Cervical screening: Third of smear tests checked under review

Smear tests check the health of the cervix

About 11,000 women in Northern Ireland have yet to have their smear tests re-checked as part of a major review of cervical screening dating back to 2008.

The Southern Health Trust said it has reviewed more than a third of smear tests.

In October, BBC News NI revealed about 17,500 women in Northern Ireland were to be reviewed.

This followed a highly critical report commissioned by the Royal College of Pathologists (RCPath).

The Southern Health Trust said that as of 1 March, the review has been completed for almost 6,500 of these women (37% of the total to be reviewed).

The trust said that women affected should receive updated letters by post from Tuesday.

In the letter, the trust said it had "taken great care to ensure that every part of the review is robust and accurate and are working to complete the process quickly and also personally inform every woman of their outcome".

Heather Thompson received her letter on Tuesday morning.

"I didn't really know what to think," she said.

"I've been waiting on a letter coming along to say whether my past test has been negative or positive.

"I was a bit apprehensive when the letter arrived but when I opened it and I read the letter I really didn't find very much reassurance in the letter."

Heather Thompson believes her health has been put at risk

Ms Thompson said she has had no communication in relation to the smear test she had in 2018 that is being reviewed.

She said the letter "doesn't inspire confidence until every last lady has had a test carried out".

"I think what's very daunting as well is that the letter points out that there is only HPV testing now," she said.

"It was never a HPV test that was under question, it was cervical cytology that was under question."

Ms Thompson said she is one of a group of women who "have been put at risk by what has happened over a 13 year period in the trust".

She said for them to "feel reassured, it would have been better that we had the option to have a full cytology test carried out instead of just a HPV test".

'Slow start'

Dr Clare McGalie, clinical director for laboratories in the South Health Trust, said they have had "a slow start" but expect to have the review completed by the summer.

"We wanted to get this absolutely right, so a lot has gone into the planning of this," she said.

Dr McGalie said they are "very grateful" to now have other labs in other health trusts on board to help with the review and they are "now going to be able to go through the slides much faster".

Dr Clare McGalie said that every person whose test is checked will be contacted individually

The Southern Health Trust aims to have all slides reviewed by the end of June and anybody who needs a repeat smear should have it completed by the end of August.

"I want to reassure everybody that when your [smear test] is being reviewed, we will contact you directly and you will have your result when it's ready," said Dr McGalie.

The trust said at the start of the review that it anticipated that for the majority of women their smear result would not change.

While it said it was still too early to provide definitive feedback on the overall outcome of the review, to date, "the vast majority of slide review results have been the same as the original one."

• 17,500 cervical smear tests to be re-checked

• Less than 2% of smear tests re-checked in review

• 'I have right to know about my smear test review'

No "high-grade" abnormalities have been found in those already reviewed (high-grade abnormalities are cell changes that could progress to cancer if left unchecked or untreated).

Dr McGalie said the results, so far, have been "very reassuring although it's too early to tell at the minute".

She said there have been some low-grade abnormalities found (just over 2%) and those women have been asked to attend for a repeat smear, which will be by primary HPV screening.

In December, Northern Ireland introduced primary HPV cervical screening.

It checks for an infection called human papillomavirus (HPV) - the cause of most cervical cancers.

Virtually all cases of cervical cancer are linked to high-risk HPV

High-risk HPV can cause cervical cells to become abnormal and potentially develop into cancer over time. .

Virtually all cases of cervical cancer are linked to high-risk HPV.

This newer HPV test is regarded as more accurate at detecting who is a higher risk of developing cervical cancer.

Dr McGalie said: "Where cytology can pick up 16 in every 20 abnormalities, primary HPV screening will pick up 18, so it is a better test."

If HPV is found to be present following a smear test, the sample will then go for further examination.

This removes the need for all samples to also undergo cytology which is time consuming and clogs up the screening system.

The Southern Trust and the Public Health Agency said they were "sincerely sorry for any distress caused" by the review.

They said they would like again to "reassure those women receiving letters that this review is a precautionary measure to ensure that their previous smear test result they received was correct".