People must learn to accept false negatives or all screening programmes will be in jeopardy 

People must learn to accept false negatives or all screening programmes will be in jeopardy 
Dr. Noírín Russell, consultant obstetrician/gynaechologist, CUMH. Picture: Denis Minihane.

CANCER screening programmes will be in jeopardy if people cannot accept that false negatives may occur, a leading medical expert has warned.

Consultant obstetrician and gynaecologist at Cork University Maternity Hospital (CUMH), Dr Noírín Russell, said if people cannot come to terms with the fact that false negatives occur in all medical screening, the programmes may need to be stopped altogether.

She was speaking after a recent High Court judgment in a CervicalCheck case.

The judgment, in the case of terminally ill Ruth Morrissey, now requires screeners to have “absolute confidence” when deciding if a smear is negative.

Dr Russell explained that no screening test in medicine has the ability to pick up its target 100% of the time.

“This is true for cervical smears, Breastcheck screening, fetal anomaly ultrasounds.

“There will always be false negatives where patients are told their result is normal but something abnormal subsequently turns up.

"Patients must be willing to accept this simple fact - a screening test cannot promise with ‘absolute confidence’ a normal result.

“If the screening population are not happy to accept this fact, which means that false negatives will occur, then screening is in jeopardy and may indeed need to stop,” warned Dr Russell.

“It is time for expectations and reality to become acquainted with each other as they are currently widely divergent.”

The ruling in the Ruth Morrissey case has caused widespread fears over the viability of screening programmes.

The Royal College of Surgeons in Ireland (RCSI), the Royal College of Physicians of Ireland (RCPI), and the Institute of Obstetricians and Gynaecologists have all expressed concern.

The organisations said the ruling sets such a high bar that it could jeopardise screening programmes if it meant a false negative amounted to a breach of care, opening the way to litigation.

RTÉ also recently revealed that the director general of the HSE, Anne O’Connor, has written to Jim Breslin, secretary general of the Department of Health, recommending that the department appeal parts of the judgment.

Ms O’Connor said the “absolute confidence” threshold was “setting such a high bar in law” that it would create “an environment that will result in unnecessary investigations and treatments among healthy people”.

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