Southern Health Trust: smear test accuracy concerns for women later diagnosed with cervical cancer that spread

Accuracy concerns over initial smear tests for eight women who were later diagnosed with cervical cancer that had spread, are identified today (Wednesday) in a major screening review at the Craigavon-based Southern Health Trust.

It has also emerged that after review an additional 11 women now require further treatment for pre-cancerous cervical cell changes, cervical cell changes or another "significant incidental finding."

The Trust's medical director, Dr Steve Austin, apologised again to all those impacted.

The Southern Trust review, affecting more than 17,000 women, was initiated last year after concerns were raised by senior laboratory staff.

These latest findings are included in today's update, completing the Cervical Cytology Review.

Two key reports are published today by the Southern Trust and Public Health Agency (PHA). The first report details findings from the review and the second report focuses on cervical cancers in the Southern Trust Area and across Northern Ireland.

Among the key findings are:

• Between 2009 and 2023 there were 207 cases of cervical cancer diagnosed by the SHSCT. The screening history of all these cases was assessed to determine whether, had they not been diagnosed with cervical cancer, they would have been included in the review.

• 12 (5.8%) of the 207 women diagnosed with invasive cervical cancer by the SHSCT during this time would have been included in the review because their last smear before they were diagnosed was read by one of the screeners. The first of these was diagnosed in 2011 and the most recent in 2021.

• All 12 cases were subject to detailed assessment as part of the Audit of Invasive Cervical Cancer. This has identified concerns about the accuracy of the original screening result in 8 of the 12 cases. Five of these 8 are subject to further investigation in line with the regional serious adverse incident (SAI) process.

Dr Austin said: “The Cervical Cytology Review Outcomes report shows that, for the vast majority of the women included in the review, their original result did not change.

"The purpose of the review was to check that the original result provided was correct and to identify anyone who may have been given an incorrect result.

"While it is reassuring that the vast majority of previous smear results have been reconfirmed as normal, the review has identified eleven women who are now receiving follow up care from our gynaecology services.

“We acknowledge that the failings in the cervical cytology laboratory extended beyond individual staff members and included system failings. The Southern Trust and PHA are committed to ensuring these failures never happen again.”

“I wish to sincerely apologise again to women and their families for any distress caused by this Review process and the publication of the outcomes report. I really hope that women will have been reassured that either their original result was accurate or that they are receiving appropriate care where that has been required.”

Meanwhile, Dr Joanne McClean, Director of Public Health at the PHA, also said she was "very sorry for any distress or worry caused by this review."

And she urged women to continue to go for screening.

"Our screening programme is very effective and the improvements put in place in the last year will make the programme better at finding women with abnormalities which put them at risk of going on to develop cervical cancer," she said.

". But we will only find these abnormalities in women who attend for screening. I ask all women who are invited to attend for cervical screening to please attend. It could save your life.”

The findings will now undergo independent expert review.

DUP MLA and Party Health Spokesperson, Diane Dodds MLA, said the findings of the review into cervical screening raised questions around processes and accountability, that must be answered to alleviate the concerns of those directly impacted and all women relying on accurate cervical screening testing.

And she has called for a public inquiry.

She said: “The findings of the review into cervical screening at the Southern Trust are deeply concerning, and will no doubt be deeply upsetting for those impacted by this scandal.

"It is heart-breaking that eight women whose smear tests were misread later developed cancer, two of whom have tragically passed away and who will not be with their families this Christmas.

"It is a very personal tragedy for these families that the review found that if their tests had been read correctly, they could have been diagnosed and treated earlier.

"These women and their families have suffered a great injustice, and my thoughts are with them at this incredibly difficult time.

"That 17,000 women have had to have their smear tests rechecked has caused widespread fear and anxiety among those affected.

"The emotional and physical impact of this error is significant and whilst some answers have been given, the question of accountability and public confidence in those managing these processes must be addressed.

"On a matter of such seriousness, a public inquiry is needed to establish the full truth and provide recommendations that restore confidence."

And she said she commended the Ladies with Letter campaign group for their "tireless work to advance this issue and to seek some form of redress for those who have paid such a huge price for the failings of the Trust."