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smear tests I am one of the 180 women called for another CervicalCheck exam - and I'm frightened

Denise Smith never misses a smear test, but now she has been told her sample wasn't tested in time

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Denise Smith

Denise Smith

CervicalCheck campaigner Vicky Phelan

CervicalCheck campaigner Vicky Phelan

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Denise Smith

Every three years I arrive at my GP's surgery and count the ceiling tiles as a nurse scrapes cells from my cervix.

It is uncomfortable, it is embarrassing, but screening is a vital and life-saving service that can protect against cervical cancer.

A cancer so insidious, so earth-shattering, that it takes the lives of 90 Irish women every year.

So when the thoughts of lying half naked in front of a stranger, or the discomfort that comes from an internal swab loom, I grit my teeth and place my trust in the system.

An imperfect system that has so publicly and so routinely failed women. But it is all we have.

Last Monday, the HSE confirmed 180 women who underwent cervical screening in recent months would be contacted for a second test because their sample expired before full testing could be completed.

Samples need to be examined within 42 days, but this did not happen at the Santry facility as Covid social distancing measures had resulted in "huge capacity pressures".

On Tuesday, more than 24 hours after the news broke, I learned I was among those women.

"You will need to be retested," I was told by my local nurse.

"You don't smoke, and your previous smears were normal, you should be fine. Obviously there is no guarantee, but try not to worry."

"Try not to worry" - reassuring words that fell on deaf ears when it was revealed that HPV, which can be a precursor to cervical cancer, was found in the 180 samples.

The HSE tells me that my risk due to the delay is very low, but I am not assured. I am frightened.

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A second smear is scheduled for late August, more than three months since my last exam. A three-minute phone call has further eroded my trust in the system.

And I know I am not alone.

Since Vicky Phelan went public in 2018, the utter failings of CervicalCheck have been laid bare. From the initial misreadings and withholding of information, followed by repeated backlogs and a grinding halt to screenings during Covid last year, public confidence is low.

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CervicalCheck campaigner Vicky Phelan

CervicalCheck campaigner Vicky Phelan

CervicalCheck campaigner Vicky Phelan

The pandemic and the unprecedented uptake in the programme has been cited as the reason for the latest CervicalCheck controversy I find myself embroiled in.

But this has not been the first time women have been forced to be retested.

In 2019 alone, a shocking 434 smear test samples expired before they could be tested.

According to the HSE, damage to vials during transport and a delay in GPs sending samples to labs caused the inexcusable blunder.

That the test now checks for the human papillomavirus (HPV), which provides better accuracy in detecting pre-cancerous abnormalities and early-stage invasive cervical cancer, should be a win, but it's hard to tune out the negative background noise.

Kim Hanley (35), who set up Cervical Cancer Awareness Ireland, a support group to help women in Ireland affected by cervical cancer, was just 26 when she discovered she had cervical cancer.

The mum-of-two's diagnosis led to a radical hysterectomy and removal of her ovaries, meaning she could never have more children.

Nine years after diagnosis, Kim is still grappling with life after cancer but what she knows for sure is delays in screening cost women their lives.

"I can put myself in these women's shoes and I know they are asking the question, 'Can I trust that I will be tested correctly in this timeframe and will this happen again?'

"It has placed needless distress on women who are already living in a pandemic. HPV does not always lead to abnormalities and oftentimes your body can clear it yourself, but among those women there may be some that have mild to moderate abnormalities.

"It is not an easy thing for a lot of women to go for a smear test. A lot of women might have past trauma or a bad experience in the past, and to have to endure another exam could be quite triggering for a lot of women."

Despite the system's failure, Kim is adamant that the programme saves lives.

When she was just 25, the new mum was experiencing post-natal depression and ignored concerning symptoms and delayed going for her first ever smear test due to embarrassment.

When she did seek treatment a year later, her doctor dismissed her.

"I started having symptoms - back pain and irregular bleeding," she says. "The GP's exact words to me were, 'Oh God no, you're too young for it'.

"But I wasn't too young. I had a two-year-old and a four-year-old at home and when I was 26, I was told I had cervical cancer.

"CervicalCheck saved my life but what is happening now isn't acceptable and there has to be change. Women putting off screening and delaying their exam are putting their lives at risk.

"If they catch HPV, they can catch it before it even develops into abnormalities. The new system is brilliant but it won't work if people do not have confidence in CervicalCheck.

"They need to learn from their past mistakes and adapt for the climate we are in - Covid has been with us for a year and a half and they knew the surge would come.

"Yes, there has been failings by the cervical screening but it does save lives. It is the best chance we have. They simply can't afford to have errors like this again."

On Friday, five days after the initial news broke, I received a letter from CervicalCheck.

A spokesperson for the Irish Cancer Society said: "Today our thoughts are with the 180 women who will receive a letter from CervicalCheck to tell them that HPV has been found and that they will need to be re-tested because their sample expired.

"Having to be re-tested will mean further worry and distress for women who were being proactive about their health by having their smear done in the first place.

"The National Screening Service have described the reason for these errors occurring as 'a delay in a sample processing centre due to Covid-19 restrictions'.

"This highlights concerns we have been raising since the beginning of the pandemic about capacity across the entire system of cancer care.

"Time and time again we have highlighted serious concerns around demand on cancer services as a result of Covid backlogs and interruptions to the health service from the data hack."

"We would urge all women to make their appointment as soon as they can and talk to their GP or call the CervicalCheck helpline Freephone 1800 45 45 55. Our nurses are also available for support on the Irish Cancer Society Support Line on Freephone 1800 200 700."

On August 23, I will return to my doctor's office for a second exam. I will count the ceiling tiles, I will wait, and I will hope for good news because this is the best chance I have.

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