking
  • having a weakened immune system
  • taking the oral contraceptive pill for more than 5 years – this risk is not well understood
  • having more than 5 children, or having them at an early age (under 17 years old)
  • the woman’s mother having taken the hormonal drug diethylstilbestrol while pregnant with the person

A GP can explain the above risks.

5.2 Signs and symptoms

Early signs of cervical cancer include:

  • unusual bleeding from the vagina (such as bleeding during or after sex, between periods or after going through the menopause)
  • pain and discomfort during sex
  • unusual or unpleasant discharge (liquid) from the vagina
  • pain in the lower back or pelvis

Later signs of cervical cancer include:

  • severe pain in the side or back caused by the kidneys
  • constipation
  • peeing or pooing more often than normal
  • losing control of the bladder (urinary incontinence) or losing control of the bowels (bowel incontinence)
  • blood in pee
  • swelling of one or both legs
  • severe vaginal bleeding

It is important for anyone who has any of these symptoms to get them checked out. Do not wait until the person’s next screening appointment.

5.3 Checklist of things to consider

When considering cervical screening for the person cared for, things to consider are:

5.4 More information

For more information on cervical screening visit:

6. Diabetic eye screening (DES)

6.1 Risk factors

A person who has diabetes is at greater risk of developing diabetic retinopathy if they:

  • have had diabetes for a long time
  • have a persistently high blood sugar (blood glucose) level
  • have high blood pressure
  • have high cholesterol
  • are pregnant
  • are of Asian or Afro-Caribbean background

Keeping blood sugar, blood pressure and cholesterol levels under control can reduce the chances of developing diabetic retinopathy.

6.2 Signs and symptoms

People who have diabetic retinopathy very rarely develop any symptoms. If any symptoms do develop, they will usually be in the later stages of the disease. This is why screening is so important – so that diabetic retinopathy can be spotted early.

On rare occasions that signs or symptoms of diabetic retinopathy develop, they usually include:

  • worsening vision
  • blurred or patchy vision
  • eye pain or redness

Only in extremely rare and serious cases, signs and symptoms include sudden vision loss or shapes floating in the person’s field of vision (floaters).

These symptoms do not necessarily mean someone has diabetic retinopathy, but it is important to get them checked out. Do not wait until the person’s next screening appointment.

6.3 Checklist of things to consider

When considering diabetic eye screening for the person cared for, things to consider are:

6.4 More information

For more information on diabetic eye screening visit:

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