The National Cervical Screening programme, the programme that was going to reduce the number of women dying from cervical cancer, is still not really working.
A questionnaire sent out to all districts where the screening programme was implemented was designed to test the uptake of the programme and its effectiveness. According to the 94 per cent of districts who responded, nearly one third don't expect to meet the target date of l993 to have screened 80 per cent of their female patients, even though most have computerized programmes in place and failsafe mechanisms to follow up abnormal smears.Nearly half the laboratories haven't implemented quality control. Four labs allowed to carry out screening have no quality control at all.
Another study in the same issue of the British Medical Journal shows that the screening programme is crippling many laboratories, which don't have the money or the staff to handle the workloads being imposed by the programme which would require no less than half their working capacity.
The study's authors conclude that investigation and treatment should be limited to severe abnormalities. "To date there has been a preoccupation with programme sensitivity because of the emotive response to false negative results," says the BMJ editorial. "It is now essential to redress the balance and give more consideration to the adverse effects of overdiagnosis and overtreatment."