NHS screening programmes in England: 2019 to 2020 – GOV.UK

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This publication is available at https://www.gov.uk/government/publications/nhs-screening-programmes-annual-report/nhs-screening-programmes-in-england-2019-to-2020
This data report covers the screening year from 1 April 2019 to 31 March 2020.
Please be aware that these data cover some of the time period during the COVID-19 pandemic at the end of March 2020. Therefore provider performance should be interpreted with caution. In addition, some providers were justifiably unable to make timely data returns or validate their data during this period.
From 1 April 2019 to 31 March 2020:
*The 15 newborn conditions screened for are:
AAA screening is offered to men when they turn 65 (cohort). Men aged 65 and over are most at risk of AAAs, and screening can help spot a swelling in the aorta at an early stage. Men aged over 65 who have not had AAA screening can contact their local service to arrange a test (self-referrals).
76.1% coverage of 2019 to 2020 screening cohort
Data source: AAA SMaRT
Date extracted: 20 July 2020
Some figures for AAA have been affected by the COVID-19 pandemic at the end of March 2020. Due to the COVID-19 pandemic response, validation of quarter 4 (Q4) data was voluntary. For more information about the effect of COVID-19 on AAA screening, see the AAA screening standards report for 2019 to 2020.
Bowel cancer screening is offered to men and women aged 60 to 74 (cohort), every 2 years. People over the invitation age range are not invited, but can request screening every 2 years (self-refer). Bowel cancer screening looks for polyps and early stage cancer. Removing polyps reduces the risk of bowel cancer developing.
Note that this data relates to FOBt testing.[footnote 2]
65.9% of people invited to participate were adequately screened
Data source: Bowel Cancer Screening IT system (BCSS), OBIEE reporting tool, national reports, FOBt Screening, fiscal year: 2019 to 2020
Data extracted: 29 March 2021
This data relates to the invited population only. Episodes originating from requests for screening or attendance at programme surveillance tests are excluded.
Making comparisons between the screening year 2019 to 2020 data and previous years needs to be treated with caution. This is because from April 2019, a new type of bowel cancer screening home testing kit stated to be rolled out. Both old and new test kit types are referred to as faecal occult blood test kits (FOBt kits). The old test kit was a guaiac kit (or gFOBt kit) and the new kit is a faecal immunochemical test kit (sometimes referred to as the ‘FIT’ kit).
There are many benefits to using the FIT kit, including increased uptake in groups with low participation rates such as men, ethnic minority populations and people in more deprived areas.
There is international and English programme pilot data to show that the new kit type increases screening participation and is a more sensitive test at the programme’s chosen threshold.
This means that the screening year 2019 to 2020 data shows more people adequately screened, more people requiring (and undergoing) further tests, and an increase in uptake and positive results when compared to previous years.
Breast screening is offered to women between the ages of 50 up to their 71st birthday (cohort), every 3 years. Women over the invitation age range are not invited, but can request screening every 3 years by contacting their local screening service (self-referrals). Breast screening detects cancers at an early stage when effective treatment is more likely.
82.9% of women aged 50 to <71 years old were invited within 36 months of their previous screening, or previous invitation if they did not attend
68.7% of eligible women invited attended for screening
NHS Digital is responsible for publishing official statistics for the NHS Breast Screening Programme.
Cervical screening is offered to women from the ages of 25 to 64 (cohort). Women aged 25 to 49 are invited every 3 years, and women aged 50 to 64 are invited every 5 years. Cervical screening detects types of human papillomavirus (HPV) that can cause abnormal cells in the cervix. Removing these abnormal cells can prevent cervical cancer developing.
70.2% of women aged 25 to 49 years were screened adequately within the previous 3.5 years (coverage)
76.1% of women aged 50 to 64 years were screened adequately within the previous 5.5 years (coverage)
NHS Digital is responsible for publishing official statistics for the NHS Cervical Screening Programme.
There was a national campaign in March 2019 encouraging women and people with a cervical to consider attending for cervical screening. In December 2019 the primary cervical screening test changed from cytology to HPV testing. Both these factors may have contributed to the difference in uptake in 2019 to 2020 and 2018 to 2019.
Diabetic eye screening is offered yearly to people aged 12 or over who have diabetes (cohort). Screening detects diabetic retinopathy, which can cause sight loss if left undiagnosed and untreated.
81.5% of people with diabetes who were offered screening completed testing
Some manual corrections made by individual services resulting in the sum of routine referrals to HES and DS not being equal to the total routine referrals.
Data source: Programme performance reports and quarter 4 quarterly submission.
Data collected June 2020.
R1 = Background retinopathy; R2 = Pre-proliferative retinopathy; R3A = Active proliferative retinopathy; R3S = stable treated proliferative retinopathy; M0 = No maculopathy; M1= Maculopathy.
Fetal anomaly screening is offered to eligible pregnant women at various points during the pregnancy (cohort). The tests are to detect the presence or chance of a range of conditions (see ‘Conditions screened for’ in the FASP programme overview).
During the COVID-19 pandemic, the FASP encouraged maternity services to continue screening where safe to do so. The lockdown period started only 8 days before the end of March 2020, so only a marginal effect on the data is seen.
84.0% screening coverage for Down’s syndrome, Edwards syndrome and Patau’s syndrome (T21/T18/T13)
99.1% screening coverage for fetal anomaly ultrasound
Data source: Down’s syndrome Screening Quality Assurance Support Service (DQASS)
For more information on FASP standards data, see the antenatal FASP screening standards report for 2019 to 2020.
Infectious diseases in pregnancy screening is offered to pregnant women (cohort), to detect HIV, hepatitis B and syphilis. Detection and treatment reduces the chance of passing on an infection to the baby, a partner or other family members.
During the COVID-19 pandemic, the IDPS programme encouraged maternity service to continue screening where safe to do so. The lockdown period started only 8 days before the end of March 2020, so only a marginal effect on the data is seen.
99.8% IDPS screening coverage (HIV, hepatitis B and syphilis)
Data source: maternity services (England)
For more information on IDPS standards data, see the antenatal screening standards report for 2019 to 2020.
Newborn and infant physical examination screening is offered for babies at 72 hours, and again between 6 and 8 weeks of age (cohort). The examination looks for problems with the baby’s eyes, heart, hips and testes.
There was some disruption to the screening programme in March 2020 due to COVID-19.
96.2% screening coverage by 72 hours
Data source is Smart 4 NIPE (S4N) / PMS.
Data extracted: 30 March 2021.
We have identified quality issues with the data submitted from S4N. Data is incomplete and may not reflect a full and accurate assessment of activity. There was not full national coverage of the IT system in screening year 2019 to 2020 so not all outcome data was entered on the system during that period.
Newborn blood spot screening is offered for babies up until their first birthday, with the exception of testing for cystic fibrosis which is only offered up until 8 weeks of age (cohort). Screening takes place for 9 conditions (see tables in sections 10.1 to 10.9 below and data for sickle cell disease in section 12 below). Newborn blood spot screening identifies conditions which can be treated to improve a baby’s health, and can help prevent severe disability or even death.
Due to the COVID-19 pandemic at the end of screening year 2019 to 2020, newborn screening laboratories were instructed to relax blood spot acceptance criteria on samples that would normally have been rejected, and also to accept day 4 samples. Together these factors may have affected the performance but the effect was limited to the lockdown period of 8 days at the end of March 2020.
97.9% of babies were tested and recorded on the Child Health Information System (CHIS) at 17 days
There were 953 babies who tested positive for a NBS-screened condition, and a further 54 babies were clinically diagnosed before screening.
Excludes 36 pre-term babies.
Data source: Newborn screening laboratories and Child Health.
Newborn hearing screening is offered to babies ideally within the first 4 to 5 weeks after birth (cohort). The test can be carried out up to the age of 3 months. Screening identifies permanent moderate, severe and profound deafness, and hearing impairment. Early detection enables interventions to improve language, speech and communication skills as the baby develops.
There was significant disruption to the screening programme in March 2020 due to COVID-19. This affected coverage and audiology assessment.
97.8% of babies with completed screening process by 4 weeks corrected age (hospital programmes – well babies, NICU babies) or by 5 weeks corrected age (community programmes – well babies)
Above figures exclude babies born or currently in Wales at time of data collection.
Data source: Smart 4 Hearing (S4H) / PMS
Data extracted: 30 March 2021.
Sickle cell and thalassaemia screening includes antenatal screening for pregnant women (ideally at 10 weeks’ gestation) and screening for fathers (if the baby’s mother is a genetic carrier). Sickle cell screening via newborn blood spot screening for babies takes place one week after birth (cohort). Antenatal SCT screening means parents can find out if they are carriers of the sickle cell or thalassaemia gene, and may therefore have passed it on to their baby.
There is no routine screening for babies at risk of inheriting thalassaemia major. However, most cases of beta thalassaemia major should be detected during newborn screening, but thalassaemia carriers are not.
During the COVID-19 pandemic, the SCT programme encouraged maternity services to continue screening as usual or within technical guidance. The lockdown period started only 8 days before the end of March 2020, so only a marginal effect on the data is seen.
99.7% screening coverage
Data source: see notes in tables above.
For more information on SCT standards data, see the antenatal screening standards report for 2019 to 2020.
Men registered with a GP in England and born between 1 April 1954 and 31 March 1955 and who have not already been treated for an AAA 2
NHS Bowel Cancer Screening is initially carried out using a home testing kit called a faecal occult blood test kit, or ‘FOBt kit’ for short. The kit is designed to look for small amounts of blood in participant’s poo, that wouldn’t normally be noticeable by eye. Finding blood doesn’t mean cancer has been detected, but means further tests, such as a colonoscopy, are usually advised. 
One invite per screening subject episode. A subject can have multiple episodes during their ‘bowel cancer screening lifetime’. Number of people invited does not include requests for screening such as over-age self-referrals, later responders or opt back-in episodes. 
Of those invited and adequately screened, the number with a FOBt outcome. Some screening subjects will need to return more than one test kit within an episode to achieve a definitive FOBt outcome. 
Of those invited and adequately screened, the number with a FOBt episode outcome of ‘further tests are needed’. All people with the outcome ‘further tests are needed’ are booked an appointment with a specialist screening practitioner (SSP) to discuss their test kit episode result and assess their fitness for further diagnostic tests, such as colonoscopy. 
The episode outcomes presented here are for the invited population only, for the specified screening year. Specifically, those invited who adequately participated in FOBt screening, were found to need further tests and went on to have a (one or more) diagnostic test within the screening episode. Episode outcomes are calculated from the findings of potentially multiple endoscopic or radiological tests within the screening episode.  2 3 4 5 6
Irregular findings can be for non-neoplastic diagnosis (such as diverticular disease, haemorrhoids, inflammatory bowel disease), non-adenomatous polyp (such as hyperplastic, inflammatory, Peutz-Jeghers polyp), non-neoplastic and non-adenomatous polyp diagnosis, or where radiological testing showed no polyps, but no histological confirmation was possible. 
Registered female population for ages 25 to 64 minus any women ceased for clinical reasons. 
Number of adequate tests minus number of negative samples. 
DQASS is the Down’s syndrome Screening Quality Assurance Support Service. Flags are assigned to a dataset of nuchal translucency (NT) and crown rump length (CRL) measurements. Flags indicate bias of the dataset. Green flag: NT bias ≤ 0.10mm. Amber flag: NT bias 0.11mm – 0.40mm. Red flag: NT bias > 0.40mm. Red4 flag: assigned if fewer than 25 paired measurements over 4 cycles. No flag: trainee sonographer has < 25 paired measurements. 
Figures based on key performance indicator (KPI) data. Exclusions were made where completed data was not submitted for all 4 quarters.  2 3 4 5 6 7 8
Figures based on annual standards data. Exclusions were made when data was incomplete or missing, not where trusts could not account for their whole cohort.  2 3 4 5 6 7 8 9
Figures based on KPI data. Exclusions were made where completed data was not submitted for all 4 quarters.  2 3 4
Based on provisional antenatal laboratory data (128 of 142 expected returns). Figures may differ to those published in the programme-specific data report for screening year 2019 to 2020.  2 3 4
Based on data submitted by PND laboratories and compiled by the National Congenital Anomaly and Rare Disease Registration Service (NCARDRS).  2
Based on provisional newborn laboratory data. Figures may differ to those published in the programme-specific data report for screening year 2019 to 2020.  2 3 4
Screen positive results include babies identified with FS, FSC, FS-other and FE
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