Screening tests for young adults


Throughout adolescence, the emphasis is on immunisations and counselling to prevent illness, injury, and early death. Attention is given to accident and injury prevention as well as health risks from sexual activity and high-risk pursuits such as smoking and substance abuse. Cervical screening is offered from the age of 18 to those young women who are sexually active, or from one or two years after first having sexual intercourse.


Related links

Healthdirect Australia
Cancerscreening.gov.au
Cancer Council Australia: Skin cancer
National Heart Foundation
Healthdirect Australia - STIs


Breast Cancer

Breast cancer is the most common cancer in women. In 2018, it is estimated that 1 in 8 women will develop breast cancer before age 85.

BreastScreen Australia provides free breast screening every two years for all well women without symptoms in Australia aged 50 to 74 years. Women aged 40 to 49 and those aged over 74 can also be screened free of charge, however they are not send invitation letters.

For younger women, breast awareness - awareness by a woman of the normal look and feel of her breasts, or examination as part of a regular medical examination is recommended.


Related links

BreastScreen Australia


Cervical Cancer

Many deaths from cervical cancer can be prevented through timely screening. Detection and treatment of precancerous lesions found with a cervical screening test (HPV test) can actually prevent cervical cancer, as well as find cervical cancer at an early stage when it is most curable.

From 1 December 2017, human papilloma virus screening has replaced the PAP smear in the National Cervical Screening Program. The following policy applies to women with no symptoms.

1. Routine cervical HPV screening should be carried out every five years for women aged 25 to 74 who have no symptoms or history suggestive of cervical pathology

2. All women who have ever been sexually active should start having cervical HPV screening after age 25, or one or two years after first having sexual intercourse, whichever is later. In some cases, it may be appropriate to start screening before 25 years of age

3. People aged 70 to 74 years will be invited to have a cervical screening test.
 

See the short video below for more on HPV testing and how it can help you avoid cervical cancer.

More information can be found at the National Cervical Screening Program.
 


Chlamydia

Genital Chlamydia trachomatis is the commonest sexually transmitted disease (STD) in Australia. Infection is an important reproductive health problem as 10-30% of infected women develop pelvic inflammatory disease (PID).

Around 9% of sexually active young women are likely to be infected and around 70% of infections are asymptomatic and so, are liable to remain undetected, putting women at risk of developing PID. Screening for genital chlamydia infection may reduce pelvic inflammatory disease and ectopic pregnancy.

Screening for genital chlamydia infection may reduce pelvic inflammatory disease and ectopic pregnancy.

Screening can be done from a urine test (first catch urine not mid stream) or a genital swab and is done by nucleic acid amplification which is where the laboratory uses a sensitive test to look for genetic material from the organism.


Related links

Healthdirect Australia: Sexually transmitted infections


High cholesterol

Under 20 years old:

Population screening for hypercholesterolaemia in children is currently not recommended in Australia. Case finding by family tracing is an effective strategy for identifying most children with familial hypercholesterolaemia. Screening should be based on:

  • a family history of familial hypercholesterolaemia or
  • premature cardiovascular disease (before 55 years in men, before 60 years in women)

Children to be screened should be tested before the age of 10 years but usually not before the age of two years. The age chosen should take into account the onset of coronary artery disease within the family and the wishes of the parents.

Blood samples: non-fasting capillary or venous samples can be used for screening measurement of total cholesterol. If the concentration is above 5.5 mmol/L, which is the 95th centile in childhood, a fasting venous blood sample should be taken for measurement of total and high-density lipoprotein (HDL) cholesterol and triglyceride. The low density lipoprotein (LDL) cholesterol can then be calculated.

20 years and older:

Widespread population screening is not currently recommended in Australia. The Australian guidelines recommend targeting those most at risk, i.e. those most likely to benefit from intervention. This is determined by the presence of known risk factors, such as smoking, high blood pressure, diabetes, chronic kidney disease, familial hypercholesterolaemia, obesity/overweight, a family history of early heart disease, aboriginal or Torres Strait islander ethnicity.

Assessment is best done by a lipid profile, a blood test conducted after a 9 to 12 hour fast, which determines your total cholesterol, LDL cholesterol, HDL cholesterol, and triglyceride levels.


Iron overload

While not recommended as a general screen, screening for iron overload disease is recommended based on known risk factors.

Hereditary haemochromatosis or iron overload disease, is the most common genetic disease in populations of North European origin, with a gene frequency as high as 1 in 8. Haemochromatosis causes the iron from a person's diet to accumulate in the body's organs. Over a lifetime and without treatment, serious and even fatal health effects can result.

General population screening is not recommended in Australia but screening of first-degree relatives of affected persons may be considered.


Skin cancer

Skin cancer is the most common cancer in Australia and accounts for about 80% of all new cancers diagnosed. 
Approximately 2 in 3 Australians will be diagnosed with skin cancer by the time they are 70. Non-melanoma skin cancer is more common in men, with almost double the incidence compared to women. In 2015, 2162 people died from skin cancer in Australia, 1520 from melanoma and 642 from non-melanoma skin cancers.

Both the Federal Government and the State Governments and Cancer Councils are active in skin cancer prevention programmes. However the Cancer Council of Australia and the Australasian College of Dermatologists do not recommend population-based screening for any type of skin cancer. They do recommend that individuals carry out self-monitoring for skin cancer.

See the Healthdirect Australia: skin cancer pages for information on screening and prevention.


Tuberculosis

While not recommended as a general screen, screening for tuberculosis (TB) is recommended based on known risk factors.

In Australia, the number of TB cases remains constant, about 1,000 new cases are diagnosed each year. Those individuals at risk for developing tuberculosis include HIV, being immunosuppressed (e.g. cancer, chronic kidney disease), migrants from high tuberculosis prevalence countries and healthcare workers. Typically, infected people do not feel ill or have symptoms but can reactivate and develop disease if treated with immunosuppressive medication or chemotherapy.

A tuberculin (Mantoux) skin test may be recommended if you are at risk of infection, have come in contact with a person infected with tuberculosis, in HIV-positive individuals, and in some individuals receiving immunosuppressive therapy. A blood test is also available called an interferon gamma release assay or Quantiferon and has the advantage of not cross reacting in people who have had the BCG TB vaccine.  

The skin or blood tests are mainly done to diagnose latent tuberculosis or for selecting people for the treatment of latent tuberculosis, and this is done through the TB health services.