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Dublin: 1 °C Sunday 15 December, 2019
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CervicalCheck backlog leaves women waiting months for abnormal cervix assessment

One women whose GP noticed a visual abnormality in her cervix was told she could be waiting more than six months.

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WOMEN WHO HAVE been referred for colposcopies after their GPs noticed abnormalities in their cervixes are being told they will have to wait months for an appointment because of the backlog created by the CervicalCheck controversy. 

One woman who was informed in June that she needed a colposcopy – a procedure used to examine the cervix – was told that she could be waiting more than six months for an appointment. 

The woman who spoke to TheJournal.ie said her GP noticed a visual abnormality during her smear test in June.

“I was told that normally, before the scandal, you’d be sent to the clinic for the colposcopy without needing the smear results back. But now it’s changed and they won’t see me until the results of the smear come back. I was told the waiting time was 6.9 months for the results,” she said.

I’m lucky to be able to afford private health insurance so I am getting a referral to a private gynaecologist in the meantime so I can get checked out. 

“Particularly with womb cancer the odds aren’t great and the whole idea is to catch it before it goes too far. If they can actually see something that might not be right when they examine you, I don’t see the logic in stalling until you get the smear results.”

‘Huge waiting lists’

A consultant in one of the country’s 15 colposcopy clinics told TheJournal.ie that GPs are “understandably more cautious now” and are referring more women when they notice potential visual abnormalities in the cervix. 

As a result of the Minister for Health’s decision to offer repeat smears to every woman in the country, there are also more abnormal results coming back that require a referral for a colposcopy.

“These two factors combined have resulted in a large increase of numbers of referrals to colposcopy clinics, which now all have huge waiting lists to work through,” the consultant said. 

“Strictly speaking the colposcopy clinics are there for people with abnormal smears, not for people with abnormal looking cervixes, but previously they would have been seen at the clinic anyway because that’s the best place for them to be seen. 

We had the capacity to see them in the clinic and still be able to see patients with abnormal smears in an appropriate time frame , but now we can’t because of the increased number of patients.

He said because of the way the screening programme operates, clinicians have to prioritise patients with abnormal smear tests over patients who are referred because of visual abnormalities.

Now when a GP refers the woman because of a visual abnormality, in many cases they are being told the clinic has to wait until the smear test results are back, which now takes months.

‘The system couldn’t cope’

The consultant said these patients could be referred to a gynaecologist outside of the colposcopy clinics instead, but these clinicians would not have a colposcope and would likely end up referring the patient on to one of the clinics anyway.

“The general gynaecology clinics have their own capacity issues and large waiting lists,” he said.

He said the backlog with smear tests is also resulting in delayed diagnoses and gave one example of one of his patients whose “smear took such a long time to report that when the result arrived she ultimately had cancer”.

“There is now a long waiting list of people to be seen in colposcopy who could have cancer.

The last year has been major challenge in trying to see patients in the clinics in an appropriate time frame. 

He said the decision by Minister Simon Harris to offer repeat smear tests without the adequate resources in place was a “naive” move. 

“It undermined the screening programme and resulted in a huge surge in referrals which the system couldn’t cope with.”

In a four-hour session, the consultant said he is now seeing 16 patients. He said he is hearing the same problems from colleagues at clinics all across the country.

He said the HSE has provided more resources but it will take time for them to get a handle on what exactly is needed to tackle this massive addition to the workload.

The HSE did not respond to a request for comment on these delays. 

Smear test backlog

Yesterday the HSE apologised to 800 women who did not receive their smear test results because of an IT glitch.

The issue occurred at Quest Diagnostics Chantilly facility in Virginia, USA which currently performs HPV testing for the CervicalCheck service.

Dr Colm Henry, HSE Chief Clinical Officer, said any delay and inefficiency in the cervical screening service “is hugely disappointing for the women involved and for our service”.

Speaking in the Seanad, during a debate on a Bill to establish the CervicalCheck tribunal, Minister Harris said a lot of progress has been made in dealing with the backlog of smear tests.

 He said the backlog would be “effectively gone” by mid-September when the Dáil and Seanad resume after the summer recess.

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