Section 2 - Background

Screening aims to detect the early stages of disease or prevent disease occurring. Through identification of people at higher chance of having a health condition, more effective treatment options can be offered, or information provided to inform decision making about their future care. Screening can also reduce the chance of developing a serious condition, preventing ill-health and the harm that would have otherwise occurred.  

The Screening Division delivers the seven national screening programmes in Wales: 

1. Breast Test Wales     

2. Bowel Screening Wales  

3. Cervical Screening Wales      

4. Newborn Bloodspot Screening Wales  

5. Newborn Hearing Screening Wales  

6. Diabetic Eye Screening Wales 

7. Wales Abdominal Aortic Aneurysm Screening Programme  

The Screening Division also coordinates and manages the Antenatal Screening Wales clinical network with screening delivered by health boards in Wales as part of routine antenatal care during pregnancy. 

Each of the programmes has a different eligible population cohort who are invited for screening at different time intervals (table 1).  

Table 1: Invited Population Cohorts for National Screening Programmes in Wales 

*a programme of optimisation of bowel screening is underway, with a phased move towards an age range of 50-74 over the next few years 

**routine recall for participants who did not have HPV found in sample aged 25 to 49 years changed to 5 years from January 2022 

*** Low Risk Recall Pathway introduced in July 2023 with a screening interval of 2 years for those eligible (participants with two screening results with no evidence of eye disease in either eye since April 2019) 

Whether or not to take part in screening is a choice for the individual that is consistent with their values and unique circumstances. However, some people do not actively make a decision to decline screening, but are unable to take up their offer due to a range of interlinked barriers. These barriers may include logistical or physical challenges driven by economic or environmental factors that reduce access to locations where screening is taking place. Other people may not have received information in a way that enables them to gain the necessary knowledge to make an informed choice. Others may not consider preventative screening as part of their social norm or cultural identity. These barriers may be relevant at a national or local level and may be specific to a programme or relate to a community or individual. 

All adult screening programmes were paused from 19 March 2020 due to the COVID-19 pandemic, with a phased reinstatement of programmes beginning in June 2020 for Cervical Screening Wales, followed by Bowel Screening Wales in July 2020, Breast Test Wales and Wales Abdominal Aortic Aneurysm Screening Programme in August 2020 and Diabetic Eye Screening Wales in September 2020. The temporary pause when participants could not be screened was followed by reduced capacity to invite participants for screening during the reinstatement of services. The recovery of screening programmes, where all delayed participants have caught up, was achieved for Bowel Screening in October 2021 and Cervical Screening in December 2021 and Abdominal Aortic Aneurysm Screening in March 2023 with full recovery in Breast Test Wales and Diabetic Eye Screening Wales still progressing.