On Tuesday 3 December, the Aggregate Report of the Independent Clinical Expert Panel Review of CervicalCheck, led by the Royal College of Obstetricians and Gynaecologists in the UK, was published on the website of my Department.
The Expert Panel has concluded, based on its overall findings, that for many women who participated in this Review, screening undoubtedly saved their lives, that there is no doubt that the Programme has been successful and that it is working effectively, and that women can have confidence in the CervicalCheck Programme. This is very welcome reassurance in regard to our national cervical screening programme.
A key finding in the report is that, in the case of 308 or 29.8% of the participants, the Review disagreed with at least one of the individual’s original CervicalCheck slide results. Of these, there were 159 cases in which the Expert Panel felt an opportunity to prevent cancer or to detect cancer at an earlier stage may have been missed. The findings in this regard are reflective of the position, as stated by the Panel, that cervical cancer screening will fail to prevent 30-35% of cancers, even in well run programmes.
Colposcopy management was also reviewed in 106 cases, of which 27 were considered suboptimal. The Expert Panel noted that it was inevitable in a review such as this that a small number of cases would be found where practice was suboptimal but were clear that this should not be taken to conclude that colposcopic practice in the CervicalCheck programme is substandard.
I note the findings of the RCOG report in which the Expert Panel noted that colposcopy is an integral component of any cervical screening programme, that colposcopy management was in line with standard practice in the vast majority of cases reviewed and that the Review Team has said that women can have confidence in colposcopy services and in the Programme overall.
Clearly, screening failures have a serious and sometimes devastating impact on the lives of women and their families. The Expert Panel has stated that these are unfortunately inevitable given the limitations of cytology-based screening.
We must do all we can, therefore, to make cervical cancer a rare disease in Ireland. This can be done through a combination of screening and vaccination, together with strong uptake, and this is my priority. HPV vaccination has now been extended to boys as well as girls, and the HSE has committed to introducing HPV primary screening in Q1 next year.
The Report of the Expert Panel contains ten recommendations, and I have written to the HSE in regard to these.