Cervical cancer: a terrible failure
External review of work of CervicalCheck service must take place as soon as possible
Vicky and Jim Phelan from Annacotty, Co Limerick, pictured speaking to the media on leaving the Four Courts on Tuesday after the announcement of a settlement of their High Court action for damages. Photograph: Collins Courts
Management of the case of Vicky Phelan, a 43-year-old Limerick mother who is dying of cervical cancer, represented a terrible failure. She wasn’t alone. Smear tests on as many as 14 other women, conducted on behalf of the CervicalCheck service, were found to be wrong. Phelan was diagnosed with cervical cancer in 2014, the same year that a review found a smear test carried out on her in 2011 was incorrect. But she did not learn of the review until 2017. The amount of information provided to the other women remains unclear.
The Government’s promise of 'a changed approach' to providing information rings hollow after what is correctly described as a 'a shameful series of events'
A HSE official would only say that medics involved in the other cases had been advised of the changed diagnosis. This amounted to a traditional hand-washing exercise. Precise information on whether, and how, the results of this audit were communicated to all those directly concerned is required. It is a matter of grave concern that written advice from CervicalCheck urged clinicians to use their judgment in discussing the faulty diagnosis with patients and that, where a woman had died, clinicians were only required to record the result in her notes.
The willingness of CervicalCheck clinical director Gráinne Flannelly to welcome an external review of “any and all” aspects of the service, in order to encourage women to participate, is encouraging. However, concerns remain and the Government’s promise of “a changed approach” to providing information rings hollow after what is correctly described as a “shameful series of events”.
Rare circumstances occur when a patient chooses not to receive a life-threatening diagnosis or a medical practitioner withholds it. That does not, however, justify the hands-off approach taken by the HSE in these cases.
Smear tests save lives. So do childhood inoculations against long-established diseases
Considerable progress has been made in recent decades in combating many forms of cancer, but it remains the second most common cause of death in this State. Survival rates have improved, even as case numbers have grown. There is no such thing as 100 per cent accuracy in detecting pre-cancerous cells through smear tests. But it represents an important technological advance and has saved the lives of many women by facilitating appropriate treatment before the cells turn cancerous. It would be a tragedy if, because of recent developments, some women decline to avail of this service.
Smear tests save lives. So do childhood inoculations against long-established diseases. Internet scaremongering has, however, brought a reduction in the percentage of families availing of these protections. A similar campaign, feeding into medical distrust, has emerged in relation to the HPV vaccine for young girls, which prevents cervical cancer in later life. The good work of CervicalCheck must not be blighted. An external review should take place as soon as possible.