Sunday 17 February 2019

GPs to offer free smear retests to women worried by scandal over cancer screening

Health Minister Simon Harris. Photo: Frank McGrath
Health Minister Simon Harris. Photo: Frank McGrath

Any woman who wants a cervical smear will be entitled to have a test free of charge at a GP surgery or clinic.

The move is aimed at easing the fears of thousands of women who are worried about their test results in the wake of the CervicalCheck scandal.

GPs were issued with guidelines yesterday and told they would be paid for the additional test or a consultation with a patient who does not opt for additional screening.

It comes as a group of senior doctors said they wanted to reassure women that they could have confidence in the screening programme.

Thousands of women have sought retests following revelations that Vicky Phelan, a mother-of-two from Limerick who has cervical cancer, had a false negative smear result in 2011.


Dr Jerome Coffey, head of HSE cancer services, said cervical screening had its limitations but a woman's risk of a false negative smear was less than one in 100.

"There is a small risk that cell changes will not be picked up. It is important to have regular smear tests," he said.

"We will be one of the first countries in the world to introduce HPV testing later this year, replacing technology that has been around since the 1950s."

Chief Medical Officer Tony Holohan said the problems with CervicalCheck related to communicating with patients, not quality control.

It was essential that women continued to have smear tests, he said, adding that since CervicalCheck started in 2008 there had been a 7pc a year drop in the incidence of cervical cancer.

"Before that, gynaecologists were coming back to work in Ireland and often seeing women with late-stage cervical cancer," Dr Holohan said.

The screening programme was having an impact on mortality and picking problems up earlier, he added.

Prof Donal Brennan, a specialist on gynaecological cancers at the Mater Hospital, said the vast majority of cervical cancer cases were now diagnosed at an early stage thanks to the screening programme.

Women whose tests show up abnormalities and are sent for further investigation have a very low risk of progressing to invasive cancer.

Anyone who had a negative smear test result should be alert for possible symptoms of cervical cancer before their next recall date. Dr Mary Short, a Dublin GP, said these symptoms could include vaginal bleeding.

She said GPs were under pressure to deal with the regular volume of patients but they would do their best to accommodate women who wanted a repeat smear test.

The consultation is likely to take longer than a routine smear test because the patient will probably have more questions and concerns in the wake of recent publicity.

It is understood that negotiations are under way with the Irish Medical Organisation to pay GPs a higher fee for the retest in light of the length of time they will have to spend with the patient.


The guideline to GPs from CervicalCheck says that if they had a patient who was diagnosed with cervical cancer since 2008 they may be referred to have their case audited.

Around 1,500 women who developed the disease in that time were not notified to CervicalCheck.

The audit was to look at whether they had a smear test result which gave a false negative in advance of the disease.

Around 3,000 women have been diagnosed with cervical cancer over the 10 years of the programme.

The note to doctors says the laboratories where the tests are analysed, including a facility in New Jersey, are all accredited with national authorities.

There are not enough quality-assured lab services in Ireland to carry out all of the analysis on smear tests under CervicalCheck.

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