US smear test analysis ‘of highest standard’

FEARS that the outsourcing of cervical smear tests for analysis in the United States may have caused some abnormal tests to slip through the net were dismissed yesterday by the Health Service Executive (HSE).

The Dublin Well Woman Centre claimed that outsourcing tests for analysis to a private laboratory in the US to clear a massive backlog earlier this year had created a new set of problems because the method of reporting results in America differed substantially to the one used in Ireland.

Well Woman chief executive Alison Begas said that sometimes the categorisation of the result in America did not exactly translate into the British one, which was what doctors in Ireland were used to looking at.

In January, the HSE outsourced the processing of 35,000 smear tests to a US laboratory — due to unacceptable delays within the State.

Ms Begas said doctors at the Well Woman Centre, which takes nearly 10,000 smears every year, had to make “tough judgment calls” about some results.

“We would always err on the...conservative side in terms of the analysis,” she stressed at the launch of the centre’s 2006 report.

Assistant national director of the HSE’s hospitals office Tom Finn said the Bethesda system used to analyse tests sent to the United States was of the highest international standard.

Results warranting further investigation were accompanied by detailed translation tables, so Irish doctors could correctly interpret them, while patient histories were sent with the tests to the US, he added.

“The feedback I had from many GPs and patients around the country was very positive,” said Mr Finn.

The HSE provided additional funding so that a backlog of questionable cases warranting a colposcopy — a medical procedure to more closely examine the cervix — did not build up.

Mr Finn pointed out that the Bethesda methodology used in the US and in most countries around the world was now being introduced on an EU-wide basis.

While many of the European countries already used the methodology, Britain and Ireland were still using the British Society of Clinical Cytology methodology.

He said the backlog was now cleared and the HSE target that no woman should wait more than four weeks for test results was being achieved.

An analysis of 37,000 smear tests taken at Well Woman’s three Dublin clinics, from 2002 to mid-2006, found that more than one in 10 had abnormal results, which required further investigation.

Poorer women were more likely to have abnormal smear results.

The analysis also found that the Human Papilloma Virus, which causes cervical cell abnormalities, was more prevalent in smokers and women who experienced their first sexual intercourse at an early age.

The centre conducted 4,089 tests for chlamydia last year of which 245 were found to be positive for the sexually transmitted disease.

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