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Irish Outsourcing of Smear Test may Result in Cervical Cancer Being Undetected

by Himabindu Venkatakrishnan on Jul 7 2007 4:26 PM

The Well Woman Centre of Ireland has warned that outsourcing of smear may result in cervical cancer being undetected in some patients. It could also lead to lead to inconsistencies in the interpretation of results by Irish doctors.

The Well Woman Centre has criticized the Health Service Executive (HSE) for sending cervical smear tests to the US, as it could have serious ramifications for women with abnormal smears.

The Irish system is plagued with long delays and this was the main reason that HSE decided to out source tests.

Well Woman Centre Chief Executive Ms Alison Begas said the move by the HSE was “purely system driven” and did not take into account the fact that the method of reporting results in the US differs from that used by Irish doctors.

“Doctors now have to make judgment calls about some results,” said Ms Begas. “Effectively, US labs use a different language and our doctors are being forced to translate from one system to another, without enough guidance.

"This compromises doctors and patients and could result in a potential abnormal result slipping through the net," she said.

Previously, all smear test data from Well Woman Centers were sent to the Royal College of Surgeons in Ireland (RCSI) accredited laboratory for analysis, Ms Begas said.

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"This offered a continuum of care to all our patients through a shared understanding of result reports," she said. "Much of this has now been lost through outsourcing."

The annual report of The Well Woman Centre carried an analysis of 37,000 cervical smear tests taken over a 4.5-year period from 2002. It found that 84.3 per cent of smears taken from women between 25 and 40 years of age produced a normal result.

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Significantly, the report concluded that women from poorer social and economic backgrounds were more likely to have abnormal smear results. The annual report also reveals more medical card patients were referred to hospital for colposcopy with abnormal smears than private patients in 2006.

A HSE statement said: "It should be noted that the Bethesda Methodology as used in the US laboratory, and in most countries around the world, is now being introduced on an EU-wide basis. "Each patient's previous cytology history was attached to the material received by the US laboratory and was therefore available for interpretation at site.

"As a result the HSE is now achieving its target whereby no woman should be waiting more than four weeks to receive test results." The Health Executive added that 97% of all smear tests come back normal, with no follow-up required. It said in a statement that the US handling meant its target of results back to women within four weeks could now be met.

Source-Medindia
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