Smear test review sees low turnout

As reported by Armaghi, Southern Health Trust reports that the majority of women contacted for a repeat smear test, following concerns over earlier results, have declined the invitation, prompting a change in focus for review clinics

It is now two months since it was confirmed that the Southern Health Trust was to review the records of 17,000 women over concerns around smear test results over a 13-year period.

It came after senior laboratory staff notified the Trust’s management team that they had concerns about performance in some steps of their laboratory’s screening system in July 2022.

To fully investigate these concerns, the Trust commissioned the Royal College of Pathologists (RCPath Consulting) to undertake an independent assessment of its cervical screening services from January 1, 2008 and October 2021.

The Trust has now provided an update on the process.

It confirmed that repeat smear clinics began on November 17, and it continues to contact women to offer appointments for repeat tests.

To date, 1,066 women have been contacted and offered a repeat smear appointment. A total of 991 patients were booked for an appointment.

Said a Trust spokesperson: “Unfortunately, the majority (676) of women so far have declined the offer or they accepted but did not attend on the day for their appointment. A total of 315 women have attended a clinic for a repeat smear test and will receive their results within six weeks of their clinic date.

“Follow-up letters will be sent to these women who did not attend to offer them the opportunity to come for an alternative appointment at a suitable time and date.

“A significant number of women (184) have requested to opt out of the review when contacted about an appointment.

“Due to the low uptake at week night smear test clinics, the Trust has decided to concentrate the clinics at weekends, Saturday and Sunday (8am – 8pm), when attendance has been much better.

“We also plan to provide clinics in other locations across the Trust including Daisy Hill Hospital, Newry after Christmas. We encourage women to attend their appointment or to confirm if they do not wish to accept the offer for a repeat smear.

“For the first clinics last month, to avoid delay in starting the clinics, our staff contacted the women involved directly by telephone to offer them an appointment. Since then, appointments are being issued by letter. Approximately 1,500 smear appointment letters were issued to women last week. If the appointment does not suit, women are being asked to contact the Cervical Review Team to arrange a more suitable date and time.

“The Trust has also been providing updates on the review via the website, social media channels, statements to the media, briefings to elected representatives and meetings with women included in the review.”

The Southern Trust also says that work is also continuing on the review of cervical smear slides.

Said the spokesperson: “Two accredited laboratories in Northern Ireland are being used to review slides as part of the review as well as undertaking ‘business as usual’ work as Craigavon Area Hospital laboratory awaits reinstatement of its accreditation which is expected very soon.

“Approximately 200 slides have recently been reviewed and more are scheduled for this week and in the weeks ahead. Letters confirming the outcome of those reviews will be issued soon and no more detail can be provided whilst this is ongoing.

“We are continuing to work with the Public Health Agency and other Trusts to ensure that the review is carried out as quickly as possible.

“Northern Ireland’s cervical screening programme continues to be very effective in preventing cancer and saving lives however no screening programme can detect all abnormalities. International evidence suggests that if 1,000 women are screened using cytology and 20 of them have abnormal cells, cytology screening will detect about 15 of the women with abnormal cells. It will not detect all 20. This does not mean the screening system has failed – a good screening programme will find most, but not all, abnormalities.

“All cervical samples in Northern Ireland have been subject to HPV testing since early 2023. This is known to be an effective way to identify those samples which are most likely to have cell abnormalities which could subsequently develop into cancer.

“The primary HPV testing pathway is expected to be fully introduced into the Northern Ireland cervical screening programme later this month.

“We are sincerely sorry for any concern the ongoing review may cause the women affected and we urge anybody with concerns to contact our cervical review information helpline (0800 9520255).

“Common questions and answers regarding the review are also available on a dedicated section of our website which is updated on an ongoing basis, based on queries women have raised with us.”