Statement by Royal College of Surgeons

In a statement after yesterday's settlement, The Royal College of Surgeons in Ireland (RCSI) said it would be contacting Janet…

In a statement after yesterday's settlement, The Royal College of Surgeons in Ireland (RCSI) said it would be contacting Janet Donnelly personally to express its sincere regret.

"In June 1999, a screening smear from Ms Donnelly was first sent to the RCSI Cytology Laboratory from the Well Woman Clinic. This smear was reviewed by two medical laboratory personnel and deemed to be normal. As a result it was not referred to a consultant pathologist as only those smears judged to be abnormal are referred. This process is still best practice today.

"In March 2000, a repeat smear was performed after Ms Donnelly presented to the Well Woman Clinic with symptoms. Adenocarcinoma (a form of cervical cancer) was identified on this smear and the Well Woman Centre was informed.

"Adenocarcinoma is an unusual abnormality of the cervix and is not as easily detected as the more frequent forms of cervical cell abnormalities.

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"Cervical screening is a test for precancerous changes in the cells of a woman's cervix. . . it involves microscopic examination of cervical cells by trained medical laboratory personnel. If the cellular sample is considered normal it is, as a fail-safe procedure, screened by another medical laboratory staff member using an internationally accepted rapid review procedure. If, however, the sample is deemed abnormal it is referred to a consultant pathologist for further examination.

"This was the procedure followed in Ms Donnelly's case.

"It is important to emphasise that cervical screening is a subjective, observation-based science and even the best international laboratories may have up to a 10 per cent false negative rate, ie, about 10 per cent of abnormal smears may be missed. For this reason it is recommended that all women present for regular cervical smears in accordance with the advice of their GPs. Cervical cancer usually develops slowly. The normal screening interval is between three and five years.

"The RCSI cervical screening laboratory reviews 40,000 smears per annum. Adenocarcinoma abnormalities appear in a very small number of cases."