Dr Ciarán Ó Riain AT SOME STAGE in the next fortnight, I will likely look down a microscope at a biopsy sample from a young woman.The doctor training to be a consultant pathologist sitting down with me has already seen cervical cancer under the microscope too many times before. The diagnosis will likely be one we can make with confidence.
Both women may have partaken in our screening program, attended for every smear test on schedule, done everything asked of them. Screening may only have worked for one of them. Plans were afoot for the introduction of a screening test involving looking for the presence of the HPV virus as a first step – undoubtedly a better test although one still with false negatives.On Wednesday, the full High Court Judgment of Mr Justice Cross in relation to the case of Ruth Morrissey was published.
While the principle is in place in the UK since 1999, there is little doubt that we operate in a very different medicolegal environment in Ireland. As well as the anxiety associated with an abnormal finding, real physical consequences are possible; repeated biopsies of the cervix may cause problems in pregnancy, removal of breast tissue may be performed for a nodule that left undetected would never have affected a woman’s life, colonoscopy with its rare but real complications would increase.
A model involving blind review of slides that mimics normal screening conditions and would answer the key question of whether the slide would have been consistently identified as abnormal.
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