Coombe had more test success than clinics
Hospital better for smear test detections
THE Coombe Hospital in Dublin had a far higher success in detecting cervical smear abnormalities than two private clinics hired by the Government, newly released HSE figures have shown.
In 2013 to 2014, the Coombe found more than twice as many abnormalities as a New Jersey-based lab.
Vindication for several experts
THE Coombe Hospital in Dublin had a far higher success in detecting cervical smear abnormalities than two private clinics hired by the Government, newly released HSE figures have shown.
In 2013 to 2014, the Coombe found more than twice as many abnormalities than a New Jersey-based lab.
Other years showed the Coombe had a similar success in finding abnormalities compared to the other two labs – one in Dublin and one in New Jersey.
The findings are a vindication for several leading experts within the health service who begged current HSE chief Tony O’Brien not to outsource smearing to the US, as they believed it was ‘dangerous’.
Several resigned their posts in the cervical cancer detection programme in protest at the outsourcing.
The newly released HSE figures for ‘Laboratory B’ total 24,705 tests between September 2013 and August 2014 – almost equal to the 25,822 smear tests from the cervical screening programme quoted in the Coombe’s annual clinical report for the calendar year of 2014.
The figures show that in the year 2013/2014, the Coombe found more than twice as many abnormalities in smear tests as the lab which the HSE will only identify as Laboratory C, in New Jersey.
In that year, the Coombe’s laboratory logged 14.1% of its smear tests with abnormalities – compared to 5.8% in Laboratory C. The Coombe also found abnormalities at between 11.6% and 14.1% of the samples between the years 2013 to 2016.
In contrast, Laboratory C found a much lower percentage of abnormalities – between 5.8% and 8.4% – from 2013 to 2016.
A HSE source confirmed that Laboratory B is the Coombe.
The number of tests it carried out, according to its annual reports, also tally with the figures for smear tests for Laboratory B released by the HSE at the weekend.
The HSE statement on Saturday evening said: ‘CervicalCheck tests are now processed in three laboratories, one in the USA and two in Ireland, all of whom have ISO accreditation. The HSE is making the data from the screening laboratories available today for the years 2013-2016.’
It added: ‘Some variation would be expected to arise from demographic variations across the population for which the labs are testing.
‘Overall, the trends are consistent, which indicates a high quality across all labs that are in line with international standards.’
The figures add weight to claims by cervical cancer
experts that the government should not have been outsourcing to the US.
A report by a senior lecturer in pathology, Dr Euphemia McGoogan, on the Irish Cervical Screening Programme urged the government as early as 2004 to make a ‘speedy policy decision’ about increasing the number of cervical cytopathology laboratories in the country to meet the needs of Irish women.
And last week, Dr David Gibbons, former chair of the quality assurance committee of the National Cervical Screening Program, said he went to Tony O’Brien’s office and asked him not to send samples to the US.
His pleas were ignored and Dr Gibbons resigned as a result. He later returned to the office with three other experts and asked Mr O’Brien to reconsider.
Speaking to RTÉ, Dr Gibbons said he warned Mr O’Brien, then the CEO of the National Cancer Screening Service, that the outsourcing of smear tests would lead to missed cases. Dr Gibbons said that he was concerned by the high volume and lower quality of US checks. He remarked: ‘Our scientist were screening 25-30 cases a day; American scientists were screening 80-100 so they were screening three to four [times as] many in a day. So we were worried with the figures we were getting back from America, and with the mismatch of the systems, that there was going to be a problem.
‘When we got the smears back from America, we looked at their figures and they were finding significantly fewer high-grade dysplasias than we were in the same population. We were finding 1.8 per 100 and they were finding 1.2, which is a third less.’
Dr Gibbons said he went to see Mr O’Brien at the time, adding: ‘I met him in his office … I expressed those concerns and I said that over a ten-year period this will cause problems. I resigned then from the committee.’
Numerous medics warned against the decision to outsource screenings. Former master of the Rotunda Hospital Sam Coulter-Smith and former health minister James Reilly were among those trying to keep the testing in Ireland.
‘I resigned from the committee’