The increased volume of smear tests since the CervicalCheck issues arose in April 2018 has been significant, and includes women who have availed of the out of cycle tests, but also a greater number of women presenting for scheduled screening. This increased level of engagement with the programme is welcome. However, the increased demand has undoubtedly put pressure on lab capacity and turnaround times.
The HSE has been working actively with the labs to manage this issue and to improve turnaround times for smear tests. In addition, the HSE is aiming to source additional screening capacity, which would improve the turnaround time of results. This is a priority concern for my Department and the HSE.
The HSE advises that the CervicalCheck Programme has recently agreed with laboratories to prioritise those slides which originate from women who attended colposcopy, as this cohort of women are considered to have the most serious need. The HSE also advises that the natural history of cervical cancer would indicate that the disease would normally develop over a period of 10 to 15 years. Due to this very fact, it is important that any woman of screening age attends for cervical screening each and every time she is invited to participate. The HSE has advised that in this context, a delay in the return of cervical screening results, whilst undesirable, is not necessarily dangerous and poses a very low risk to women.
I have asked the HSE to introduce HPV testing as the primary screening method for the prevention of cervical cancer as soon as possible. Funding to implement the switch to HPV screening, and extend HPV vaccination to boys, has been allocated in Budget 2019. The decision to switch to primary HPV screening follows on from a Health Technology Assessment carried out by HIQA. This found that it would be beneficial, both clinically and from a cost effectiveness perspective, to make this transition. The introduction of primary HPV screening is in line with developments in cervical screening internationally. Ireland will be among the first countries in the world to make this transition. Work is progressing across a range of workstreams including procurement, ICT and colposcopy services, pre-tender market engagement has been completed and a Prior Information Notice was published on 20 February.
I have asked the HSE to respond directly to the Deputy in relation to the specific number of women who are waiting more than four weeks for their results and the length of time women are waiting.