Woman died from cervical cancer after being ‘wrongly excluded’ from screening

·4-min read

A woman died after being “wrongly excluded” from the cervical cancer screening programme, a Scottish Government minister has said.

Meanwhile around 430 women who were also incorrectly excluded from the programme in Scotland over the last 24 years are to be offered fast-tracked appointments with GP practices or gynaecology services following an urgent review of cases.

Scottish women’s health minister Maree Todd told Holyrood that an audit by an NHS board in December 2020 “discovered a very small number of women had developed cervical cancer after being wrongly excluded from the screening programme following a hysterectomy”.

She added: “I am extremely sorry to say that one of those women has died.

“These exclusions from the cervical screening programme should not have happened and I want to apologise to all those affected by this error.

“I offer my heartfelt apologies in particular to the women who were excluded from the programme who went on to develop cancer, and to their families.”

Ms Todd accepted the incident “will be profoundly worrying to many people” and that there had been “devastating consequences” for those women who had been diagnosed with cancer.

While acknowledging that “nothing I can say can undo that”, Ms Todd told MSPs lessons will be learned “so it cannot happen again”.

Part of the cervix can be left behind when a patient undergoes a hysterectomy (Johnny Green/PA)
Part of the cervix can be left behind when a patient undergoes a hysterectomy (Johnny Green/PA)

While most patients undergoing a hysterectomy have their uterus and cervix removed completely, some women have a “sub-total hysterectomy” where part of the cervix can be left behind – and these women still require to be screened for cervical cancer.

A review “confirmed there are instances where exclusion has been wrongly applied across Scotland”, Ms Todd said.

She added it is an “extremely complex issue, spanning a number of decades and involving a variety of potential errors”.

There are 220 women in the 25 to 65 age range for cervical screening who were excluded in error, and Ms Todd said they would be written to, “to apologise, to explain the situation and to offer personalised advice”.

GP have been told to prioritise these patient for a “timely screening appointment” in the next few weeks, the minister added.

Meanwhile there are 149 women whose health records are unclear whether they had a full hysterectomy, and they will be offered a gynaecological appointment, and screening if this is found to be appropriate.

Similar letters will be sent to 65 women who were incorrectly removed from the screening programme but who are now outside of its age range.

Ms Todd said the Scottish Government, where necessary, has given health boards funding to run additional clinics so those requiring gynaecological appointments can be seen within the next few weeks.

She also said work is under way to contact a “very small number of individuals” who have left Scotland.

Acknowledging that anyone who receives a letter “may be extremely anxious”, Ms Todd said the Scottish Government has provided additional funding to the charity Jo’s Cervical Cancer Trust “to ensure its helpline is appropriately resourced and available for anyone seeking support or reassurance”.

Ms Todd said: “Anyone whose records indicate they may have had a sub-total hysterectomy after 1997 and been wrongly excluded from screening will have received a letter or be in the process of receiving one within the next few days and will be offered an appointment appropriate to their individual circumstances.

“While some exclusions have been wrongly applied across Scotland, the vast majority will have been applied correctly and additional control measures have been put in place to prevent any new exclusions from being applied incorrectly.

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“It is important to stress that the overall risk of developing cervical cancer remains low and people should not be unduly alarmed.”

MSPs questioned Ms Todd about the development following her statement in the Scottish Parliament.

Scottish Conservative MSP Sandesh Gulhane, who is a doctor, said: “My thoughts and prayers go out to the women and their families that have been affected by this terrible error.

“This is simply awful. It might shake women’s faith in the cervical screening programme and as a GP I must be clear that attending your cervical screening is vital.”

He asked the minister if the failure was systemic or due to issues with surgeons’ recordings.

Ms Todd said four potential points of error had been identified, including a mismatch between operations proposed and operations carried out.

Samantha Dixon, chief executive of Jo’s Cervical Cancer Trust, said: “For those affected this may be an incredibly difficult time and we are here for anyone who needs support through our helpline.

“NHS Scotland is acting quickly to contact everyone who may have been wrongly excluded from cervical screening, however swift action must be taken to identify what went wrong and ensure it cannot happen again.

“Cervical screening remains an important test and it’s important that women and people with a cervix, including those who have had a sub-total hysterectomy, continue to have access to it.”

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