As the Deputy will be aware, the RCOG expert panel provided an independent analysis of their slides to women diagnosed with cervical cancer from 2008 to 2018, who had been screened by the CervicalCheck programme and produced an Aggregate Report, published in December 2019.
The key conclusions of the RCOG Expert Panel were that the CervicalCheck programme has undoubtedly saved the lives of many of those who participated in the Review; that the programme is working effectively and that women can have confidence in the programme.
In July 2023, the World Health Organization’s International Agency for Research on Cancer (IARC) published a report on Recommendations of Best Practices in Cervical Screening Programmes, which includes best practice on audit, quality assurance and communication.
One international best practice approach to quality assurance is for a programme to undertake an audit of invasive cervical cancers (after diagnosis and confirmation of cancer) and to review the entire screening pathway of these cases to determine if there were opportunities for learning and improvement.
By reviewing the slides of women who had developed cancer after a negative screening test / negative triage, the RCOG review showed that Ireland’s false negative rate was within international norms. It found that Ireland’s cervical screening programme is effective in identifying the majority of people amongst an apparently healthy population who may have an increased chance of cancer.
The National Screening Service and CervicalCheck have been developing an audit and communications process in line with the WHO/IARC international best practice, and in line with Dr Scally’s recommendations.
It is important to note that audit is one element of a broader Quality Assurance or Quality Improvement exercise of any screening programme. The purpose of an audit is not to examine individual care. An audit looks at system-level data and audit recommendations feed into ongoing quality improvement.
A new patient-requested review process has been developed in CervicalCheck, and designed in conjunction with patients, including the 221+ Group. Under the Patient Safety Act 2023, it will be mandatory to fully disclose the results of these reviews to women. These new personal cervical screening reviews will be offered to women, who have previously attended screening, after they get a diagnosis of cervical cancer.
It is important to remember that population-based screening programmes are for healthy people without symptoms. If anyone becomes aware of symptoms, or if they have concerns or worries, they should contact their GP who will arrange appropriate follow-up care.
