Wednesday 17 July 2019

Is there something I should be doing about my cervical smear test? All your questions answered

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Eilish O'Regan

Eilish O'Regan

It has been an emotional week for women who have developed cancer after being through CervicalCheck, the national screening service.

Our Health Correspondent, Eilish O'Regan answers the questions you need to know:

If I regularly get smear tests, is there something I should be doing now?

The advice is to always be alert for potential symptoms of cervical cancer. Never ignore them.

In most cases, vaginal bleeding is the first noticeable symptom of cervical cancer. It usually occurs after having sex. Bleeding at any other time, other than your expected monthly period also considered unusual. This includes bleeding after the menopause.

Visit your GP for advice if you experience any type of unusual vaginal bleeding. 

Or, if you have any worries, it is possible to ring the CervicalCheck helpline 1800 45 45 55.

Can women find out what lab their own smear tests were read in?

It is not automatically available in the information they receive after a test. However, it is possible to ring the CervicalCheck helpline 1800 45 45 55 and request the information.

If someone does not have confidence in the cervical screening programme, is there a way to get a smear test privately or is there any alternative to a smear test?

Yes, the Dublin Well Woman Centre and other services provide a private service. It can cost €85 to €100.

Are we any nearer to relieving women’s worries?

A small step was made yesterday in identifying 208 women whose smear test gave a false negative result. They went on to develop cancer.

It was quite shocking for an audit team to find 162 of these women were not told of an internal CervicalCheck review of their case.

These reviews were a look-back, they had already been diagnosed with cancer. It was an examination of what went wrong.

Were they better off not knowing about the internal reviews?

No. They had an absolute right to be told a review was carried out and the findings.

Crucially, these reports told them how they developed cancer.

Abnormalities were missed in a test. The women would not have known that.

These reports contain vital information. Why were so many kept in the dark?

The audit deep who did a deep dive of relevant records last weekend said they could not speculate on why women were not informed. Some detail on this was included in a briefing note prepared for Health Minister Simon Harris such audits were carried out to determine how cancers are diagnosed and develop. Before 2015 these audits were intended for "education and training purposes".

"In 2015 a decision was taken by the HSE, in line with international best practise, to provide information on outcomes of clinical cancer audits to treating clinicians for onward communication to patients as appropriate," the briefing note states.

Are many of the women dead?

Yes, 17 are dead. Just two knew their report findings before passing away.

Which laboratories were the tests read in?

The audit team said they did not know.

Was there some cluster of mistakes?

No. The cases go back 10 years since the service started.

Will more women with wrong tests emerge?

It cannot be ruled out. Hiqa, the patient safety body, is to probe CervicalCheck. It is very good at this kind of detective work.

Had the audit team anything to say about the quality of testing?

They had no evidence that it is below standard. They also said out-sourcing half of smear tests to a lab in the US is not a risk.

When was Vicky Phelan pressed to agree to sign a confidentiality agreement?

At the back of it all is Vicky Phelan, the Limerick mother fighting cancer. She refused to sign a confidentiality agreement to prevent this being made public.

She was put under pressure by lawyers for CervicalCheck and the Texas lab where her test was misread. It happened at a mediation hearing of her case on April 9.

Health Minister Simon Harris was told of her High Court case on April 16. Did he take any action?

No. Sadly Vicky had to have a full day’s hearing in the High Court on April 19. There was a shocking revelation about an internal CervicalCheck report on her case. But she was not told for three years about it.

It was striking and led to an instant HSE press query from the Irish Independent.

Did Mr Harris act on the revelation and order CervicalCheck to release the review?

It seems not. It took several days for the gravity of Vicky disclosures to prompt action.

Irish Independent

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