sounds indeed like a fan's on its way out. It's very little to do with the fixing screws, the bearings are shot. Get a replacement from PC World for about a tenner. BUT - there are several sizes, might be best to bring along your old one. Oh, and if the new fan is thicker then you need new fixing screws too, but you should be able to replace it easily enough for an exact copy.
BTW - in the slim possibility that it's not your fan (you should check with the cover off, you can slow/stop a fan (but only for a second!) to check ) it could be either a cd drive has worked loose (tighten all screws) , or a harddrive heading for the hills. If it's the latter, back up your files now!