A national cervical screening programme must be provided for Irish women as soon as possible, an international expert's report has recommended.
The report, commissioned by the Health Board Executive on behalf of the chief executive officers of the health boards, found the screening available to Irish women at present, which is on an "opportunistic" basis "has failed to achieve a significant reduction in the incidence and mortality" from cervical cancer. "Indeed there is a suspicion that the trend is upwards," it states.
The Republic's invasive cervical cancer rate is one of the highest in western Europe, it says. "In order to achieve an 80 per cent reduction in cervical cancer in the Irish population, there is a need for an organised population health-based programme rather than continuing with opportunistic screening as at present," it says.
The report was carried out by Scottish-based consultant cytopathologist Dr Euphemia McGoogan, who was asked to review the effectiveness of a pilot cervical screening programme set up in October 2000 for women living in the Mid Western Health Board region.
"Phase I of the Irish cervical screening programme in the Mid Western Health Board worked well and provides a sound basis for national roll out," she concludes.
Dr McGoogan has recommended a national programme, which she estimates would take at least 18 months to set up, should be organised around four regional screening centres: two in Dublin, one in the south and one in the west.
Women aged 25 to 35 years should be screened every three years and after that they should be screened at five-year intervals until the age of 60, unless they have abnormal smears.
Once screening commences, opportunistic smears should be actively discouraged, she says, so that laboratory capacity can be concentrated on delivering speedy results for those availing of the national screening programme. She is concerned that over 25 per cent of relevant laboratory staff were over 50 years of age and due to retire in the next 10 to 15 years.
"Consideration should be given to improving recruitment and retention of cervical cytopathology laboratory staff. Innovative ways to address the discrepancies in the take home wages between cytopathology and staff in other laboratory disciplines should be explored," she says.
A rapid decision should be made by the Department of Health on her recommendation for a national roll out, she adds.
A comparative study of deaths from cervical cancer published last month found rates fell substantially in the UK after a national screening programme was introduced in 1988.