Review Of Northland Screening Case Completed
National Screening Unit Review Of Northland Screening Case Completed
2 May 2002
The National Screening Unit (NSU) has completed its review of the cervical screening history of Northland woman Sharon Pahau along with a wider assessment of pathology services in Northland. The results of the review do not indicate systemic issues within the programme requiring further investigation.
The case was brought to the attention of the NSU after the ACC accepted a claim by Ms Pahau for medical misadventure in relation to the mis-reading of her cervical smears in July last year.
National Cervical Screening Programme (NCSP) Manager Jane McEntee said the objective of the review was to determine if there was any evidence of possible systemic problems that would require further investigation.
"The Unit convened a sub-group of the NSU Screening Programmes Advisory Group to consider the specific case and other relevant information in order to provide advice to the Unit. This Group comprised public health physicians, an epidemiologist, pathologists a gynaecologist, consumer representatives and smear takers. The Group considered the information provided by the NSU and advised that based on this material there was not evidence of a systemic issue and recommended that no further specific action was required in Northland," Ms McEntee said.
"While the Advisory Group would not normally consider individual cases we felt an assessment by the Group would be beneficial in this instance. In 1999 the Group was called upon to provide initial advice on the membership of an expert group to oversee the Gisborne Investigation."
To assist with the review the NSU provided the Group with information about the operation of the cervical screening programme in Northland as well as an analysis of laboratory reporting for Northland women during the 1990s against the current national indicators and targets.
"For the laboratory that read Ms Pahau's slides ? Northland Pathology Laboratory ? the review found its performance between 1991 and 2001 was generally in line with current national indicators. For instance the percentage of smears reported as HSIL by the laboratory ? indicating a high-grade pre-cancerous abnormality ? was in line with current national indicators for all but two years ? 1995 and 1999. It would not be unexpected for a laboratory to deviate from national targets from time to time although in the current programme an explanation would be sought for this type of variation.
This case has highlighted the need for a consistent slide review methodology and on this point the Advisory group has provided some specific advice on progressing this issue.
"It is important to remember that all women recently registered with invasive cervical cancer will be approached and invited to participate in the Audit of Invasive Cervical Cancers. The planning and design work for this Audit has been completed and key clinical and public health experts have been appointed. In February the NSU submitted applications to all ethics committees and we expect final Ethics Committee approval within the next few weeks. The Audit-proper will start as soon as possible after that.
"The NCSP has been extremely successful in its objective to reduce the rate of incidence and death from cervical cancer. In the ten years from 1987 ? 1997 cervical cancer rates dropped by 39 per cent. Over the same period the death rate for cervical cancer dropped by 44 per cent. These statistics show that the anticipated 'epidemic of cervical cancer' has been averted," Ms McEntee said.