Suspect cancer labs revealed

By MARTIN JOHNSTON

Health officials have finally named laboratories with low reporting rates for potentially serious cervical abnormalities.

The laboratories' reporting rates, covering the period from mid-1991 to mid-1994, were equal to or lower than those of Dr Michael Bottrill, whose misreporting of cervical cancer tests triggered the Gisborne ministerial inquiry.

Under pressure from the Ombudsman, the Ministry of Health yesterday gave the Herald the full version of its report containing cervical smear reporting statistics from 31 hospital and community laboratories. In the earlier version the names were censored.

But the Health Funding Authority is refusing to name labs about whose performance it has raised concerns. The Ombudsman is investigating the Herald's appeal to identify the labs.

The authority told the Gisborne cervical cancer inquiry in July of six laboratories it had targeted for closer evaluation after looking at 17. Three had addressed their problems and three were still of concern. No serious concerns were raised about women's health.

Women on the national cervical screening register are recalled for smears every three years or earlier if abnormalities are detected.

The ministry report says Dr Bottrill reported 0.6 per cent of satisfactory cervical smear slides as containing high-grade abnormalities up to mid-1994 - the first three years of the cervical screening programme.

Those with equal or lower rates were:

Christchurch-based Cardinal Laboratory, 0.5%

Pathlab Hamilton, 0.4%

Medlab South, Christchurch, 0.5%

Wellington-based Valley Diagnostic, 0.4%

Diagnostic Nelson, 0.4%

Auckland Diagnostic, 0.6%


The average for community labs was 0.8 per cent.

The report does not address what would be considered under- or over-reporting and the ministry would not comment yesterday beyond a statement from the Director-General of Health, Dr Karen Poutasi.

She said the statistics in the report were very old, might be inaccurate, and could reflect unfairly on laboratories. Far fewer women allowed their screening histories to be put on the register in the early days of the programme.

When the ministry refused to release the names to the Herald, it said it was prevented by a suppression order at the Gisborne inquiry.

But it was the ministry which sought the order when the report was given to the inquiry in April. The inquiry lifted the suppression last Thursday.

The lawyer for Dr Bottrill, Christopher Hodson, QC, is overseas and could not be contacted yesterday, but he has pushed for the release of information on other laboratories.

He said at the inquiry in April that Dr Bottrill had been heavily criticised because the rereading of his slides by a Sydney lab came up with a high-grade rate of 3.73 per cent - six times his client's rate.

Dr Tony Bierre, head of cytopathology at Diagnostic Medlab, which now incorporates Auckland Diagnostic, defended its 1994 high-grade reporting rate of 0.6 per cent.

It was 0.68 per cent earlier this year and the rate for Australian laboratories was 0.61 per cent.

He said Diagnostic Auckland's rate for low-grade abnormalities was higher than the average in the report, as was its referral rate for specialised internal examinations. These factors had contributed to the laboratory's lower-than-average rate for high-grades.

He believed it was the correct level for Auckland. Gisborne could have expected a higher rate owing to a higher incidence of cervical cancer.

Pathlab Hamilton pathologist Dr David Bruton said the six-year-old figures were "hardly relevant."

Herald Online feature: Gisborne Cancer Inquiry

Official website of the Inquiry