Dear Colleague,
A review of cervical screening records in another international screening programme has found that some women had been removed incorrectly from that country’s population screening programme following hysterectomy procedures.
The review found that people who had undergone a partial (subtotal) hysterectomy (where the cervix is retained) had been removed incorrectly from the screening register.
While we have no reason to believe the Scottish experience will have implications for Ireland, the HSE is examining the Scottish review as we continue to evaluate best practice across international screening programmes. We will consider any potential implications of the Scottish experience as part of our ongoing drive to improve the quality and safety of our processes.
Our analysis will take place across the relevant areas of the HSE, including the National Screening Service, the National Women and Infants Health Programme and the National Cancer Registry of Ireland, and we will provide updates on our progress.
Hysterectomy and screening in Ireland
Unlike Scotland, Ireland does not automatically remove anyone from the CervicalCheck cervical screening register. We continue to invite people for screening post-hysterectomy, unless we receive confirmation from the participant, in consultation with their GP or hospital doctor, that screening is not required.
Offering reassurance to women
We understand that women, who have undergone a hysterectomy and opted out of the cervical screening programme, may have concerns around their care.
We are letting people know that for more information they can check the CervicalCheck website, www.hse.ie/cervicalcheck.ie or contact CervicalCheck’s Freephone line on 1800 45 45 55 or contact info@cervicalcheck.ie
We will be doing our best to answer all their questions via our infoline. We appreciate, however, that your patients may come to you seeking further information also. We are therefore also sending on a healthcare professionals FAQ and an information sheet on hysterectomy types, to help you answer questions your patients may have. These resources will also be available on the CervicalCheck healthcare professionals website here
If you have a query about your patient’s status on the screening register following hysterectomy, please contact CervicalCheck’s Freephone line on 1800 45 45 55.
What we are doing
- HSE Digital is updating our information for women on hysterectomies and screening on the CervicalCheck website.
- We are working closely with the National Screening Service and the National Women and Infants Health Programme on our evaluation of the Scottish report.
- We continue to invite people for screening, post-hysterectomy, unless we receive confirmation from the participant, in consultation with their GP or hospital doctor, that screening is not required.
- As a precaution, CervicalCheck has paused any requests for removal from the register for any hysterectomy.
- CervicalCheck informs all people who have had a hysterectomy that they may need to continue to have screening tests if:
- They have had a subtotal hysterectomy (uterus removed) and still have a cervix
- Changes in the cells of their cervix were detected before or at the time of surgery
- The hysterectomy was for treating cervical abnormalities (cancer or pre-cancerous conditions).
It should be noted that most hysterectomies carried out are total hysterectomies, which includes removal of the cervix, and therefore the risk of developing abnormal cell changes after hysterectomy is low.
We continue to emphasise to our participants that CervicalCheck is a screening service for well women within the population age range (25 to 65 years) and is not a symptomatic service. If a person has any concerns or symptoms, we strongly encourage them to contact or attend their GP to ensure that they are given the appropriate advice or referral. A list of symptoms is available on our website here.
For further information participants can see www.hse.ie/cervicalcheck or Freephone 1800 45 45 55.