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CERVICALCHECK, THE National Cervical Screening Programme, has been very much in the spotlight over the past week.
Despite the ongoing controversy, women are being encouraged to continue to avail of the service and advice has been issued to women who may be considering a repeat test.
But what exactly does the test look for and how effective is it in helping in the fight against cervical cancer?
Women aged between 25 to 60 are covered under the screening programme and are advised to be rechecked every one, three or five years depending on their age.
The smear test is not a test for cervical cancer but is a laboratory test for cell changes in the cervix. Some of these changes could develop into cervical cancer if left untreated.
Most smear tests do not find any changes but changes are not uncommon either.
Of the changes that may be discovered, they are classed as either low-grade or high-grade.
Low-grade changes are common and they clear up on their own but if high-grade changes are discovered then a more detailed examination is required.
This may include a colposcopy, where the abnormal cells are removed from the cervix and examined.
The high-grade changes may take years to develop into cancer cells and so treatment is possible when screening identifies them.
The HSE has said that in the past 10 years 50,000 women were informed of high-grade changes and that this had “improved their health chances considerably”.
Samples
Under the current CervicalCheck programme, the smear test samples are examined at laboratories in the United States and results are returned to women in Ireland.
As was practice under the current system, the smear tests of some women who were subsequently diagnosed with cervical cancer were reexamined to see if the interpretation of a previous test could potentially have been different.
In the current controversy, in at least 208 cases a different result could have been reported. It was established that, in 175 of these cases, different clinical care would have been recommended to the woman.
This could have included the more detailed examinations mentioned above including a colposcopy.
False negative
What has been very much unclear is exactly how often a different result should be expected to be reached after a review of a previous smear.
Answering questions before the Oireachtas Health Committee today, Dr Peter McKenna, Clinical Director at the National Women and Infants Programme, said that a false negative could occur in “around 10%” of cases.
The HSE’s director Tony O’Brien said that tests may be 70% effective overall.
Facing questions from TDs, it was suggested that literature presented to women during the smear testing process could be altered to give a greater clarity around the accuracy of testing.
The CervicalCheck website says that “no screening is 100% accurate” but it does not give any greater detail about precisely how accurate the screening process is.
Speaking at a media briefing earlier this week, O’Brien said that test results could either give false negatives or false positives.
“A result may be negative, even though there are changes to the cells of the cervix, this is called false negative, this is why it is important to have regular tests and to consult your doctor if you experience any symptoms.”
A result may be positive even though there are no changes in the cells of the cervix, these are called false positive. If your result is positive you will be offered a more detailed investigation. What this is a screening test and not a diagnostic test. It seeks to the greatest extent possible, to identify CIN*, and the women who are identified with such can then go into a diagnostic process”
“We knew when establishing this programme, as other screening programmes, that it would not and could not be 100% effective.”
CervicalCheck has said any woman who had normal screening results at their most recent test does not need an urgent screening test but they may avail of one if they are concerned.
*Cervical intraepithelial neoplasia (CIN) are cervical changes that are potentially cancerous if left untreated.
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SOCIALISM
You have 2 cows.
You give one to your neighbour
COMMUNISM
You have 2 cows.
The State takes both and gives you some milk
FASCISM
You have 2 cows.
The State takes both and sells you some milk
NAZISM
You have 2 cows.
The State takes both and shoots you
BUREAUCRATISM
You have 2 cows.
The State takes both, shoots one, milks the other, and then
throws the milk away
TRADITIONAL CAPITALISM
You have two cows.
You sell one and buy a bull.
Your herd multiplies, and the economy
grows.
You sell them and retire on the income
ROYAL BANK OF SCOTLAND (VENTURE) CAPITALISM
You have two cows.
You sell three of them to your publicly listed company, using letters of credit opened by
your brother-in-law at the bank, then execute a debt/equity swap with an associated general offer so that you get all four cows back, with a tax exemption
for five cows.
The milk rights of the six cows are transferred via an intermediary to a Cayman Island Company secretly owned by the majority shareholder who sells the rights to all seven cows back to your listed company.
The annual report says the company owns eight cows, with an option on one more. You sell one cow to buy a new president of the United States , leaving you with nine cows. No balance sheet provided with the release.
The public then buys your bull.
SURREALISM
You have two giraffes.
The government requires you to take harmonica lessons.
AN AMERICAN CORPORATION
You have two cows.
You sell one, and force the other to
produce the milk of four cows.
Later, you hire a consultant to analyse why
the cow has dropped dead.
A GREEK CORPORATION
You have two cows. You borrow lots of euros to build barns, milking sheds, hay stores, feed sheds,
dairies, cold stores, abattoir, cheese unit and packing sheds.
You still only have two cows.
A FRENCH CORPORATION
You have two cows.
You go on strike, organise a riot, and block the roads, because you want three
cows.
A JAPANESE CORPORATION
You have two cows.
You redesign them so they are one-tenth the size of an ordinary cow and produce
twenty times the milk.
You then create a clever cow cartoon image called a Cowkimona and
market it worldwide.
AN ITALIAN CORPORATION
You have two cows,
but you don’t know where they are.
You decide to have lunch.
A SWISS CORPORATION
You have 5000 cows. None of them belong to you.
You charge the owners for storing them.
A CHINESE CORPORATION
You have two cows.
You have 300 people milking them.
You claim that you have full employment, and high bovine productivity.
You arrest the newsman who reported the real situation.
AN INDIAN CORPORATION
You have two cows.
You worship them.
A BRITISH CORPORATION
You have two cows.
Both are mad.
AN IRAQI CORPORATION
Everyone thinks you have lots of cows.
You tell them that you have none.
No-one believes you, so they bomb the ** out of you and invade your country.
You still have no cows, but at least you are now a Democracy.
AN AUSTRALIAN CORPORATION
You have two cows.
Business seems pretty good.
You close the office and go for a few beers to celebrate.
A NEW ZEALAND CORPORATION
You have two cows.
The one on the left looks very attractive…
Classic. Funniest thing I read in ages :)
Agree, very funny indeedy! Sorry Lily, I’ve just shared this on fb :)
Where do you think I found it ; )… I had to share…
* It’s been doing the rounds since at least 2008. In one form or another with people adding their own take on it… It called ’2 cows’ if you want to google it…
Brilliant.
For the sake of the cows, Ireland and Northern Ireland should just become the one country. Again.
This Linda Martin story keeps on mooing.
Didn’t the Church do away with Limbo?
So the problem is that they have to label the cows as Irish-born, British slaughtered, yes? All for the sake of travelling a few kilometres.
Couldn’t they just label them as Irish-born, reared and slaughtered? Even Paisley proudly calls himself Irish (his own words) by virtue of the fact that Northern Ireland is still part of the island of Ireland. So why can’t the cows be Irish too? Labelling problem solved. Everyone can calm down, relax and take a breather. This economic crisis that could have brought the continent to a screeching halt has been averted, so the European Parliament can go back to discussing the shapes of bananas instead.
Cows in limbo priceless
Limbo’s burgers
Some load of bull
I know a farmer in Roscommon. I wonder if he will let me try convince one of his cows to shimmy under a low fence to the sound of some Calypso music.
Limbo, Limbo, Limbo!
They are up in the dall
Seriously though Irish beef factories paying poor prices at the moment for home grown stock. They dont want farmers cattle. Not even interested in Bord Bia quality assured animals. The have sheds full of their own fit for slaughter. LH reg (Goodman country)lorries delivering cattle into Goodman factory into Bandon . Same story different year.
Sectarianism rears its ugly head again. Are cattle religious? This could get messy.
So these cows haven’t been baptised then?
All i remember about that article is, ive got 2 cows.
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