Two more women excluded from cervical screening diagnosed with cancer

A further two women who had been wrongfully excluded from cervical screening went on to develop cancer, the Scottish Government has confirmed.

Speaking to parliament, women’s health minister Maree Todd confirmed there was a “high level of clinical suspicion” that an inappropriate exclusion of one woman may have resulted in a cancer diagnosis.

In another more complex case, several factors are thought to have contributed to a cancer diagnosis, one of which was incorrect exclusion from screening, Todd added.

The errors were found after an audit of the cervical screening programme in December 2020 revealed 430 women had not been invited to a smear test when they should have been.

A small number of these women went on to develop cervical cancer and one woman had died.

The women had been excluded from the programme after being recorded as having total hysterectomies when in fact they had had sub-total hysterectomies, meaning part of the cervix is left behind.

The initial review only looked at those who had had the procedure after 1997 and a second review was commissioned to investigate those who had hysterectomies before then.

It is from this cohort the two further women have been found.

The Scottish Government has now commissioned a review of all 200,000 records of individuals who have been permanently excluded from the programme.

Todd warned this would “likely” mean more people will be found to be wrongly excluded, though she added the “overwhelmingly majority” will be correct as 95 per cent of hysterectomies are total.

This review is expected to take 12 months to complete, though affected women will be contacted as soon as possible.

Todd also confirmed wrongful exclusions from the programme had been found as early as 2006 through smaller reviews. Others surfaced in reviews in 2015, 2016 and 2017.

The minister explained these had been corrected when first discovered and it was believed all errors had been resolved at the time.

Healthcare Improvement Scotland have now been instructed to review the entire process for permanent exclusions from the screening programme, to be chaired by an independent expert from outwith Scotland.

Todd said: “We must consider whether opportunities were missed to identify the wider issues now being investigated. That is essential if we are to fully understand what happened in the past and to prevent similar incidents in the future.”

Of the 430 women found in the initial review, 112 have had a smear test and 130 have attended a gynecology appointment.

Of those, seven women have been referred for further investigations and those with pre-cancerous cells have been treated through the normal pathways.

No further cancer diagnoses have been found in this cohort so far, though 193 women have yet to attend either a smear test or gynecology appointment. Of these, 68 either did not attend, declined or cancelled an appointment without rescheduling.

Scottish Conservative health spokesperson Annie Wells called for a full inquiry into how some women ended up being wrongly excluded from the screening programme.

She said: “This error has had a profound effect on the women involved and they deserve answers as soon as possible.”

And Scottish Labour deputy leader Jackie Ballie questioned why the error had not been found earlier given the previous reviews highlighting inappropriate exclusions.

She said: “Time and time again, this government allowed this scandal to go uncovered and, as a result, lives have been put on the line. The government must take responsibility for their continued oversight on this matter and act to put this right as soon as possible.”