What is this review about?
As part of the ongoing investigation into the National Cervical Screening Programme, an expert panel has been set up to examine the screening history of women who took part in the screening programme before they were diagnosed with invasive or microinvasive cancer.
Who will be included in the review?
The review will examine the screening histories of women who developed invasive or microinvasive cervical cancer and who were screened by the National Cervical Screening Programme before their diagnosis. Any woman whose cancer was notified to the National Cervical Screening Programme or was registered with the National Cancer Registry of Ireland (NCRI) at the beginning of May 2018 will be included in the review, if they wish.
This will not include all cases of cancer. There is a gap in time between when a case of cancer is diagnosed and when it is registered on the national cancer register. This time is needed to gather and validate all the necessary information before a case can be registered.
The review will only examine the smears or screening history of women who were subsequently diagnosed with invasive or microinvasive cervical cancer.
Why is this review being done?
For each woman, this review will aim to:
- give an independent examination of her screening history and results
- identify if there was a failure by the National Cervical Screening Programme to detect underlying abnormal cells that could lead to cancer or to intervene at an earlier stage in the development of her cancer
- provide an individual report for each woman whose case is reviewed (if she wants one).
For the National Cervical Screening Programme and those who take part in it, this review will aim to:
- assess the performance of the programme
- produce a report on the programme containing recommendations where appropriate. This report will not identify individual women.
Who is doing this review?
The review is being carried out by an independent panel of experts from the Royal College of Obstetricians and Gynaecologists in the UK and the British Society for Colposcopy and Cervical Pathology.
How long will the review take?
The Expert Panel has indicated that it will take at least six months, from when the analysis of the slides begins, to complete the review and the individual reports for each woman whose case is reviewed. The physical transfer of slides has commenced and the receiving laboratory in the UK started to receive slides on behalf of the RCOG in February 2019.
What will the review cover?
The review will examine any screening samples (smears) taken by the National Cervical Screening Programme before a woman was diagnosed with invasive or microinvasive cervical cancer. The findings will then be compared with the original smear result(s) as reported by the screening programme.
If a woman had a colposcopy (an examination of the cervix using a type of microscope called a colposcope) after a smear test, and if this happened more than six months before her cancer diagnosis, the results of the colposcopy will also be examined.
If the review finds an abnormality in a screening sample that was not originally detected or if the review has questions about the colposcopy, the panel may need to look at more information in the woman’s clinical records. This may include information about her treatment and outcome.
Where will smears be examined and how long will they be needed?
The smears will be examined in laboratories in the UK that are used by the cervical screening programme there.
The smears will be returned to the original laboratory they came from as soon as possible but may be required for up to 4 months.
Who will have access to my screening samples and to my clinical records?
- Only those directly involved in carrying out the review in the UK will have access to the woman’s screening samples and clinical records
- Any personal information which is given for the review will only be used for the review
- Those involved in carrying out the review will be required to keep women’s information strictly confidential
- Appropriate measures will be taken to safeguard women’s personal information
- Once they have been checked by the expert panel, screening samples will be returned to the laboratory which had originally examined them.
What are the benefits to me of taking part in this review?
The individual report which you will get (if you want it) will try to identify if there was a failure by the National Cervical Screening Programme to detect underlying abnormal cells that could lead to cancer or to intervene at an earlier stage in the development of the cancer.
By taking part in the review, you will also help the expert panel to assess the quality of the National Cervical Screening Programme and to make recommendations for improvements. This assessment and recommendations will form the overall report. This overall report will not identify you or anyone else. However, the assessment and any recommendations made will benefit all women now and in the future.
What are the limitations of taking part in this review?
Where errors are identified by this review, it may not be possible to say conclusively that they resulted in a poorer outcome for the individual woman.
Where an error is identified by this review and communicated to you, it may cause concern, stress and anxiety for you and your family. Therefore, some people may not want to be told of the outcome of the review of their own case. It is still possible for you to take part in this review even if you don’t want to be told the outcome in your case. The details on how to do this are explained in the information about consent.
The individual report produced for each woman will not determine whether the failure to detect underlying abnormal cells when her screening sample (smear) was being examined was negligent in a legal sense. Taking part in the review will not, however, prevent any woman from pursuing legal redress in relation to any such failure.
If you decide during the course of this review that you wish to withdraw from the process your smear(s) will be returned within one month to the laboratory which originally examined them. If the expert panel has not completed a review of your smear(s) prior to their return, you will unfortunately be excluded from the review.
