By Cara Cullivan
Since I initially wrote this piece, Vicky Phelan, mother-of-two, settled a high court action against a lab that provided an incorrect “all clear” smear test report in 2011. A report that did not tell her that she did, in fact, have cancer. When her doctor informed her in 2017 that there was an audit of smear tests completed, and a query in relation to hers, she was still not told of the incorrect result. Vicky is now terminally ill. 206 other women, for whom there was also a delay in detection and who missed out on earlier intervention, are also ill.
In a statement before the Public Accounts Committee on May 16th, Vicky expressed that she is not interested in revenge. Her interests lie in patient safety, accountability, and an assurance that this will never happen again. Although the Minister for Health, Simon Harris, said he did not currently have full confidence in the management of the screening program, he does have confidence in the screening service. In response to the revelations, the Cervical Check program will undergo an International Review; it remains vital to women’s health that, in a response to Vicky’s plight, and the plight of other women, the Cervical Check Program be restored.
This piece is meant to be an anecdotal overview of my experience with the Cervical Check scheme, and my diagnosis and treatment for moderately abnormal cells detected during my smear. This type of change is not cancer, but may become cancer and spread to nearby normal tissue if not treated. It is important to ensure that people do not lose faith in testing; the maximum reduction in incidences of Cervical Cancer appears to be 75%. 75% is a good place to start.
A smear test is, at present, the most effective way to detect changes in the cells of the cervix and the most effective method of reducing a woman’s risk of developing cervical cancer; disrobe, lie down, legs aloft, speculum, lube, some brief discussion about the weather, and we’re done. Should everything show up as normal, expect a letter in the post and positive affirmations from the universe. Should it not, expect a letter in the post with a referral for a colposcopy.
My first smear came back abnormal; acronyms like “HPV” with some added “Cs” and “Is” where thrown around with some reassuring nods and rationalisations. CIN2, to be exact. Moderate. Although you’ll be informed that HPV is a common viral infection and most adults will get it at some time in their lives, that it’s usually spread by skin to skin contact during sexual activity, and that you shouldn’t really be worried, it can be worrisome.
I was worried and disappointed. I was disappointed firstly, that I had HPV, secondly, that it had altered my cells, and, thirdly, that I was never offered the chance to avail of the HPV vaccine effective in preventing the virus which leads to most (70%) of cervical cancers. 300 Irish women get cervical cancer every year, and 90 of those women will die from the illness. It was a sobering fact. HPV is not uncommon, it is not incurable and it is not leprosy. But CIN is still a precancerous lesion.
I was referred to the National Maternity Hospital in Holles Street for a closer look, who then monitored the changes for around 6 months. A colposcopy here and there, like a smear test with some extra “oomph” and a sample of your cervical tissue for good measure. Apparently CIN is like a friendly stray, it can go away on its own or it can stick around so these changes are analysed carefully by the nurses and doctors who see you on the day. I cannot commend the staff of Holles Street enough for their warmth, consideration, and openness. They kept me informed at every stage, at every step of the colposcopies, and of every change they observed through the microscope. My cervix however, was not so accommodating. CIN2 required what’s called a LLETZ treatment to “zap” precancerous changes of the cervix. A thin wire loop heated by an electrical current is used like a scalpel to remove the abnormal tissue from the cervix. It was painless, it was fast, and it was effective.
Around that time, the more I spoke about colposcopies and CINs, the more I realised that most of my peers had been, or would be, in the same boat at some stage. Disrobe, lie down, legs aloft, speculum, lube, some brief discussion about the weather, and we’re done. And that’s okay.
Professor Grainne Flannelly, Clinical Director of CervicalCheck recently shared the news 80% of women in Ireland have had a smear test in the last five years through the scheme. In addition, Irish cervical cancer rates have been reducing by 7% per year since 2010, according to the latest National Cancer Registry figures.
Your health is important, your smear tests are important. Do not lose faith in them and do not ignore your health.
If you’re looking for something else to read, why not check out some of our most recent posts on what it’s really like to act as a juror on a rape trial and the true cost of free contraception?