Screening Tests

Detecting bowel cancer early can give you a better chance of survival. One of the easiest ways to look for any abnormality is by examining a stool sample for blood. But Ramsay hospitals can also offer a number of other tests which include:

• Stool testing- to test for blood hidden in small poo samples
• Colonoscopy - a long flexible tube with a light and a tiny camera is inserted through your back passage to examine your large bowel lining,If polyps are seen they can be cut away and sent for examination.A colonoscopy is particularly suitable for people with a family history of colorectal cancer who fear they may also be at risk.
• Flexible sigmoidoscopy - a shorter flexible telescope is used to look inside your rectum and the lower part of your large bowel only
• CT colonography - an investigative procedure that is performed using a CT scanner that produces images of the inside and outside of the large bowel and rectum. This is less invasive but if suspected abnormalities are seen, the patient may need further interventions to establish what they are.

Find out more about bowel screening here.

Diagnosis of bowel or rectum cancer can include a barium enema, sigmoidoscopy, CT and MRI scans, and ultrasound.

A recent study found that screening using sigmoidoscopy (a flexible tube inserted into the bowel) to detect polyps and then removing them reduced the incidence of bowel cancer by a third in the 55-64 age group*. 

Find out more about colorectal cancer screening here.

Mammograms can provide your doctors with important information about your breasts and can pinpoint any changes in the breast tissue - often before you would notice any changes yourself. They are a detailed X-ray picture of your breasts which will show up both cancers and deposits of calcium which can be an early indicator of breast cancer developing.

Mammograms are not very painful and only take a few minutes. Many women, especially those with a family history of breast cancer, have regular mammograms to spot any early changes in the breast tissue.

Other types of breast screening:

• Breast MRI - uses magnetic waves to build up a detailed picture of your breasts. MRI scans are often used for younger women with denser breast tissue as can give a clearer image. Breast MRI is also used as a screening test for women who have a high risk of breast cancer.
• Ultrasound - sends high-frequency sound waves through your breast and converts them to images. Targeted ultrasound allows your doctor to look at a specific breast area of concern.

Find out more about breast screening here.

This involves taking a few cells from your cervix and then examining them to see if there are any pre-cancerous changes; it is also known as a smear test. If abnormalities are found, it does not mean you have cancer but your doctor may suggest treatment to remove them or, in some cases, more regular screening to check for further changes. Although many women find the screening procedure uncomfortable, it is an excellent way of identifying abnormalities which might go on to become cancer if left untreated. Early diagnosis and treatment can prevent as many as 75 per cent of these cancers developing.

Prostate screening tests might include:

• Prostate-specific antigen (PSA) test - measures the level of prostate-specific antigen (PSA) in your blood. A high PSA might be a sign of prostate cancer or another condition.
• Digital rectal examination (DRE) – a physical examination of your prostate gland to check its size and for anything unusual.
• An MRI scan - detailed scan of your prostate to help identify signs of cancer.
• A biopsy – is the only way to know for sure if a man has prostate cancer. A core biopsy is often used where a thin, hollow needle is passed through the rectum wall or through the skin between the scrotum and anus into your prostate. The needle removes small samples and is repeated several times. It can also help determine the likelihood of growth and rate of spread of prostate cancer.

Find out more about prostate cancer screening here.

At present, there is no national lung cancer screening programme in the UK. In the meantime, diagnostic tests for lung cancer include:

• Chest X-ray - usually the first test for lung cancer but it cannot give a definitive diagnosis. A chest X-ray can show changes in your lungs that may be due to cancer or other lung conditions.
• CT scan - uses X-rays to make 3D images of the inside of your body. It detects smaller tumours and provides information about the tumour and lymph nodes.
• PET scan – shows if there are active cancer cells and can be used to stage lung cancer after diagnosis.
• Bronchoscopy and biopsy – a thin, flexible telescope, called a bronchoscope is used to see inside your airways and remove a small biopsy sample of tumour cells
• Percutaneous transthoracic needle biopsy - a needle under CT scanner guidance is inserted through your skin and into your lung where the suspected tumour is. A small amount of tissue is removed and tested in the laboratory.
• Endobronchial ultrasound scan (EBUS) – a newer procedure that combines bronchoscopy with an ultrasound scan. It looks inside your airways and locates your central chest lymph nodes to allow a biopsy to be taken from them. EBUS can show if you have lung cancer and the size of the tumour. It can also show if cancer has spread to other areas of your lung or your lymph nodes.

Other biopsy's

• Thoracoscopy - examines a particular area of your chest by taking tissue and fluid samples.
• Mediastinoscopy - a test to examine the centre of your chest. Under general anaesthetic, a cut is made at the bottom of your neck and a thin tube with a camera is passed into your chest. The doctor can see inside your chest and take samples of your lymph nodes. It shows if cancer cells have spread into the lymph nodes around the windpipe.
• Percutaneous needle biopsy – under local anaesthetic and CT guidance, a biopsy sample from a suspected tumour is taken by passing a needle through your skin and into your lung. The biopsy is tested in a laboratory.

Find out more about lung cancer screening here.

A biopsy is the first test required, which involves removing some or all of an affected lymph node for examination under a microscope. If your biopsy confirms a lymphoma diagnosis further testing is needed to check how far the lymphoma has spread. 

Further tests may include:

• blood tests – blood samples are taken throughout your diagnosis and treatment. They check your general health, the levels of red and white cells and platelets in your blood, and how well your liver and kidney are working.
• chest X-ray – pictures of the inside of your body check if the lymphoma has spread to your chest or lungs.
• bone marrow sample – a biopsy sample of bone marrow is taken from your pelvis to check if the lymphoma has spread to your bone marrow.
• CT scan – uses X-ray and a computer to take a series of X-rays that build up a 3D picture of the inside of your body to check the spread of cancer.
• MRI scan – uses magnetism and radio waves to build up a detailed picture of areas of your body to check the spread of cancer. It shows up soft tissue very clearly.
• PET scan – uses a mildly radioactive drug to show body areas that have more active cells than normal. It can check if tissue is active cancer or not. It is usually done at the same time as a CT scan to show how the tissues of different areas of the body are working.
• lumbar puncture – using a thin needle, a sample of cerebrospinal fluid is taken and examined to see if lymphoma cells have spread into the fluid around your brain and spinal cord.

Find out more about lymphoma screening here.

Initially, a urine and blood test is required to check for certain antibodies and proteins. If they suspect myeloma, you will be referred to haematologist for further tests and scans including X-rays, CT scans, MRI scans, and a biopsy sample of bone marrow.

Leukaemia tests might include:

• Blood tests – to check your full blood count, see if your cells are healthy, and to check how well your liver and kidneys are working.
• X-rays and scans - MRI scans, CT scans, PET scans, ultrasound scans or X-rays to create detailed pictures of the inside of your body.
• Bone marrow biopsy - a sample of bone marrow is removed and checked under a microscope.
• Genetic tests - looks for changes to the genes in your cells.
• Immunophenotyping - looks at proteins on the surface of your cells.
• Lumbar puncture - may be done if it’s suspected that acute leukaemia has spread to your nervous system.
• Lymph node biopsy - removing and examining a swollen lymph gland.

Find out more about leukemia screening here.