1. Women’s Health Evening Portishead Medical Group Monday 12 th October 7.30-9pm

2. Introduction Mary Adams, North Somerset CCG Dr Kate Wood, PMG Dr Emily Lake, PMG Dr Gerwyn Owen, PMG Mary Adams, North Somerset CCG Dr Kate Wood, PMG Dr Emily Lake, PMG Dr Gerwyn Owen, PMG

3. Topics to be Covered Disease screening for women Hormone replacement treatment Vaginal Prolapse Osteoporosis Questions on any other concerns Disease screening for women Hormone replacement treatment Vaginal Prolapse Osteoporosis Questions on any other concerns

4. Screening Programmes in the UK What is screening? Why do we screen? What is screening? Why do we screen?

5. Wilson Criteria for Screening the condition should be an important health problem the natural history of the condition should be understood there should be a recognisable latent or early symptomatic stage there should be a test that is easy to perform and interpret, acceptable, accurate, reliable, sensitive and specific there should be an accepted treatment recognised for the disease treatment should be more effective if started early there should be a policy on who should be treated diagnosis and treatment should be cost-effective case-finding should be a continuous process the condition should be an important health problem the natural history of the condition should be understood there should be a recognisable latent or early symptomatic stage there should be a test that is easy to perform and interpret, acceptable, accurate, reliable, sensitive and specific there should be an accepted treatment recognised for the disease treatment should be more effective if started early there should be a policy on who should be treated diagnosis and treatment should be cost-effective case-finding should be a continuous process

6. Breast Cancer Screening Incidence rate is 125.1/100,000 (men 0.9) Eligible women, aged 50 to 70, receive an invitation letter explaining: the programme the benefits and risks of breast screening Women do not always receive an invitation when they turn 50. They can expect their invitation within 3 years of their 50th birthday. Women cannot walk in and request breast screening unless they are over 70, when they can request screening every 3 years Incidence rate is 125.1/100,000 (men 0.9) Eligible women, aged 50 to 70, receive an invitation letter explaining: the programme the benefits and risks of breast screening Women do not always receive an invitation when they turn 50. They can expect their invitation within 3 years of their 50th birthday. Women cannot walk in and request breast screening unless they are over 70, when they can request screening every 3 years

7. Breast Cancer Screening Early detection and treatment Screening for high risk groups where significant family history ( first degree relatives) Evaluation of the scheme has demonstrated more new cancers found and treated early Debates Early detection and treatment Screening for high risk groups where significant family history ( first degree relatives) Evaluation of the scheme has demonstrated more new cancers found and treated early Debates

8. Cervical Cancer Screening Programme Incidence rate in UK 8.9/100,000 NHS cervical screening programme is available to women aged 25 to 64 in England Women aged 25 to 49 receive invitations every 3 years. Women aged 50 to 64 receive invitations every 5 years. The HPV vaccination programme started in 2008. Vaccinations will not have an impact on incidence for many years; vaccinated women should continue accepting offers of cervical screeningHPV vaccination programme Incidence rate in UK 8.9/100,000 NHS cervical screening programme is available to women aged 25 to 64 in England Women aged 25 to 49 receive invitations every 3 years. Women aged 50 to 64 receive invitations every 5 years. The HPV vaccination programme started in 2008. Vaccinations will not have an impact on incidence for many years; vaccinated women should continue accepting offers of cervical screeningHPV vaccination programme

9. Cervical Cancer Screening Programme What happens if screening is positive? Colposcopy, biopsy Treatment What happens if screening is positive? Colposcopy, biopsy Treatment

10. Bowel Cancer Screening Programme Incidence rate 37.6/100,000 Stool sample Screening every 2 years to all men and women aged 60-74 Positive result leads to colonoscopy usually Treatment If older than 74 then can request a kit by ringing 08007076060 Incidence rate 37.6/100,000 Stool sample Screening every 2 years to all men and women aged 60-74 Positive result leads to colonoscopy usually Treatment If older than 74 then can request a kit by ringing 08007076060

11. Infectious Diseases in Pregnancy Screening The infectious diseases in pregnancy screening (IDPS) programme currently screens for: HIV hepatitis B syphilis rubella susceptibility The infectious diseases in pregnancy screening (IDPS) programme currently screens for: HIV hepatitis B syphilis rubella susceptibility

12. Sickle Cell and Thalassaemia Screening It screens for: genetic carriers for sickle cell, thalassaemia and other haemoglobin disorders genetic carriers for sickle cell, thalassaemia and other haemoglobin disorders sickle cell disease thalassaemia haemoglobin disorders It offers screening to: all pregnant women fathers-to-be, where antenatal screening shows the mother is a genetic carrier all newborn babies, as part of the newborn blood spot screening programmenewborn blood spot screening programme It screens for: genetic carriers for sickle cell, thalassaemia and other haemoglobin disorders genetic carriers for sickle cell, thalassaemia and other haemoglobin disorders sickle cell disease thalassaemia haemoglobin disorders It offers screening to: all pregnant women fathers-to-be, where antenatal screening shows the mother is a genetic carrier all newborn babies, as part of the newborn blood spot screening programmenewborn blood spot screening programme

13. Diabetic Eye Screening This evidence shows that early identification and treatment of diabetic eye disease could reduce sight loss. The main treatment for diabetic retinopathy is laser surgery. The eligible population for DES is all people with type 1 and type 2 diabetes aged 12 or over. People already under the care of an ophthalmology specialist for the condition are not invited for screening. The programme offers pregnant women with type 1 or type 2 diabetes additional tests because of the risk of developing retinopathy. Screening gives people with diabetes and their primary diabetes care providers information about very early changes in their eyes. Early warnings allow people to take preventative action to stop serious retinopathy developing. This evidence shows that early identification and treatment of diabetic eye disease could reduce sight loss. The main treatment for diabetic retinopathy is laser surgery. The eligible population for DES is all people with type 1 and type 2 diabetes aged 12 or over. People already under the care of an ophthalmology specialist for the condition are not invited for screening. The programme offers pregnant women with type 1 or type 2 diabetes additional tests because of the risk of developing retinopathy. Screening gives people with diabetes and their primary diabetes care providers information about very early changes in their eyes. Early warnings allow people to take preventative action to stop serious retinopathy developing.

14. Free NHS Health Checks Men and women between 40-74 invited to have one Every 5 years Family History and Lifestyle Questions Height, weight, BMI, BP Cholesterol Blood glucose if at risk due to family history, raised blood pressure or obesity Advice about smoking, exercise, alcohol and dementia awareness Men and women between 40-74 invited to have one Every 5 years Family History and Lifestyle Questions Height, weight, BMI, BP Cholesterol Blood glucose if at risk due to family history, raised blood pressure or obesity Advice about smoking, exercise, alcohol and dementia awareness

15. Conclusion Any questions Conclusion Any questions