Cancer rate worried doctor

By FRANCESCA MOLD

When Gisborne gynaecologist Diane Van de Mark became alarmed at the number of women coming to her with invasive cervical cancer, she started recording their names in a notebook.

She collected 17 names in 30 months. Three of those on her list have died.

Dr Van de Mark, who moved to Gisborne in 1997 after nine years as a gynaecologist and obstetrician in Boston, United States, broke down yesterday as she told a ministerial inquiry of her anguish and frustration.

She said she had been struck by the size and depth of many of the pre-cancerous cervical lesions she found when treating the women.

Overseas, she had been trained to remove cervical lesions to a depth of about seven millimetres with a laser.

But as a specialist in Gisborne, it was not unusual to remove tissue three times that depth and still find some of the disease had been left behind.

Dr Van de Mark said when she became concerned about the high rates of cervical disease, she tried to find statistics comparing incidence and mortality rates between regions.

She could not find the information and was told by the Cancer Register that an inquiry would cost $800.

When she raised concerns with other Gisborne medical professionals, she was told the rates for the region were the same as for the rest of the country.

But figures revealed by the Health Funding Authority at the inquiry have shown that between 1994-97 Tairawhiti had a cervical cancer rate more than double the national average.

Dr Van de Mark was asked several times who had given her the false information about cancer incidence rates in Gisborne but she was reluctant to reveal the names.

"I don't think there was a cover-up," she said.

She eventually resorted to raising her concerns in a newspaper in August 1998, saying Tairawhiti cervical disease levels were at epidemic proportions. But instead of raising awareness as she had hoped, she faced accusations she was being alarmist.

"It was suggested that my remarks would serve only to make women lose faith in the national cervical screening programme.

"No one proposed that an investigation might be in order to find out if there was a real cause for concern. No hard questions were asked."

She said many of the women on her list were later identified during a rescreening exercise as having had their smears misread.

Meanwhile, a woman who headed the Tairawhiti cervical screening programme also wept yesterday when she told the inquiry she had not acted after hearing about a patient whose slides had been misread by Dr Bottrill.

Sharon Reid, who began working with the programme doing data entry and was promoted to the senior position of coordinator after very little training, said she had believed the case was an isolated one and thought that someone "bigger than me" would act.

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