Thousands at risk as labs ‘throw swabs in the bin’

YOUNG women are being put at risk of deadly cervical cancer because ‘bureaucratic’ NHS labs are refusing to process tests carried out on those under the age of 25, a leading gynaecologist has warned.

A Freedom of Information request by The Mail on Sunday has revealed that hundreds of young women are having their cervical smear tests ‘rejected’ by labs without being checked – because they are under the official screening age.

Although specialists ‘might be able to push individual tests through by making a few calls and knowing the right people’, the majority that are carried out in good faith by GPs and nurses will have simply been ‘thrown in the bin’, claimed one doctor, who wishes to remain anonymous.

Figures obtained from 40 NHS trusts in England revealed that 903 smear tests were rejected in the past three years because women were under 25, the age at which screening starts.

Angus McIndoe, consultant gynaecologist and gynaecological oncologist, warned that the number could run into thousands if replicated throughout the NHS.

‘These figures are just the tip of the iceberg,’ said Mr McIndoe, of the Nuada Gynaecology clinic. ‘Women have gone through the indignity and discomfort of a test because it has been deemed necessary by a doctor, only for a lab to refuse to test it.

‘Common sense needs to be exercised here, rather than sticking to rigid guidelines all the time.

‘What happens if that patient whose test was refused develops cancer three years later – who takes responsibility for that?’

The national age for cervical screening was changed from 20 to 25 in England in 2003 because health chiefs concluded that testing did ‘more harm than good’. Scotland followed suit in June.

NHS advisers argued that abnormal cells flagged up by the test are common in younger women and may clear up of their own accord.

If the results of a cervical screening test show abnormalities, the follow-up investigations can increase the risk of women subsequently suffering premature labour.

Guidance from NHS England states that ‘out of programme’ tests, including those where the woman is under 25, should be discarded.

An exception may be made for samples taken by a gynaecologist or other specialist ‘where they have clearly documented on the request form the rationale for taking the sample’.

Dr Helen Stokes-Lampard, of the Royal College of GPs, said: ‘It benefits nobody when a smear test is wasted – not the patient, not the NHS, not the labs, not the GPs. Nobody wins.

‘The rules are clear: there is no point in carrying out smear tests on women under the age of 25. They will be disregarded by the lab.

‘The only reason why it may be that they are carried out anyway is that a nurse or GP is not up to speed with the regulations or understand how strict they are.

‘If a GP is worried about a patient – regardless of her age – but a smear test is not due, the right action, according to clinical guidelines in all four nations of the UK, is to refer her to a gynaecologist for a more appropriate assessment, such as a biopsy or a colposcopy.’

Mr McIndoe called for the testing age to be brought back down to 20.

‘The peak incidence of cervical cancer is in women aged between 25 and 29, and if we want to catch it early we need to start screening earlier,’ he said.