Cervical cancer need not be a death sentence. Between vaccination, routine screening, timely follow up, and early detection, cervical cancer is preventable and highly curable. When a woman dies from cervical cancer, something went wrong. For at least 17 women with cervical cancer who have died in recent years in Ireland and for others whose diagnosis is now terminal, what went wrong is scandalous.
Ireland has a national cervical cancer screening program called CervicalCheck, which outsources some of its tests to US laboratories.
Between 2008 and 2014, 208 women who later developed cervical cancer were incorrectly cleared as normal. A 2014 audit revealed these false negatives. But even after this, at least 162 of the women were not told their earlier tests indicated they needed follow-up because there was no clear policy about what to do when false negatives were found.
The multiple levels of failures are nothing short of astounding.
The controversy came to light after Vicky Phelan, an Irish woman with cervical cancer and only months to live, refused to sign a non-disclosure agreement about her settlement with the Texas-based laboratory that returned her false negative. After she was diagnosed with cervical cancer in 2014, her 2011 screening test was audited according to procedure. This time, the 2011 test found strong indications of the presence of cancer. She did not learn that until September 2017.
There is a lot we don’t know about the cervical cancer scandal. A number of Irish doctors voiced concerns about outsourcing work to the US, citing lower quality assurance levels and different screening systems in US labs. Experts feared that differences between the two countries would means that cancer cases would be missed.
And cases were missed.
The Irish government has acknowledged that there were “appalling communication failures” and will investigate whether a different testing system could have reduced the number of false negative tests. Delayed treatment can render cervical cancer terminal and women have a right to access complete and accurate information about their reproductive health. False negatives can happen, but patients should be informed when they do.
Such failings in relation to women’s reproductive health have no place – in the US or Ireland. US federal health authorities should be reviewing what happened to ensure that all women have access to a quality and accurate cervical cancer screening test process. Heartbreakingly, if Phelan had been properly diagnosed in 2011, she would have had a chance to live.