The tragedy of being diagnosed with Cervical Cancer, must be compounded by the discovery that one or more of the cervical smears in the preceding years, before the onset of symptoms/ diagnosis, did not detect abnormal cells. This phenomenon is called an ‘interval cancer’ (1/n)

Interval cancers are at the heart of the #CervicalCheck controversy.

Let’s say 1,000 women undergo screening with their GP:
a) Some smear results will flag potential cellular abnormalities (smears now test for the virus 'HPV') suggesting that precancerous cells could be

present- and further follow up is needed.
b) Some will be told ‘no abnormalities are detected’ – these will be called for a follow up screening test.

Out of the 1,000 women, roughly 20 of these women will actually have abnormal (pre-cancerous) cervical cells: 18 diagnosed

through screening (this has improved with HPV screening); however 2 will be missed by screening. This is not negligence- it is a recognised feature of cervical cancer screening. It is part of informed consent (see here: https://www2.hse.ie/screening-and-vaccinations/cervical-screening/your-results/accuracy-of-results.html).

Those women who had a previous cervical smear test which did not show any abnormalities, but then went on to develop cancer are very unlucky. This is an interval cancer.

300 people are diagnosed with cervical cancer each year in Ireland- some of these are interval cancers.

The RCOG report in Dec 2019 highlighted that #CervicalCheck is performing very well by international standards and also that 'cervical screening cannot detect all cases of cervical cancer' ( https://www.gov.ie/en/publication/a4e567-expert-panel-review-of-cervical-screening/).

The Scally Report was published in Sept 2018. It highlighted issues with communicating audit results, open disclosure and governance of CervicalCheck. It alluded to misogynistic language used by some doctors. Highlighting these wrongs was long overdue. But it specifically did

now show any evidence that there is a higher incidence of interval cancer in Ireland. Scally recommended we continue using the laboratories we had been using. The report can be found here:
http://scallyreview.ie/wp-content/uploads/2018/09/Scoping-Inquiry-into-CervicalCheck-Final-Report.pdf

Obviously a point of difference is present and we must be able to talk about it- with those advocating for women effected by interval cancer diagnosis (e.g. 221+) on one side; and screening experts, most doctors and the State on the other. This difference of opinion is very

difficult to discuss as it is such a traumatic issue for those families who are effected. I am profoundly moved by the tears and struggles of those women who have gone through the courts to claim that their interval cancer was a negligent failure of the State (HSE and medical

labs). I can understand why they have done this. And I also wish they did not have to go through the courts.

But I can also understand why the State has not admitted full liability or a failure with regard to interval cancers. I am writing this thread, not to undermine their

stories, but in a desire to support a conversation about what screening is. It is terrible that women and families have to go through the courts. But equally,if the State does not believe there is negligence, we need to be able to have a conversation about what is the best way to

proceed. Ultimately I hope a tribunal, if agreed, can support those who are effected, so they do not have to access our courts.

And I also hope some of the information in this thread can dispell some of the widespread misinformation on twitter relating to CervicalCheck.