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Personal cervical screening review

If you developed cervical cancer after screening you can request a personal cervical screening review.

A review may help you or your family if you:

  • are looking for answers or ways to understand how and when your cancer developed
  • want to ask questions about your screening experience

You will find information about how to request a review in the leaflets we send you when we:

  • invite you for screening
  • send you your screening result

We are updating these leaflets to include information on screening reviews.

Who can ask for a review

You can only request a review if you have cervical cancer and:

  • had a CervicalCheck screening test in the 10 years before your diagnosis
  • have not had a previous review related to the CervicalCheck programme, for example, a CervicalCheck audit review or a Royal College of Obstetricians and Gynaecologists (RCOG) review

We will not be able to offer you a review if you:

  • do not have cervical cancer
  • had a previous review related to the CervicalCheck programme, for example, a CervicalCheck clinical audit RCOG review

If you’re not sure when your last CervicalCheck screening test before your diagnosis was, you can:

What is a CervicalCheck screening test

A CervicalCheck screening test is a test taken through Ireland’s CervicalCheck programme - from September 2008.

It does not include cervical tests:

  • you had done privately (paid-for tests)
  • taken under the mid-west Irish Cervical Screening Programme
  • taken outside of the Republic of Ireland

CervicalCheck screening test

How to request a review

Contact us by email or post to ask for a review.

Email: review.request@screeningservice.ie

National Screening Service,
King’s Inns House,
200 Parnell St,
Freepost FDN7612,
Dublin 1,
DO1 A3Y8

What to expect

After you ask for a review we will get in touch with you to let you know if you are eligible.

We will meet you before the review starts and at the end of the process.

There are 4 parts to the review:

  • how we invited you to screening
  • your screening test results
  • your colposcopy care
  • your histology (biopsy) results

We will look at the parts that are relevant in your case and:

  • compare your care against the quality assurance standards at the time
  • tell you if there was anything we could have done differently

Meeting with you

To fully understand your experience, we would like to speak to you directly as part of the review process.

We will accommodate your needs as much as possible. For example, when and where we meet or if you need to change the meeting time, date or location.

We recommend you bring a friend or family member with you to these meetings for support.

Introductory meeting

In the first meeting, you can tell us about your screening experience. We will also take you through what to expect from the review process.

You will meet members of our team who specialise in screening.

We may not be able to answer all of your questions until your review is complete. Knowing your questions will help us to focus the review on what matters to you.

Accessing records

Review results meeting

In the second meeting, we will:

  • go through the results of your review
  • answer your questions
  • go through the next steps

We will send you your review report within 5 days of the second meeting.

Someone to support you

You might need independent support to help you through the review.

This could be:

  • a member of your family
  • a close friend
  • a carer
  • an independent advocate

Choose someone who:

  • you are comfortable with and can talk to easily
  • can come with you to meetings, if needed
  • we can share your personal information with

Patient Advocacy Service

You can get support and an advocate through the Patient Advocacy Service. It is free and fully independent.

After you request a review

After we get your letter or email asking for a review, we will contact you.

Before your review starts

If you are eligible for a review we will:

  • ask you to confirm your identity - to make sure we protect the privacy of people who use our services
  • give you the contact details of the person who will be your point of contact during your review - you can contact them at any stage during the review
  • ask you for your consent to access your relevant medical records

Consent for medical records

We may need to access your relevant medical records to do the review. These are different to your National Screening Service records.

Hospitals hold your medical records. We need your consent to access them.

We need to look at your medical records to make sure we have the relevant information to go ahead with your request for a review.

Your medical records

Your medical records include:

  • colposcopy notes - these are notes the doctors and nurses made if you attended colposcopy
  • histology (biopsy) records - these include samples taken from your cervix and reports on these samples if you attended colposcopy
  • notes from multidisciplinary team meetings - meetings doctors held if they met to talk about the best way forward for your case

Within 3 months of receiving your permission we will write to you. We will let you know if your records show that we can do a review.

How we use your personal information

If we cannot do a review

If your medical records show a reason why we cannot do a review, we will write to you to tell you why.

Your personal cervical screening review

We will:

  1. Let you know we are starting the review and invite you to an introductory meeting - ideally within 3 months of getting your permission to look at your medical records.
  2. Do a review of your case and write a report - ideally within 12 months of your first meeting.
  3. Meet you to give you your report and discuss it with you - ideally within 3 months of completing your review.

If there is a delay we will let you know.

Report on your screening history

In your personal cervical screening review we look at your screening history to see if there is anything we could have done differently.

We will write a report as part of the review.

It will say if your care was satisfactory, satisfactory within limitations or unsatisfactory in these 4 areas:

How we invited you to screening

We will check that we followed the correct invitation processes. This means we will look at how we invited you and reminded you to attend for screening.

The possible review results are:

Satisfactory

The reviewers find no improvements could have been made in how we managed your screening invitations. You were invited for your screening and follow-up procedures as you should have been.

Satisfactory within limitations

The reviewers find that we could have improved how we managed your screening invitations.

Unsatisfactory

Reviewers find they would have changed how we managed your screening invitations.

Your screening test results

We will look at your CervicalCheck cytology (smear) samples and HPV test results from the 10 years before your diagnosis. The external reviewers will look at the slides and give a result.

The possible review results are:

Satisfactory

The reviewers found the same result on your previous cytology (smear) sample when they looked back.

Satisfactory within limitations

The reviewers saw some small differences on your previous sample. They report that they would not expect a skilled screener to pick up these differences at the time of screening. This is because they are classified as 'difficult to find'.

Unsatisfactory

The reviewers saw some differences on your previous sample. They report that they would expect a skilled screener to pick up these differences at the time of screening.

Your colposcopy care

If you had a colposcopy as a follow-up to your CervicalCheck screening tests, we will look at the care you received. We will also look at your notes from the multidisciplinary team meetings.

The possible review results are:

Satisfactory

Your colposcopy care was in line with the CervicalCheck programme quality assurance standards in place at the time of your appointment. The reviewer finds they would have made no changes to your care plan.

Satisfactory within limitations

The colposcopy care was in line with the CervicalCheck programme quality assurance standards in place at the time of your appointment. The reviewer finds they may have made some changes to your care plan.

Unsatisfactory

Your colposcopy care was not in line with the CervicalCheck programme quality assurance standards in place at the time of your appointment. The reviewer finds they would have made changes to your care plan.

Your histology results

We will look at your cervical histology results from any biopsy sample or samples you had taken.

The possible review results are:

Satisfactory

The reviewers found the same result on your previous histology sample when they looked back.

Satisfactory within limitations

The reviewers saw some small differences on your previous sample. They report that they would not expect a skilled histopathologist (a doctor who specialises in checking cancer screening biopsies in a lab) to pick up these differences.

Unsatisfactory

The reviewers saw some differences on your previous sample. They report that they would expect a skilled histopathologist to pick up these differences.

What happens when we look back at your slides

We know what to expect from reviews done by other countries.

For every 100 screening slides taken from women who have developed cervical cancer we can expect to find about:

  • 60 of the slides will have a review result that is ‘satisfactory’
  • 35 will have a result of ‘satisfactory within limitations’ - the screener did not detect difficult-to-find pre-cancer abnormalities on their slide
  • 5 will have a result of ‘unsatisfactory’ - the screener did not detect obvious pre-cancer abnormalities on their slide

If your slide should have been read differently

For every 100 slides reviewed, we expect to find that around 5 slides should have been read differently.

This means that a small number of women will be told that an error was made in the reading of their slide.

This can be devastating news to hear.

When this happens our clinical review team will listen to and respond to all your questions. We will talk to you about your concerns.

Reasons a slide should have been read differently

This can happen for a number of reasons:

  • abnormal cells that look very similar to normal cells
  • low numbers of abnormal cells mixed in with lots of normal cells
  • human error

When looking at a screening slide, a screener is looking for pre-cancer cells.

They will usually decide on a grade of either:

  • most likely normal
  • most likely abnormal

It is rare for them to find obvious cancer cells on a slide. This is because most cervical screening slides do not have cancer cells.

Patient safety incident

We will let you know as part of your review results meeting if we find that there was a patient safety incident.

If we find during the review that there was a patient safety incident, we will:

  • examine what happened
  • report it

We do this in line with the:

Impact of your screening review on your care

The result of your review will not affect past or ongoing decisions made about your care.

You may have questions about whether your care would have been different if a different result was given in the past. We will do our best to answer any questions you have in an open and transparent way.

Page last reviewed: 29 March 2023
Next review due: 29 March 2026