Covid-19: Up to 50% of women due to have cervical smears missed out

'Evidence shows because of the typically slow progression of cervical cancer (five to 15 years) the beneficial outcomes don’t reduce if screening is delayed for six months'.

Up to half of the women who would normally have received a cervical smear missed out due to the lockdown conditions, the Health Committee heard today. Dr Noirin Russell, director of the CervicalCheck programme, said they hope to have extra staff and capacity to increase screening numbers next year.

“We have screened over 117,000 women in primary care in the programme to date this year," said Dr Russell. "We had an incredibly busy November, we screened 24,000 women. At the end of the year, we expect to have screened 50% of the women we would have expected to screen [pre-Covid-19].” 

Dr Russell, previously an obstetrician at Cork University Maternity Hospital, said 80% of result letters have been sent to women within six weeks. By year’s end, all 270,000 women due for screening will have an invitation letter.

“While we continue to work to minimise the impact of Covid-19 on screening, I can also tell you evidence shows because of the typically slow progression of cervical cancer (five to 15 years) the beneficial outcomes don’t reduce if screening is delayed for six months. 

“No screening programme will pick up all potential cancer cases; none are designed to do so.” 

Aontú TD Peadar Toibín said he is aware of 231 legal cases linked to concerns around CervicalCheck in the past.

Fiona Murphy, chief executive of the National Screening Service (NSS), said roughly 160 cases are in progress and she expects some to be heard by the CervicalCheck Tribunal.

“We don’t anticipate that all 160 will show evidence of negligence,” said Ms Murphy. 

She said out of almost 70,000 women invited this year to a BreastCheck screening, some 46,000 have attended. However, they have screened about 139,000 fewer women this year than planned.

Responding to questions from Social Democrat TD Roisin Shortall, she said: “We have re-started. It won’t be possible to double-up on screening, we don’t have a timetable for catch-up. We have approximately 70% capacity in our screening units.” 

BowelCheck has also been affected, with 81,000 fewer people seen than the pre-Covid target of 125,000. So far, 44,000 people have taken the BowelScreen FIT test this year.

The Irish Examiner previously reported that the NSS had planned to screen 433,100 people this year through cervical, breast, and bowel check programmes. But the lockdown conditions meant just one-third of this target was met by September.

Professor Risteard Ó Laoide, director of the National Cancer Control Programme, said the impact of Covid-19 has been a “significant challenge”.

But he said the number of cancers diagnosed at the Rapid Access Clinics has increased since September to reach 90% of last year’s numbers.

“It is expected that this percentage figure will continue to increase for the remainder of the year with a consequent reduction in the number of lost cancer diagnoses," he said.

Rachel Morrogh, director of advocacy with the Irish Cancer Society, welcomed extra funding for cancer in the budget.

But she warned: “Insufficient hospital capacity, inbuilt inefficiencies, and too few healthcare professionals, plus an increase in cancer cases of 3-4% annually has led to lengthy and growing waiting lists.

"The truth is that, in Ireland, access to care is being rationed by waiting lists.” She said there are more than 100,000 people waiting for a radiology appointment.