Harris orders review of screening service

CervicalCheck is to undergo an external review following revelations that it took three years to notify a woman with terminal cancer of missed abnormalities in her initial screen.

The national screening service is also writing to the doctors of women who may have had cancers missed by the US firm that analyses smear tests on behalf of Cervicalcheck.

The doctors are being asked to confirm that the women, estimated at 15, have been informed that they were part of a review following a cancer diagnosis. The review examined their screening history and found initial screens had failed to pick up precancerous abnormalities.

CervicalCheck began writing to these doctors yesterday.

A 2014 audit identified that the initial screening result for Limerick woman Vicky Phelan was incorrect, and abnormalities that led to terminal cancer were not picked up in 2011.

In 2014, the 43-year-old mother of two was diagnosed with terminal cancer but it was another three years before she was told the results of the three-year-old audit.

Ms Phelan took legal proceedings against both the HSE and the US laboratory, and settled in the High Court this week against Clinical Pathology Laboratories in Texas for €2.5m. The case against the HSE was struck out.

It emerged in court that up to 15 other women may have been given incorrect test results — but CervicalCheck could not confirm if all the women had been told.

Amid a public backlash at the manner in which Ms Phelan’s case, and the other cases, were handled, Health Minister Simon Harris yesterday instructed HSE director general Tony O’Brien to conduct a review of the national screening service.

The Irish Cancer Society (ICS) said an external review “needs to take place to make sure that processes for communicating information about missed abnormalities or missed diagnoses are put in place, and that the responsibility for who must do that is made absolutely clear”.

In addition, the society said there may be a need to legislate for a duty of candour in state bodies, “so that patients get the information relevant to them and to stop the same problems happening again and again”.

Séamus O’Reilly, consultant medical oncologist at Cork University Hospital (CUH) had earlier warned on RTE radio that failure to conduct a review could jeopardise the screening service.

“I would be very concerned if we don’t have a review of the service which is transparent and open that women will not trust the service,” he said.

And that’s not good. We know that that screening saves lives and I think that we are going to jeopardise the service by not being transparent about it.

Prof O’Reilly also said there should be a transparent structure in place “so that if someone is on the screening programme and they are diagnosed with cervix cancer, there should be an automatic look back in a timely manner.

“I would say 3-6 months looking at their previous smears, and then an open disclosure meeting with them at the end of a prescribed period of time where they would be told whether there was something there or not”.

Since 2010, the screening history of women diagnosed with cervix cancer is reviewed and the results sent to her doctor, with advice from Cervicalcheck to use their clinical judgment to communicate this to the woman.

Mr Harris said he wanted it to be automatic, going forward, that women whose smear test results were the subject of review were made aware of the review and the results.

Prof Gráinne Flannelly, the clinical director of CervicalCheck, said she had no difficulty with an external review of the service.

ICS trained cancer nurses are available at 1800 200 700.

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