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Monday, January 18, 1999 Published at 01:47 GMT


Cervical cancer case begins

Screening saves 3,900 lives a year

A High Court case which could lead to a landmark ruling on standards for the national cervical screening programme has begun.

James Westhead: "The first time victims have gone to court for compensation"
Sandra Penney, of Ramsgate; Helen Palmer, of Whitstable; and Lesley Cannon, of the Isle of Sheppey, who are all in their 30s, are attempting to sue the former East Kent Health Authority over the running of the pathology laboratory at the Kent and Canterbury Hospital.

The three women claim the authority is responsible for the fact that they developed cancer because its cervical screening programme failed to identify them as being at risk.

Sarah Harman: "National standards are needed"
The Canterbury case dates back to 1996 when 90,000 smears had to be rechecked because early signals of cervical cancer were missed.

At least eight women are believed to have died as a result of the failures and 300 required urgent treatment.

So far, 89 women have made claims for compensation and more than £1 million has been paid out to 45 of them. The cases today are the first to come before the High Court.

Action team

An inquiry found widespread flaws in the screening process due partly to understaffing, low morale and poor training.

The case prompted the government to set up an action team to investigate cervical screening nationwide.

A 1997 Department of Health report found that more than one in three laboratories failed to meet national standards for screening.

But the government's Public Accounts Committee still found significant problems in the screening programme in 1998.

[ image: Sarah Harman:
Sarah Harman: "This is a landmark case"
Sarah Harman, solicitor for the three Kent and Canterbury women and around 100 others seeking compensation, says cancer screening varies widely across the country.

She said: "There have been many blunders publicised about cervical screening failing over the years, but this is the first time women have actually got to court in disputing whether or not their cervical screening tests were misreported.

"It is crucial because thus far no standard has been of what we can expect from cervical screening. It is going to be a landmark test."

Helen Palmer, one of the women who is taking legal action, said: "I feel very strongly. I did everything I was supposed to do to, I went for my tests I was called for. I don't see there was anything else I could have done."

Lost fertility

James Badenoch QC, acting on behalf of the women, said the staff at the laboratory had been poorly managed, badly trained and isolated.

He said all three women had faced major surgery as a result of the blunders.

He told the court: "In consequence of these failures to detect abnormalities in the smears, the opportunity for an early and complete detection of the dangerous development of these cancers was lost in that their cancers proceeded unchecked to the invasive stage, and in consequence they came to need major surgery."

There was a loss of their fertility and permanent consequences included a small but nevertheless statistical reduction in their expectation of life.

"The dispute before the Court centres on the question of what it is that these smears actually show and, perhaps more importantly, what they should show and the report that should have been done on the smears if it had been done acting in accordance with the ordinary, reasonable and appropriate standards of skill and care to be expected of the screening staff at the relevant time."

Mr Badenoch told the court that the screen service had fallen below the standards to be expected of "ordinary and skilful screening".

The health authority, which has already paid more than £1bn to 45 women affected by the screening problems, argues that it cannot be held responsible for failing to spot the three women's abnormalities because they were very low grade.

However, the women say standards need to be improved in Kent so that such abnormalities are spotted.

Confidence undermined

[ image: Helen Palmer:
Helen Palmer: "I did everything that was asked of me"
Cancer experts are concerned that the Canterbury case and other subsequent failures have undermined public confidence in the screening programme.

They say deaths from cervical cancer have decreased by 40% since 1979 because of the programme, saving some 3,900 lives a year.

Women aged 20 to 65 are screened at least every five years for pre-cancerous changes at the neck of the womb which may signal the onset of cancer.

Cervical cancer is the most common cancer in women under 35 in the UK. If it is caught in the early stages, treatment is much more successful than if left until the cancer develops.

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