Poor communications at core of cervical cancer scandal

World of Politics with Harry McGee – harrymcgee@gmail.com

The cervical cancer scandal isn’t about false smear tests; it is about disclosure – or to be more accurate, lack of disclosure, coming from the recent past when conveying all the full and relevant information to patients was not a priority.

The thinking, of course, has evolved. Informing the patient (or the patient’s family), in a sensitive manner, is not only the right thing to do; it is a right.

A decade ago, it was decided to outsource cervical smear tests. Up until then, the smear tests were done in Irish public laboratories but the service was not comprehensive and there were long delays in getting results back.

The argument at the time was that there was an urgent need for a national screening programme that was capable of delivering results quickly to women. By then, it was well established that early intervention, on the basis of results from a smear test, would be critical in dealing with cervical cancer, one of the most serious cancers for women, with a high mortality rate.

So a comprehensive national programme was put in place. The testing was outsourced, mainly to the US. They could do more tests and produce results very quickly, within weeks. The cost was also much less.

But from the start there were issues. Routinely, smear testing took place far more frequently in the US, once a year typically compared to every three years in Ireland. And the different systems, methodologies and standards produced different results that varied slightly.

And over-riding all of this is that smear tests are not always 100 per cent accurate. They give an indication only and sometimes there can be false positives and false negatives.

So it was always the case the service would have to go back to women and say that what had seemed negative in the initial smear test, might in fact have been positive.

Cervical Check has undoubtedly saved lives; over one million women have taken the test in the past decade.

Almost 1,500 cases of cervical cancer were identified since 2008 and the latest information suggests that in 206 of these cases, there was delay in the cancer being detected. This might suggest that there could have been earlier intervention.

It has also emerged that 17 women in this group have since died.

For more, read this week’s Connacht Tribune.