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Health

Doctor 'predicted cervical smear test issues 10 years ago'

  • Doctor 'raised concerns about outsourcing of Irish smear tests'
  • Dr Gibbons said he predicted problems would arise 'in 10-12 years time'
  • Explains how US screening does not suit Irish testing system
  • Doctor said he resigned from committee after concerns were allegedly dismissed
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A former member of the National Cervical Screening Programme said he raised concerns about the outsourcing of Irish smear tests 10 years ago - and predicted there would be problems about quality assurance.

Dr David Gibbons was chair of the Cytology/Histology Group within the Quality Assurance Committee of the National Cervical Screening Programme when he expressed his concerns in 2008.

Speaking to RTE Radio One's Morning Ireland, Dr Gibbons said he warned the then CEO of the National Cancer Screening Service Tony O'Brien that the outsourcing of cervical smear tests to the US would lead to missed cases or misdiagnoses.

He predicted it would become a problem in approximately 10-15 years time.

He also said he and a group of "very well-qualified scientists" resigned after their concerns were allegedly dismissed.

"From 2006 to 2008 I was the Quality Assurance chair of the Quality Assurance committee... I was also running a large screening lab in Dublin," Dr Gibbons said.

"At that time, we had a backlog due to under-resourcing."

Dr Gibbons said tests were outsourced to laboratories in the US and he expressed concern about the figures they received back.

"They were predicting fewer pre-cancer cases in a batch of similar population size to us.

"We were finding 1.8 cases per 100, they were finding 1.2.

"This was a third of a difference."

Dr Gibbons explained that the US system screens women on a yearly basis. In Ireland, a three-year screening scheme is in operation.

"So even though they do the tests quickly in the US, they do it once a year. So they have a substandard screen, but more often," he continued. 

"[With the annual screening], you do the testing three times for every time you do it once here.

"We were getting figures back from the US and there was a mismatch in the systems.

"I was worried there would be a problem.

"The American system works for them, but it's a different approach.

"We were getting one third of the high-grade cases we were finding in our population.

"That was worrying for us, that they were finding too few," he added.

Dr Gibbons said he organised a meeting with Tony O'Brien to raise his concerns. He alleged that Mr O'Brien dismissed these concerns.

"I started and said I was QA advisor and then I expressed my concerns. I said over a 10-year period this would cause problems, problems what wouldn't be there for 10 years.

"I subsequently resigned from the committee and some very well-qualified scientists resigned as well.

"Myself and three people running the labs went to see Tony O'Brien, two other people were in the room on his side.

"We thought [the lower figures] were dangerous and would lead to problems, problems that wouldn't become apparent for 10 years.

"They continued to introduce the outsourcing. It became a political football and, as democracy works, the majority pushed it through.

"Unfortunately, this is where we are now," he added.

"We estimated 10-15 years and I don't think we were wrong."

Dr Gibbons said they estimated that approximately 1,000 cases might be missing in a year.

Meanwhile, Chairman of the National Association of General Practitioners Dr Andrew Jordan said he and a group of GPs were also "unhappy" that screening was being outsourced.

"We were embracing a system where women were getting an annual smear, where we were telling women they would be okay for 3-5 years.

"You heard the figures, they were doing three times as many smears in a given time. Something has to give there.

"We would obviously prefer smears to be examined and looked at here in Ireland.

"We have an excellent pathology service and some of the best trained doctors in the world."

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