If you developed cervical cancer after screening you can have a free 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 journey
We will meet you before we start the review and after we have written your review report.
What we do in a review
There are 4 parts to the review:
- how we invited you to screening
- your screening test results
- your colposcopy care
- your histology (biopsy) results
For each part of the review we will:
- compare your care against the quality assurance standards at the time
- tell you if there was anything we could have done differently
Who can ask for a review
To request a review, you must have:
- had a cervical cancer diagnosis
- and had a CervicalCheck screening test in the 10 years before your diagnosis
If you’re not sure when your last CervicalCheck screening test before your diagnosis was, email review.request@screeningservice.ie or freephone 1800 45 45 55.
We will not be able to offer you a review if you have:
- not developed cervical cancer
- had a previous review related to the CervicalCheck programme, for example, a CervicalCheck clinical audit or Royal College of Obstetricians and Gynaecologists (RCOG) review
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
A review of someone else's screening history
You may be able to ask for a review on behalf of someone else, for example, a family member.
You will need to send us proof that you have the right to request information on their behalf
We will contact you to let you know what information we need.
How to request a review
To ask for a review, contact us by email or post. You must include a copy of your government-issued photo ID, such as your:
- passport
- driver’s licence
Contact
review.request@screeningservice.ie
National Screening Service,
King's Inns House,
200 Parnell St,
Freepost FDN7612,
Dublin 1,
D01 A3Y8
After you request a review
After we get your letter or email asking for a review, we will contact you.
Consent for medical 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.
These are different to your National Screening Service records.
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 to 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 do reviews in groups, starting with those who have been waiting longest.
We will:
- 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.
- Do a review of your case and write a report - ideally within 12 months of your first meeting.
- 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.
We will give you the contact details of the person who will be your point of contact during your review. You can contact us at any stage during the review.
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 scan
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’
- 5 will have a result of ‘unsatisfactory’
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.
Patient safety incident
If we find during the review that there was a patient safety incident, we will:
- examine what happened
- report it
- let you know as part of your review results meeting
We do this in line with the HSE Incident Management Framework and the HSE Open Disclosure Policy.
What happens when a patient safety incident is found
Impact of your screening review on your care
The report will not have an effect on your current care.
Your doctor will not make different decisions based on the result of your review.
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.
Someone to support you during your review
You might need extra support to help you through the review.
For example, 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
This might be a:
- a member of your family
- a close friend
- a carer
- an independent advocate
Your support person or advocate can be your point of contact with us if you want. You will need to give us your consent and their contact details.
Patient Advocacy Service
You can get support and an advocate through the Patient Advocacy Service. It is free and fully independent.
Meeting with you
We will meet with you twice during the review process. We will accommodate your needs as much as possible. We recommend you bring someone with you to these meetings.
Share your experience with us
We welcome your feedback throughout the review process.
We want to hear about what:
- is working
- we could improve
- is not working
Ways to give feedback about your screening review
You can give your feedback to:
- your designated point of contact
- a National Screening Service Complaints and Feedback Officer - email your.say@screeningservice.ie
- an independent advocate such as the Patient Advocacy Service
Your feedback could be about the personal cervical screening review process, the cervical screening programme or staff.
It could be a:
- suggestion
- compliment
- complaint
- comment
At the end of the review, we will also ask you to complete a short questionnaire. This will help us to continually improve our review process.