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Wednesday, April 22, 1998 Published at 07:53 GMT 08:53 UK


Smear tests criticised
image: [ Cervical cancer: most common cancer among women in England under 35 years ]
Cervical cancer: most common cancer among women in England under 35 years

A report by a government watchdog has criticised the cervical screening programme in Britain.

The National Audit Office (NAO) found faults at every stage of the system including women having to wait too long for their results.

It said there were serious quality failings in the National Health Service's cervical screening programme.

[ image: Screening programme is
Screening programme is "faulty at every stage"
Women were waiting too long for their smear results and to be seen at a clinic if treatment is needed, it stressed.

The NAO said laboratories were failing to comply with official guidelines, published two years ago.

Reporter Sanchia Berg examines the effect of the report on BBC Radio 4's Today programme (2'52")
In the first full year after the guidance was issued, around half the laboratories reported levels of inadequate and abnormal results which were outside the "acceptable ranges".

"Some important objectives are not being met and this may be placing accuracy at risk," warned the NAO.

Cervical screening is a method of detecting pre-cancerous changes in a woman's cervix, or the neck of the womb. It is the most common cancer among women in England under the age of 35 years.

The NAO report found faults at every stage of the system. It will increase concern about the effectiveness of the programme to screen women for cervical cancer after a series of high-profile failures in the system.

The most serious was the Kent and Canterbury Hospitals NHS Trust, which admitted that inaccurate testing by its former screening service may have contributed to the deaths of eight women.

The NAO report said that while such cases were small in number, they were a "disturbing feature" of the overall programme.

"These have caused anxiety and inconvenience to women recalled for screening and avoidable harm and death to some women wrongly told their smear was normal," said the report.

It said that while overall, the 100 English health authorities were meeting their target to screen 80% of eligible women every five years, 13 were failing to do so.

Some steps already have been taken to improve the reliability of the screening programme.

Following the disclosure last year of problems at Kent and Canterbury Hospitals, the NHS required that all laboratories involved in cervical screening be accredited by an independent organisation.

But the NAO said much more needed to be done. It recommends that the NHS do more to reach the under-screened female population, largely women from ethnic minorities and economically deprived neighbourhoods.

It also asks the NHS to consider screening women every three years instead of every five years, and to provide more training to health professionals who take smears.


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