Thereâs a lot of false reporting on the cervical cancer scandal. The real scandal here is that widespread testing for cervical cancer didnât start until 2008 in Ireland, for a test that was around since the 1940s.
The reality is that the cervical pap smear test is not very sensitive nor reproducible, studies have shown the false negative rate can be as high as 50%, so similar to tossing a coin whether the abnormal cells get caught or not. This can be improved with more modern techniques, but the rate of false negatives is still as high as 20%. Itâs just not a very reliable test, testing for HPV is far more reliable.
Itâs also untrue that the standard in the US is annual pap smear testing, the recommendation is every three years.
I suspect the number of false negative readings in Ireland may be no higher than any other country, but the rate of undetected cervical cancer must historically be much higher, given that screening didnât start until 2008.
I wouldnât have thought so. A memo of that kind would almost certainly have gone into DOH at sec gen level and itâs not credible that Leo wouldnât have seen it then.
If I am reading this right the HSE deliberately delayed telling patientsâ doctors about their cancer diagnoses in order to mitigate negative media attention and allow more time for their spin machine.
Being kicked out of his job is the least should happen OâBrien. He is resigning in disgrace and should have his lump sum and pension withdrawn.
Iâm not sure thatâs the case. My understanding is that the screening threw up false negatives. This is expected in a program of this nature. In the meantime some women got diagnosed with cancer and were being treated for it. They werenât told about the false negatives but it didnât impact upon their cancer treatment. Still an absolute shocker from the HSE but not as clear cut as saying they could have prevented the cancer. In fact I think they were caught as false negatives when samples were re-examined after cancer was detected. The thing is that as there was always going to be false negatives then youâd imagine they could have planned a better response.
I made a bit of a balls of that post. I should have said missed cancer diagnoses. The following from the Irish Times today describing the response to the 2016 memo:
âIts next steps were to pause all letters, await advice of solicitors, decide on the order and volume of dispatch to mitigate any potential risks and continue to prepare reactive communications response for a media headline that âscreening did not diagnose my cancerâ.â really sums up the HSE priorities. Their reflex reaction always seems to cover up and spin. Maybe this culture is a result of the whole thing being too big and unwieldy. I donât envy the new boss and the job that faces him.
Well as itâs a screening program, not a diagnostic one, it wouldnât have been âmissed cancer diagnosesâ either.
Some of the political point scoring off this has been genuinely disturbing and potentially puts further women at risk by undermining a worthwhile screening program.
That aside, the HSE response was poor. I suspect it mostly arises from a misjudged effort to minimise legal and financial liability. Again though, knowing that there would be false negatives, this was always going to be an issue
It would clearly have been much better for the HSE/Health minister to get out in front of this issue instead of reactively. Bureaucrats are not good at that type of thing unfortunately and prefer to wait until the SHTF. The concerns raised in the memo though have some merit as the media circus surrounding this case unfolds. You only have to read the comments after the journal article posted above to see how nuts the reaction is, driven by media hysteria.
The reality is even in the US, where pap smear cancer testing has been done for decades, about 4,500 women die of cervical cancer every year, and about 12,500 new cases diagnosed. The test just isnât that reliable, with on average 20% false negatives. The narrative thatâs being spun, or at least believed, is that HSE cock ups have caused the deaths of dozens of Irish women. This is utter nonsense, cervical cancer screening saves millions of lives worldwide and likely thousands in Ireland, but sadly some are not detected or detected early enough.