Head of CervicalCheck service ‘would welcome review’

Up to 15 women were identified in a 2014 audit of tests found to be incorrect

A coloured scanning electron micrograph of a cervical cancer cell.
A coloured scanning electron micrograph of a cervical cancer cell.

The clinical director of CervicalCheck, Professor Grainne Flannelly, has said the organisation would welcome a peer review of its performance.

Her comments came as a leading oncologist s warned the Cervical Check service will be jeapordised is there is not a transparent review of how incorrect smear test results were not communicated to patients for three years.

Up to 15 women were identified in a 2014 audit of smear tests which were found to be incorrect, High Court documents have revealed.

Doctors treating women who were wrongly given the all-clear from cancer were urged to exercise their “judgment” on whether to tell them about the misdiagnosis, the documents show.

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CervicalCheck, the national cervical screening service, also advised doctors to “simply ensure the result is recorded” if any of the women affected by botched smear tests had died in the meantime, according to the solicitor for one of the women.

“We take the quality of our programme very seriously” Professor Flannelly told RTÉ’s Today with Sean O’Rourke programme. “Women should be reassured by our programme. It is successful. We know it is not a perfect screening progamme. Smear tests are not designed to diagnose cancer.

“We are learning from this process. Recent cases are being dealt with in a more timely manner.”

Professor Flannelly said the screening history of every woman diagnosed with cancer is checked post-diagnosis to see if there is any way to improve the service. However, she said such reviews take time, noting the cytology review involves three different laboratories.

On the issue of how women are informed of such reviews, Professor Flannelly said CervicalCheck is working to develop its communications and how it educates its stakeholders. She maintained that the women involved in any reviews were all told about the process. “To my knowledge their clinicians told these women.

“We tell clinicians that they should tell women. The general agreement is that women should be told. The general rule of thumb is please tell women.”

Earlier, Professor Seamus O’Reilly of Cork University Hospital told RTE’s Today with Sean O’Rourke show that there needs to be an independent review of the CervicalCheck service.

He pointed out that medical mistrust had led to a decrease in numbers taking up the HPV vaccine and he was concerned that something similar could happen to CervicalCheck.

“We need a robust structure in place.”

Professor O’Reilly pointed out that Irish society is spending €200 million on medical negligence cases every year. There needs to be an automatic look back when cancer is diagnosed, with a defined time limit for reviews.

“We have to learn from this. Nobody is served by delays in getting closure.”

He maintained that patients have a right to know the full details of their case and that patient trust is important and must be maintained.

“I am concerned that if we don’t have a review of the service that is transparent and open women will not trust the service. We know that screening saves lives.”

Dr Jerome Coffey, director of the HSE’s National Cancer Control Programme said that in the 10 years of the screening programme, there have been over three million smear tests carried out. .

“It’s important to say that cervical screening smear tests is the best test, but it’s not a perfect test,” he told Newstalk Breakfast. “We know that sensitivity is about 70 per cent, and because of that we repeat smears.”

He explained that in certain cases smears are re-reported, and in a ‘very small percentage’ there is a change in the report - but stressed that international research shows that is not unusual.

“It’s vitally important that people continue attending for smears, that they take their advice, and that they have faith in the fact that this is one of the best public health programmes for reducing the risk of cancer anywhere.”