HEALTH SERVICES
Biopsy result delays after smear tests
August 1, 2019
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Women who potentially have high-grade abnormalities that are initially detected by a smear test, may now face delays in obtaining vital biopsy results, it has emerged.
Furthermore, in some cases, this key information is being relayed to women via a recorded voice message, only when they call looking for their results.
Following the controversy surrounding CervicalCheck last year, women are already facing major delays for smear test results. Results that used to take four to six weeks are now taking up to 20 weeks, and sometimes even longer.
While most smear tests produce normal results, up to 5% of women require further investigation or treatment at a colposcopy centre. There are 15 public colposcopy centres in Ireland.
A colposcopy is a procedure which looks at the cervix (neck of the womb). It can more clearly identify abnormal areas or cells changes. In some cases, a biopsy may be carried out, which is when a small sample of tissue is removed for closer examination in a laboratory.
Irishhealth.com has been contacted by a woman who underwent a colposcopy in the Rotunda Hospital Colposcopy Clinic, during which a biopsy was carried out.
She was told during the procedure that she was either CIN 2 or 3 and treatment would be required. The biopsy results would confirm the course of action needed.
CIN (cervical intra-epithelial neoplasia) refers to abnormal cells found on the surface of the cervix. CIN 1 refers to cells that are unlikely to become cancerous. They may go away on their own and often, treatment is not needed.
With CIN2, there is an increased risk that cells will become cancerous. Treatment is usually recommended, although not always. With CIN 3 there is a high chance the cells will become cancerous and treatment is recommended.
The woman explained that she had been told by the colposcopy clinic that she would have to wait up to six weeks for the biopsy results, but she would then receive a letter with the full results and a treatment date for two weeks later.
"I had the date in my calendar marked off. When the six weeks was up and no letter had arrived, I rang the colposcopy clinic, only to get an answering machine, which told me results were now taking 10 weeks.
"I have been so anxious for these six weeks as I am worried I may be CIN 3. But now I have to wait four more weeks for results and I have no idea when my treatment will be. I rang a number of times but kept getting the answer machine. I just feel like my life is on hold now," she told Irishhealth.com.
When queried about the delays, the HSE told Irishhealth.com that due to "unprecedented demand in cervical screening in 2018 and a subsequent increase in referrals to colposcopy, the 15 clinics nationally that provide colposcopy services for the CervicalCheck programme have experienced significant pressure on their services".
The HSE confirmed that the waiting time for biopsy results in the Rotunda Colposocy Clinic is currently 10 weeks, despite the HSE's own website advising that the waiting time for biopsy results is "up to six weeks" (see here).
The HSE said that is "very sorry for these delays and understands the impact they have on women who are referred to colposcopy under the cervical screening programme".
The woman who contacted Irishhealth.com said that while she understands why delays are occurring, the manner in which the information was relayed upset her greatly.
"I just wanted to talk to someone, get an explanation. Instead it was an answering machine telling me about the delay, but with no other information. I thought given all that has happened in the last year, women would be kept better informed," she said.
Irishhealth.com understands that most biopsies are sent to the Coombe Hospital for analysis and there is currently no backlog there, so it is unclear why there is a delay in some biopsy results.
When contacted by Irishhealth.com, the Rotunda Hospital made no comment.