GPs delay smear tests so staff can retrain
GPs have agreed to extend screening intervals for cervical cytology to allow laboratory staff to train in new techniques flying in the face of recommendations by Government-commissioned researchers.
Draft guidance from the National Institute for Clinical Excellence set to be adopted next month advocates a switch from the Pap smear test to
liquid-based cytology as the primary screening method in England and Wales. Scotland will follow suit next June.
Practices in some areas have already been told to 'slow down' recall of women to allow staff to train in the technique. Experts have warned it will take years to train everyone, leading to a national problem accessing cytology services.
The National Cancer Screening Committee is expected to follow up the switch to LBC by setting a national screening interval of three years for women aged 25-49 (five years for those aged 50-64).
A Government-commission- ed study showed five-yearly screening in younger women was significantly effective in preventing cancer.
But Manchester LMC is supporting proposals by local health officials to lengthen its current three-year interval for all women because of the crisis.
LMC secretary Dr Peter Fink said every region faced a 'balancing act' of training while avoiding service delays. 'There's clearly going to be a backlog and a training agenda across the country,' said Dr Fink, a GP in Newall Green, Manchester.
He claimed the LMC's move was 'entirely justified' under current guidelines that allow screening at three- or five-year intervals on an ad hoc basis. He added: 'If new guidance comes out that may alter.'
Dr Fink said patient care would not be compromised, arguing: 'I don't think people are necessarily aware when their next smear is due and what you don't know doesn't harm you.'
Dr Ray Lonsdale, programme co-ordinator for cervical screening and consultant histopathologist at Norfolk and Norwich University Hospital Trust, said: 'If LBC is approved by NICE it'll take years for the whole country to be retrained. At the moment most of the cytology training schools aren't trained themselves.'
Dr Angela Raffle, head of cervical screening for the former Avon health authority area, said her area was facing a similar dilemma and called Manchester LMC's approach 'very pragmatic'.