@Firstofall there were issues with the labs.
Slides which showed abnormalities were given the all clear
When VP [REDACTED] was diagnosed with cervical cancer in 2014, an audit was carried out by CervicalCheck of her smears, as is the protocol when a woman who has previously had a smear test receives a cervical cancer diagnosis, in an attempt to improve the system.
Despite this, and against best practice, VP was not told of the audit or the result of it until 2017 – a year after her doctor was first informed about it. The audit found that the result was a ‘false negative’ – which meant that abnormalities were present in her earlier smear, despite it being reported to her as negative.
‘False negatives’ fall into two categories:
• cervical cell abnormalities that most screeners would not have detected, and
• ones that most screeners would have detected.
Which category a false negative result would fall into depends on each individual smear.
PC [REDACTED], a 51-year-old mother of four, received an out-of-court settlement of €2.75 million and an apology in October 2020. Two months later, she had died. Three of her smear tests – in 2014, 2016 and 2019 – were reported as having no abnormalities. Five months after the 2019 result, she was diagnosed with cervical cancer which had spread to her lymph nodes.
For example, Ireland’s CervicalCheck leaflets said that cervical smear screenings “are not 100% accurate”, where as information in Northern Ireland and Wales gave more detailed information of accuracy (“prevents 7 out of 10 cervical cancers”, “75% accurate”).
Most is the human error part of the screening as its a subjective process.
Per the UK It has a 30%/ 25% failure rate
So if your slide is examined you had a 25%ish chance that your pre-cancer cells were not detected.
Some of that will be down to the training given or how experience the individual is detecting abnormalities as its not a Y/N process.
If my memory is correct one lab had 1 person looking at the slide and made a solo decision a different lab had 2 independent people look at the same slide. The 2nd person is a control as (hopefully ) one is fail, one is pass so the slide gets an additional test process.
If you have 3 tests over a short period of time you would be very unlucky to get 3 clear tests and be found to have progressed to secondary cancer 5 months after the last.
Not sure which controls you mean specifically. The audits themselves were a safety mechanism.
Audits are not a safety mechanism
Remember Anglo and the Directors Loans?
The accounts passed the audit by getting the loans moved for a single day while routing the transaction outside the scope of the employees who were responsible for loans and bypassing control functions by having 2 process. Directors ticked the box no loans on 31/12/YY and audit of system proved no loans on the books that day.
Audits examine how robust the process is and how closely employees follow the process method.
The investigation, dubbed ‘The RCog Review’, found that the screening service is “in line with internationally respectable programmes”.
Out of a total of 1,038 women or their families who agreed to take part, the review disagreed with the CervicalCheck diagnoses in 308 cases (30%). In 159 of these cases (15%), the RCog Expert Panel “considered that the CervicalCheck result had an adverse affect on the woman’s outcome”.
So the safety is the process used to minimise human error.
The audit finds all the "uncrossed T's and undotted I's" with in a test sample
But if staff are looking at 100% of the slides and as expect every 4th slide result is wrong and on average that happens with the sample the system works with in the agreed failure rate.
CC needed a manual that duplicated the expected workflow from when the slide arrived to when the lab sent the result back to CC.
And samples of what was a "clean" to a "questionable" to a "problem" slide. The expectation would be that a good number would not be text book clean or problem.
The important ones being the questionable and how each should be managed.
So a "training manual for dummys" with
if slide
• looks like X go to page 3 go down the list and if too many boxes are ticked do Z
• looks like Y go to page 5 go down the list and if too many boxes are ticked do Z
is documented
That is what a trained experienced person is doing as they look but it having an agreeded method which documents that on paper.
In relation to the procurement process for hiring laboratories, the Scoping Inquiry said that the State didn’t place enough emphasis on quality assurances: the report said of a 2008 tender that it “underspecifies detail in respect of expected service and quality levels and quality”; in a 2010 request for proposals, the report said “service and quality remain underspecified”.
Its not possible for CC to audit what has not been agreed or what is not documented.
meant people women weren’t being treated for cancer on purpose.
Thats poor listening on behalf of the individual as VP's case and the whole thing had multiple investigative programs run around that time.
I don’t agree Cervical Check has an anti-woman bias, though it’s true their literature tried taking out the word woman for a while too. We used to call it ‘political correctness gone mad’ in the old days. Anyway, they were told, and they put woman back in. I’d be more concerned that they now communicate that screening helps but is not infallible.
I disagree that it was just PC at the time banks were creating polish documentation to assist the Polish population access services, yet a female cancer service was choosing to move to using a body part when poor education or non english speaking as a first language creates a barrier.
The government policy was use simple direct plain english to communicate and write documentation.
The change was due to lobbying by individuals who were vocally anti-women when the CC was asked to put the word woman back. And from memory the message and women involved were not welcomed by CC staff.
Other Health staff were boasting on twitter how they too were removing the word woman. Plus the trope women are people was rolled out to justify the people with a cervix.