Almost two-thirds of women with invasive cancer of the cervix whose cases were examined in a research project, had either not been screened for the disease or were not having cervical smears carried out at recommended time intervals. A quarter of the cervical cancer patients studied had never had a smear.
Doctors at the National Maternity Hospital, Holles Street, Dublin, writing in the current issue of the Irish Medical Journal, say their research shows the present method of screening for cervical cancer has failed and emphasises the need for the urgent implementation of a national cervical cancer screening programme.
Dr Michael Foley, consultant obstetrician/ gynaecologist, and his colleagues examined the screening history of 100 women surgically treated for early stage invasive cancer of the cervix at the Holles Street hospital, between 1998 and 2002. Some 60 either never had a smear or had smears carried out at greater than five-yearly intervals. And 50 per cent of these women had the opportunity for regular cervical screening because they were regularly attending a doctor for the prescription of medication.
Compared with similar research carried out in 1990, the same proportion of women treated for cancer of the cervix at the hospital (23 per cent) never had a cervical smear. The authors calculated that 137 of 147 women in the two groups should, in theory, have been able to obtain a smear. "However, there has been no improvement in the percentage of patients with cervical carcinoma being picked up by opportunistic screening over a decade," they said. "This study confirms that opportunistic cervical screening is not currently effective."
Opportunistic screening, under which doctors and patients informally organise cervical smears, is still the method of screening used in the Republic. In 2000, a population-based screening programme was initiated, but so far it is only available to women who live in the mid-west region.
At the launch of a new cancer control strategy earlier this month, Minister for Health Mary Harney said her goal was to have a cervical screening programme for women aged 25 to 60 rolled out nationally by 2008. The National Cancer Forum, which drew up the new strategy, called for the programme to be completed "as a matter of urgency", a view echoed by the authors of the Holles Street study.
There are about 170 new cases of cervical cancer and about 76 deaths from the disease annually, according to the National Cancer Registry.