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Prof Donal Brennan, University College Dublin (UCD) Professor of Gynaecological Oncology, said the review should have been conducted in a “blinded fashion”, where the pathologist or cytologist was not aware the women being reviewed had been diagnosed with cervical cancer.
“This was what I would call a ‘cancer review’, because an audit would be looking at referencing back to international standards, which hasn’t actually happened yet,” he said.
“The cancer review was, I assume, well intentioned but poorly planned. It was also poorly performed because if it was performed correctly, it should have been performed in a blinded fashion, but this wasn’t performed in a blinded fashion — that means that the people who were reviewing the slides actually knew these women had developed cancer and were already biased.
“Whilst in reality, in a true audit or a true review, those slides should have been put into a set of slides that were due for routine testing and the pathologist or cytologist should not have known that these were review slides.”
Prof Brennan said the way in which cancer data is managed in Ireland needs to change and that a national cancer data management service should be established. He also called for the immediate introduction of gender-neutral HPV vaccination.
“The whole way we manage cancer data is not properly joined-up in Ireland, from screening to diagnosis, to treatment, to outcome,” he said.
“Really, what we need is a much more in-depth understanding of cancer activity in Ireland to avoid things like this happening again, such as this issue that there were cervical cancers that CervicalCheck didn’t know about that were listed in the National Cancer Registry.”
Prof Brennan cautioned that currently, there is no evidence to suggest laboratories involved in examining smear tests performed poorly. He said more information is required before assessments can be made.
“Now, it could be that there is a problem with one of the labs, but we don’t know, therefore we need to wait to get that information before jumping to any conclusions.”