Dr. Irene Regan:

I will take the first question. We discussed the capacity issue previously. Senator Colm Burke asked whether there are other clinical laboratories that can take on this workload. As we mentioned previously, medical scientists are highly qualified. They spend up to five years in undergraduate education, which includes an obligatory clinical placement. Cervical screening is very specialised so they need to train in that area so we just cannot take somebody and train them in a day. It does take up to two years to do that. They must meet competencies, look at 5,000 cases in order to be declared competent, be signed off and complete various courses. That is the protocol for that and the academy would definitely support that and expect nothing else in the future for that. There is a long training process. We are talking about quality here and training and standards are very important. This is what the academy is about. It is about professional standards and recommending. As a result, we cannot have a sticking plaster. If we bring it back here, we want it the experts to do it and we want to assure the women of Ireland that they have a quality system operated by highly-trained experts who specialise in cervical cytology. It will not be a quick fix. We cannot just move people back and forth to do this. Clinical diagnostics is a very specialised area. We train for a long time to do it. Many decisions are made on the work we do so it is very important to get it right and to be qualified and expert in it. The academy would support that.

I will discuss Professor Brennan's report and my colleague, Dr. Lambkin, will elaborate on HPV testing because the Senator asked about that. There is a bit of debate and confusion regarding statistics concerning the 65% to 75%. This is about the screening process. This is the whole process, this is what the 65% to 75% concerns. It relates to if the smear is taken at the right time and in the right way, and what it picks up. There will be adenocarcinomas. There are different cancers that will not be picked up by a screening process. When he talks about the screening, it is the process and, of course, the laboratory analysis of that smear is included in that. He is talking about 60% to 75%. I think it has got lost and it very confusing for people out there. Women are thinking that it will pick up their positive result only six out of ten times. This is a positive result at which we are looking in respect of a smear. That is not six out of ten times. It is the whole process involving whether it is taken properly. The women about whom we are talking had positive results. The cells were on the slide. This is a very different thing to whether it was taken at the right time or whether they had pre-cancerous cells that could be picked up by the screening process. There is confusion out there and it is important to clarify what those statistics mean.

With regard to the 95%, Professor Brennan has said otherwise on the issue because it does not identify other cancers. When one considers the overall figure it is not 95% of all abnormalities. As I understand it, the screening process is 90% of all abnormalities in that particular area but not in other areas that are cancer related.