RCOG review of smear tests to be published

RCOG review of smear tests to be published
Peter McKenna: Discordance rate likely lower.Picture: Niall Carson/PA

An independent review of the smear tests of more than 1,000 women who developed cervical cancer is due to be published today.

The long-awaited report, by the Royal College of Obstetricians and Gynaecologists (RCOG), commissioned by the Government in May 2018, will reveal the extent to which abnormalities were missed in the smear history of 1,079 women, prior to their developing cancer.

The HSE had originally planned for a finding that as many as 40% of the slides — more than 430 women — would come back with a different outcome.

However, in September, Peter McKenna, HSE director of Women and Infants Health Programme, said the evidence they had at that point “suggests that the discordance rate is going to be substantially lower”.

He said the 40% was a “worst-case” scenario and that similar audits to the one conducted by RCOG showed a discordance rate — where review results are at odds with the original findings — of 25%-35%.

Dr McKenna also said at the time that there was a “priority group” of approximately 400 women with discordant smears, which included 221 women with cervical cancer who were previously told that their original test results were wrong.

The 400 figure also included patients who had died, patients referred for colposcopy, and patients whose slides had been lost or broken.

The RCOG review was commissioned as part of the Government’s response to the scandal surrounding the national screening programme, when it emerged through the court case of Limerick woman Vicky Phelan that women who had developed cervical cancer after availing of a screening were not told that their smear histories were part of an audit by CervicalCheck.

RCOG review of smear tests to be published

It also emerged that the CervicalCheck look-back had identified, in the case of at least 221 women, that their original smears could have given a different result or warning of an increased risk of developing cancer.

The more recent RCOG review was open to participation by every woman diagnosed with cervical cancer since September 2008 whose cancer was registered with the National Cancer Registry of Ireland before May 5, 2018, and who had one or more tests under the CervicalCheck programme.

It was designed to provide them with independent clinical assurance about the timing of their diagnosis and treatment, and to determine, where possible, any failures to prevent cancer or intervene at an earlier stage.

Women who took part were notified of their results over the past number of weeks. RCOG completed individual reports for each of the women or their next-of-kin.

An anonymised summary/aggregate of RCOG’s findings was due to go to Health Minister Simon Harris in October. However, it is understood that report has only gone to the minister now, with a view to publication after today’s Cabinet meeting.

The report was to include recommendations, where appropriate, designed to improve women’s health outcomes.

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