WOMEN WHO want to have a cervical smear test will no longer be able to get one automatically under proposals that come into force in September.
Everybody who is eligible for the national cervical screening programme will be sent a letter informing them of the transition to a call-recall system.
However, the letter to GPs from the CervicalCheck National Cervical Screening Programme (NCSP) states that, during the initial transition period, women requesting a smear test are likely to have to wait six months.
At present, any woman who requests a smear can go to her GP or local clinic and have it done free under the programme introduced last autumn.
Family doctors are concerned that women most at risk of cervical cancer are being discriminated against by the move.
They say women in lower socioeconomic groups and traveller women are least likely to have access to e-mail; they also tend to be less organised and more spontaneous about healthcare so the six-month delay between registering for a smear and receiving an invitation to attend is likely to constitute a significant barrier to the service.
Writing in the latest issue of the Journal of the Irish College of General Practitioners, the medical editor, Dr John Latham, said it was a “short-sighted measure” if the new system was a way of saving the colposcopy clinics from overload.
Colposcopy clinics are run by gynaecologists and are the next stage in the investigation of a woman with an abnormal cervical smear.
Dr Marian O’Reilly, head of cervical screening with the National Cancer Screening Service (NCSS), confirmed that due to the success of the programme, there was additional strain on colposcopy clinics. However, she said the NCSS and the HSE had recently agreed to provide additional resources to deal with this.
Dr O’Reilly said that once a full screening round had been completed, health promotion officers could then target areas of poor uptake.
From September 1st, women eligible for the programme – between ages 25 and 60 – will now receive letters of invitation telling them they can have a smear test if they want one.
Well Woman medical director Shirley McQuade said the new system would increase the barriers to having a test. “A lot of women don’t like having these tests done and they have to pluck up the courage to have them. If they come to us in September, we’re going to have to tell them that they don’t have an invitation, and if they want one done straight away, they will have to have it done privately,” she said.
An NCSS spokeswoman said they were satisfied that those who had worries about cervical cancer had already availed of the service in the past year and it was now ready to move on to the next stage. “It has been the experience internationally that opportunistic screening does not work,” she said.
CervicalCheck chief executive Tony O’Brien said it was always intended to move from an open access system to an active call-recall system.
“CervicalCheck remained on an open access system for the initial 12 months to ensure that the initial expected interest in the programme could be effectively accommodated during the first year of screening.”
He said the ultimate goal of the service was to have a national uptake of 80 per cent which, in turn, has the potential to cut the incidence of cervical cancer by the same amount.