Cancer concern prompts tests call

By NAOMI LARKIN and FRANCESCA MOLD

Northland women with fears about the reliability of their cervical smear results are being urged to have fresh tests.

Government minister Phillida Bunkle said yesterday that women who had any concerns about historic tests carried out by the Northland Pathology Laboratory should have another smear and examination.

The call follows the revelation that the laboratory may have misread up to seven smears taken from Paihia resident Colleen Poutsma between 1989 and 1998. Mrs Poutsma is now dying of cervical cancer.

A Northland obstetrician and gynaecologist, Dr Graham Parry, is facing medical disciplinary charges over his handling of Mrs Poutsma's case.

She has said that in 1997, when she first visited him, he failed to perform an internal examination. It was only months later that he took a biopsy.

Ms Bunkle's call also comes as the Health Funding Authority announced that it was introducing quality standards into its new contracts with the country's community medical testing laboratories.

The HFA said yesterday that it was investigating the Northland laboratory's reading of Mrs Poutsma's smears but there would be no review or inquiry into its work.

"It's an isolated case. We've had no other issues relating to Northland," said spokesman Rob Eaddy.

The situation was not the same as that of Dr Michael Bottrill's laboratory, which triggered the Gisborne cervical cancer inquiry, he said.

"With Bottrill, he didn't have any assistance. He was really a lone agent operating in circumstances which weren't good."

But Ms Bunkle, who is also a leader of the Women's Health Information Resource Trust, said she knew of two other women who had gone on to develop invasive cervical cancer despite having several clear test results.

One, who lives in Whangarei, had four "normal" results from three smear tests read by the laboratory and one read in Auckland.

However, discomfort and persistent back pain resulted in her visiting a specialist. A cone biopsy - which involves taking a minute amount of living cervical tissue for examination - revealed that she had invasive cancer.

She had a radical hysterectomy and her lymph glands were removed.

Ms Bunkle said the other woman was being treated now and there was "a lot of uncertainty" about her future.

"What we need to know is, was there a systemic problem in the [Northland] lab, in which case shouldn't that be public, shouldn't that be studied?"

The laboratory was owned by pathologists Reese Jones and Edgar Johnson until 1995, and then by Dr Johnson alone until last year. It is now under new ownership.

Dr Johnson said yesterday that the laboratory had always been at the forefront of assuring its quality by becoming registered and adhering to Ministry of Health quality guidelines.



Mr Eaddy said the quality standards the Health Funding Authority was introducing into new contracts did not yet include cervical smears and breast cancer testing.

These were expected to be implemented within two months.

Quality standards on tests, including those for prostate cancer, blood and urine, pregnancy, throat and skin swabs, and then the breast and cervical tests, would give the HFA the right to terminate funding arrangements and inspect records.

The HFA, on behalf of the Government, contracts and funds privately owned community laboratories and public Health and Hospital Services (HHS) laboratories to provide medical diagnostic tests. There are 22 HHS laboratories across the country and 12 privately owned ones.

At the Gisborne cervical cancer inquiry yesterday, panel chairwoman Ailsa Duffy, QC, took the unusual step of commenting on a refusal by health authorities to provide information requested by the Herald under the Official Information Act.

The Herald asked the HFA in July to release the names of six laboratories identified in a study comparing laboratory performances as being of concern.

The HFA turned down the request.

It said it could not release the name of one laboratory under investigation as the result of a complaint relating to smear misreading because it had been suppressed by the inquiry.

The identity of that laboratory - Northland Pathology Laboratory - was released yesterday when the inquiry lifted the suppression order.

Ms Duffy said she wanted to make it clear the inquiry had never suppressed the names of the six laboratories contained in the study known as the "DuRose report."

She said the HFA had provided the inquiry with only a copy of the report but had removed the identities of the laboratories.

Herald Online feature: Gisborne Cancer Inquiry

Official website of the Inquiry