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Cervical Check...No Scandal..

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Comments

  • Registered Users Posts: 4,366 ✭✭✭jackboy


    neonsofa wrote: »
    It was in januray this year, i heard something on the radio around that time, thats how i know there were a hundred or so other people who received a similar letter, but i dont remember reading much about it beyond that either tbh.

    I found the letter, says "it is recommended that hpv testing is carried out within 30 days of the smear test being taken. One of our labs has told us that your hpv test was one of a number of samples that were tested after the recommended date i.e. after the recommended 30 day timeframe". Very vague on details.
    An insert with the letter says "Quest diagnostics has advised us of an issue... testing was done outside of manufacturer's guidelines"

    Such communication from the lab is a good sign of the lab. Question is, why was the test done late? It might not have been a fault with the lab.


  • Registered Users Posts: 2,540 ✭✭✭Martina1991


    jackboy wrote:
    Such communication from the lab is a good sign of the lab. Question is, why was the test done late? It might not have been a fault with the lab.
    In 2018 Simon Harris urged any woman who was doubting the results of their own smear to go and have another one done for free.

    This led to a huge volume of smear samples being sent to the U.S. over a short period of time.

    This caused a long backlog and a delay in testing. The cervical check service should have resumed as normal until investigations into the external labs were compete.


  • Registered Users Posts: 5,476 ✭✭✭neonsofa


    jackboy wrote: »
    Such communication from the lab is a good sign of the lab. Question is, why was the test done late? It might not have been a fault with the lab.

    The letter was from hse/cervical check, how or why the lab advised them of the issue isnt actually outlined, so we cant say for sure that the communication is a good sign of the lab. It seems it only came to light once all of the other stuff did. Maybe hse only notified me at that point. Who knows.

    The lab tested samples outside of the recommended time frame between 2015 and 2018. So thats an ongoing issue. I was notified in 2019 after other issues had emerged in the media. My test was in 2016.

    The letter even states "we appreciate that you may have initially become aware of this issue in the media and we apologise for this. This was not our intention."


  • Registered Users Posts: 5,476 ✭✭✭neonsofa


    In 2018 Simon Harris urged any woman who was doubting the results of their own smear to go and have another one done for free.

    This led to a huge volume of smear samples being sent to the U.S. over a short period of time.

    This caused a long backlog and a delay in testing. The cervical check service should have resumed as normal until investigations into the external labs were compete.

    These errors didn't occur during the backlog, it was during the period of 2015 to 2018. My own was 2016. Before any of that started. When testing was supposedly being carried out as normal.


  • Registered Users Posts: 4,366 ✭✭✭jackboy


    neonsofa wrote: »
    The letter was from hse/cervical check, how or why the lab advised them of the issue isnt actually outlined, so we cant say for sure that the communication is a good sign of the lab. It seems it only came to light once all of the other stuff did. Maybe hse only notified me at that point. Who knows.

    The lab tested samples outside of the recommended time frame between 2015 and 2018. So thats an ongoing issue. I was notified in 2019 after other issues had emerged in the media. My test was in 2016.

    The letter even states "we appreciate that you may have initially become aware of this issue in the media and we apologise for this. This was not our intention."
    It sounds like even after all the reports, there is still important information to be determined and made public. Details regarding such late testing should be clarified and communicated.


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  • Registered Users Posts: 5,476 ✭✭✭neonsofa


    jackboy wrote: »
    It sounds like even after all the reports, there is still important information to be determined and made public. Details regarding such late testing should be clarified and communicated.

    Yeah absolutely. In fairness, they sent the letter and gave free priority screening for a repeat test- 3 years too late but... !
    Although as Martina outlined above, this was in january 2019, when every woman in ireland was also looking for repeat smears, so i really didnt have much confidence that the re test would be done corrrectly due to the backlog, but i did appreciate the transparency, even if it was 3 years late. But that is only to those who were affected, it wasn't exactly made public or explained like you say.

    Maybe i could have gotten more clarity if i asked though. Or perhaps not if they did not want to admit fault/attribute blame.


  • Registered Users Posts: 25,594 ✭✭✭✭Mrs OBumble


    Nothing is perfect but if you buy cheap tyres there's a risk you will crash.

    They cut costs and we pay the price

    If you have cheap tyres, but change them annually as recommended, you will face no extra risks.

    The problem arose because we used cheaper testing, but didn't increase the frequency as recommended.

    Foreigner resident sample readers are no more or less competent at analysing samples than Irish resident sample-readers


  • Registered Users Posts: 2,540 ✭✭✭Martina1991


    Screening of cervical smears does not diagnose cancer. The process involves looking for changes in cells. These changes may be cancerous or they may not.
    High grade (cancerous) changes in cells would be easier to spot than small changes.

    In the US, scientists were reading about 80 to 100 smears a day. Scientists in Ireland were getting through 25 to 30 smears a day. Those in the US were not spending the same amount of time reviewing each smear. But their service is meant to be carried out yearly, ours is 3 yearly.

    The service in the US works for them and is acceptable because patients are being screened more often. Our women were being screened more thoroughly but less often.

    Outsourcing our smears meant our smears weren't screened as thoroughly as they should have been and we kept the 3 yearly time frame.


  • Registered Users Posts: 2,540 ✭✭✭Martina1991


    Foreigner resident sample readers are no more or less competent at analysing samples than Irish resident sample-readers
    The title is Medical Scientists, not sample readers.


  • Registered Users Posts: 290 ✭✭lozenges


    The media have been massively irresponsible and reckless in spreading disinformation and sometimes outright falsehoods about the Cervical Check story.

    There is a fundamental misunderstanding among many people as to what screening programmes can feasibly achieve and what they cannot achieve. Screening is a blunt instrument. It is not, and is not supposed to be, a highly accurate diagnostic test. Part of the false negative rate in cervical screening is due to the smear not collecting abnormal cells where they are in fact present. Some are due to human error. But the slides are analysed by people and in any process involving humans there will be a degree of human error, which is unavoidable.
    In addition some slides will have cells which are marginal calls. The level of abnormality is open to interpretation, it's not as black or white as 'definitely normal' or ' definitely cancer'
    Obviously if somebody looks back at a slide knowing that that person later developed cancer they are more likely to interpret that slide as abnormal.

    The Scally report and RCOG reports have consistently found that the quality of the screening programmes including the expected false positive and false negative rates have been within accepted guidelines.

    The issue the Scally report raised was the failure by clinicians to disclose to women the findings of the audit. That is a significant issue and should not be minimised. But the media seem to have given people the idea that Cervical Check has a dangerously high false negative rate which is simply not the case.


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  • Registered Users Posts: 4,825 ✭✭✭LirW


    lozenges wrote: »

    The issue the Scally report raised was the failure by clinicians to disclose to women the findings of the audit. That is a significant issue and should not be minimised. But the media seem to have given people the idea that Cervical Check has a dangerously high false negative rate which is simply not the case.

    This is the issue in combination with how it was tested as Martina1991 mentioned above. It was a simple cost cutting exercise by contracting a lab that can read a larger amount of smears by testing less thorough. This suits annual testing but not 3 year testing.
    I still believe the CervicalCheck program is good, it might be inefficient with waiting times for colposcopies and the HSE handled the backlog poorly, but that's not the problem of initial smear readings.


  • Registered Users Posts: 8,031 ✭✭✭ceadaoin.


    Martina1991s post above explains very well what happened. So, how is it not a scandal that the samples from Ireland were insufficiently tested and cell changes were missed until it was too late in many cases? That's a complete **** up by the HSE which cost some women their lives.

    Pretty sure no one would be saying that the whole thing is overblown and that theres "very little in it" if it was a member of their family who was affected. How rude


  • Registered Users Posts: 2,744 ✭✭✭marieholmfan


    The biggest issue with this is that the huge outcry and the millions paid out on compensation means that the HSE will think twice to introduce any similar programmes because of the danger of massive payouts e.g. the 2.5m to Vicky Phelan.

    Not saying that she didn't deserve that but thousands of others get cancer and don't get payouts just because there is no tests with the possibility of errors.
    She got it because she had terminal cancer and yet she's still around.


  • Registered Users Posts: 8,031 ✭✭✭ceadaoin.


    She got it because she had terminal cancer and yet she's still around.

    Yeah she should hurry up and die already to justify that payout? Seriously?


  • Registered Users Posts: 2,021 ✭✭✭Miike


    She got it because she had terminal cancer and yet she's still around.

    You are an abhorrent individual, honestly.


  • Registered Users Posts: 2,540 ✭✭✭Martina1991


    ceadaoin. wrote:
    Martina1991s post above explains very well what happened. So, how is it not a scandal that the samples from Ireland were insufficiently tested and cell changes were missed until it was too late in many cases? That's a complete **** up by the HSE which cost some women their lives.
    Ireland put their trust in the policies and procedures of the US labs. By doing that, we had no control over the process or any audits.

    The Academy of Medical Scientists in Ireland (AMLS) warned the HSE in 2008 not to outsource the smears but it fell on deaf ears.


  • Closed Accounts Posts: 8,474 ✭✭✭Obvious Desperate Breakfasts


    She got it because she had terminal cancer and yet she's still around.

    I’ve had terminal cancer for 4.5 years. The palliative treatments work for different amounts of time for different people. One person might get six months out of a treatment, another might get three years. The treatments run out eventually but some people knock a lot of time out of them. The ignorance around cancer is depressing.


  • Registered Users Posts: 152 ✭✭Caledonia


    Ireland put their trust in the policies and procedures of the US labs. By doing that, we had no control over the process or any audits.

    The Academy of Medical Scientists in Ireland (AMLS) warned the HSE in 2008 not to outsource the smears but it fell on deaf ears.

    No issues have been found with the labs in the states tho. Scally cleared them. As a GP said on Twitter, people are losing their **** over something that is actually working well.
    I did find it funny that rte journalists didn’t lead with the main point of RCOG - we are performing as well as the worlds longest established programme. That was major as people wanted to know if it was inherent screening limitations or out of line which would suggest negligence.
    There was no scandal.
    But fair play to some they will still try to make one out of it.


  • Registered Users Posts: 6,125 ✭✭✭beer enigma


    Caledonia wrote: »
    As a GP said on Twitter, people are losing their **** over something that is actually working well.

    Can I take a guess at the missing word, is it Wives or their kids mothers?


  • Registered Users Posts: 152 ✭✭Caledonia


    Can I take a guess at the missing word, is it Wives or their kids mothers?

    No four letters


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  • Registered Users Posts: 2,744 ✭✭✭marieholmfan


    Can I take a guess at the missing word, is it Wives or their kids mothers?
    Cervical check saves lives.


  • Registered Users Posts: 1,493 ✭✭✭crossman47


    All those politicians and journalists who blew up the cervical check issue to be much more than it was can be proud of themselves https://www.irishtimes.com/news/health/lack-of-trust-causing-women-to-put-their-lives-at-risk-cervicalcheck-warns-1.4493346?mode=sample&auth-failed=1&pw-origin=https%3A%2F%2Fwww.irishtimes.com%2Fnews%2Fhealth%2Flack-of-trust-

    This is costing lives.


  • Closed Accounts Posts: 8,474 ✭✭✭Obvious Desperate Breakfasts


    Didn’t Lynsey Bennett have four smear tests between 2010 and 2016 that showed no abnormalities, only to be diagnosed with advanced cervical cancer less than a year after the she got the results of the 2016 test? Even taking into account human error, that does raise questions about the quality of the testing done in the US labs. That not one of those smear tests was read as abnormal seems to fall outside the human error explanation. It’s mighty unlucky to have four smear tests read as normal when cancer was proliferating in the cervix.


  • Registered Users Posts: 152 ✭✭Caledonia


    I saw the below report so one was Dublin and one was atypical... (not to detract from your overall point)

    Ms Bennett had a smear test on 3 February 2010, which was sent to Eurofins Biomnis in Dublin. The test came back as negative and another smear test was recommended in three years.

    On 16 December 2013, Ms Bennett had another smear test as part of the national cervical screening programme.

    This sample was sent to US lab Quest Diagnostics and came back as showing atypical squamous cells of undetermined significance. A smear test in 12 months was recommended.

    On 2 December 2014, Ms Bennett had another smear test and the sample was reviewed by Quest Diagnostics.

    It was claimed the result came back negative and she was advised by CervicalCheck there were no abnormalities and a repeat smear in a year was recommended.

    She had another smear test in January 2016, which was tested at the US laboratory Quest Diagnostics, and she was told no abnormalities had been detected and she would be reminded to have her routine smear test in three years' time.


  • Registered Users Posts: 1,493 ✭✭✭crossman47


    How is it, following Vicki Phelans appearance on the LLS, that many in the media continue to misrepresent (a mild word) what happened? Some keep saying "these women had cancer and the state did not tell them". This is not true. All those whose samples were audited had already been diagnosed and were being treated. The problem is they were not told about the audit results. The media love to make a story worse than it is.



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