Cervical cancer deaths fuel fears over screening

New doubts about the accuracy of screening for cervical cancer were raised yesterday after an investigation revealed that one-third of women who developed the disease had early warning signs missed during smear tests.

New doubts about the accuracy of screening for cervical cancer were raised yesterday after an investigation revealed that one-third of women who developed the disease had early warning signs missed during smear tests.

The high level of mistakes exposed by the study will increase anxiety among women, whose confidence in the national screening programme has been dented by a series of scandals over the past decade.

The audit, in Leicester, showed that 14 women died of the disease after being given the all-clear from smear tests, and another 64 women had to have more radical treatment than would have been necessary if the disease had been detected earlier.

Professor Mike Richards, the Government's national cancer director, said the same degree of fallibility could be repeated across the rest of the country. But he stressed that many more cases of cervical cancer were detected by screening than were overlooked, and urged women not to abandon smear tests. He said screening had almost halved the death rate from cervical cancer, saving about 1,300 lives a year and preventing 3,900 cases annually.

Department of Health officials said they were disclosing the audit as part of a new policy of openness, in spite of fears that it could cause alarm among women. They also said that Leicester services were not failing and were up to the standards of the best.

In the biggest study of its kind, specialists at Leicester Royal Infirmary checked the screening histories of 403 women diagnosed with cervical cancer between 1993 and 2000.Of these, 324 women had taken at least one smear test prior to the disease being diagnosed. When the slides of their cervical cells were re-examined, discrepancies were found in 122 cases, or more than a third, and 84 of these cases were considered to be "false negatives" ­ where abnormal cells were not detected and an all-clear was wrongly given.

Leicester's NHS trust expects to pay compensation in some cases where tests were wrongly interpreted. The trust has offered legal representation to the women and families involved, who were yesterday told about the audit results.

Professor Richards said: "We recognise this may and will cause distress to some of the patients. But there is a balance between the NHS being open and saying sorry when they get things wrong. We want to learn and improve from this.

"We can assume that around the rest of the country there will be other cases where diagnosis of cervical cancer or an abnormality on the smear were not picked up." He said women diagnosed with cervical cancer would, in future, have their previous smears rechecked and told the results if they wanted. New liquid-based cytology tests were also being piloted, which will make slides easier to read. And in June, new leaflets will be published to tell women about the benefits and limitations of screening at three-year to five-year intervals.

Cervical cancer is the most common cancer in women under 35. But death rates have fallen by 7 per cent a year since screening was introduced in 1988 and Julietta Patnick, the national co-ordinator of the screening service, said it helped to prevent 80 to 90 per cent of cervical cancer cases.