Oireachtas Joint and Select Committees

Wednesday, 18 December 2019

Joint Oireachtas Committee on Health

Royal College of Obstetricians and Gynaecologists Independent Expert Panel Review into Cervical Screening: Discussion

Dr. Tony Holohan:

There are some issues, as Dr. Doherty has rightly pointed out, that mean the system that pertains in the United States is not comparable to what happens here. Testing is offered through laboratories, but it is at the individual level. In this country what we have is an organised population-based programme where people are invited proactively on the basis of their age. In effect, what our programme is saying to people is that if a woman participates in the organised programme from the age of 25 to the age of 60, at different intervals depending on one's age, over one's lifetime it will reduce the risk of mortality from cervical cancer. They do not make that offering in the United States because they do not offer a population-based programme.

As part of our programme, we were then able to have in the quality-assurance arrangements a retrospective audit, which does not exist in the United States. The non-disclosure of those findings of retrospective audit, which happened here, is not part of the design at all of what happens in the United States, so there is no comparable circumstance that could have arisen regarding what happened here.

As I said previously to this committee, the quality assurance arrangements and the retrospective clinical audit that was in place for CervicalCheck made us one of the very few programmes in the world that offered that. The United States is quite a substantial way from that, and it does not have any of the features of an organised population-based screening.

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