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Monday, December 7, 1998 Published at 21:40 GMT


Health

Scientists hail 'infallible' smear test

The current screening programme has a 10% to 30% failure rate

Scientists believe they have developed a smear test that could end the scandals that have plagued the UK's cervical cancer screening programme.


The BBC's Fergus Walsh: The test is proving to be 100% accurate in early trials
The test, which has been pioneered by Cancer Research Campaign scientists at the University of Cambridge, uses a new way to diagnose suspect smears.

It could dramatically reduce the current error rate, save thousands of lives and millions of pounds.

Known as the Campaign Test, it uses antibodies to home in on any abnormal cells in a conventional smear test.

A fluorescent or coloured dye is then used to highlight these antibodies so that the abnormal cells stand out and can be identified more easily.

The conventional smear test, called the Pap Test, is described as the most successful public health cancer screening measure in the world.

However, it wrongly gives the all-clear in around 10% to 30% of cases, leading to women dying from cancer.

There have been several high-profile failures of the current system which health workers fear may have undermined public confidence in screening.

These include:

  • The deaths of at least eight women following a failure of the screening programme at Kent and Canterbury Hospitals NHS Trust
  • The recall by St George's Hospital, south London, of more than 1,000 women after a woman died despite being given the all-clear.

In early trials, the new system has proved 100% efficient at detecting abnormal cervical cells in smears.

The Cancer Research Campaign believes the new test could be combined with the Pap procedure to improve cervical screening programmes worldwide.

Large-scale patient trials of the combined test are due to start in the USA within the next 18 months. If these are successful, the new test should be available in the UK and worldwide three years later.

Amazing discovery

Director-General of the Cancer Research Campaign, Professor Gordon McVie, said: "This discovery is amazing because it effectively makes any suspect cells stand out from the crowd.


[ image: Professor Gordon McVie:
Professor Gordon McVie: "This is an ideal solution"
"If large-scale trials prove successful, I believe it could be an ideal solution to the mistaken cervical smear diagnoses which we have sadly all heard so much about."

Professor McVie said the test could in the short-term be used to improve human assessment of cervical smears. In the longer-term, it could be automated so that only suspect smears are scrutinised by the human eye. This would save millions of pounds.

Health Secretary Frank Dobson welcomed the development of the new test and hoped it would lead to a big improvement on the present system.

"Ever since I conducted the first national survey of cervical cancer screening arrangements in 1985 I have been hoping that someone would come up with a method that would help the screeners," he said.

"I've always believed that cell changes that are discernible under a microscope must involve chemical changes that can be spotted by a chemical test and that's what this new test is."


[ image: Frank Dobson: Determined to raise standards]
Frank Dobson: Determined to raise standards
Mr Dobson said the government was determined to raise the reliability of the cervical and breast cancer screening processes so that cancers could be identified early.

"No test can be perfect, but the standard in many places was simply not good enough," he said.

"That's why we have introduced measures to raise quality standards and to make sure they are met.

"We have made sure that someone is clearly in charge of each call and recall system where women are invited for tests every three to five years, each laboratory service and each colposcopy service."

The new test works by using antibodies which home in on protein molecules called Cdc6 and Mcm5.

These molecules, only recently discovered, regulate the production of DNA - the building block of the cell.

They are only present in cells that have the potential to reproduce themselves. Cells taken in a normal cervical smear should not be dividing, so the presence of these molecules indicates abnormality.

The researchers did a trial on 58 cervical smears and compared the findings of the new test with conventional diagnostic methods.

The new test found abnormalities in three smears that had been diagnosed as normal by the conventional Pap Test.

The three problem cases were re-examined and shown to have low-grade abnormalities on the smear. On further investigation of the patients by biopsy, high abnormalities were found in all three cases.



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