Aussie lab netted 68 bad slides

By FRANCESCA MOLD

Sixty-eight Gisborne women with high-grade abnormalities or cervical cancer were picked up during a mass rescreening of smear slides previously read by Dr Michael Bottrill as normal.

Australian cytopathologist Dr Annabelle Farnsworth, who led the rereading of 23,000 slides, told a ministerial inquiry that smears from 68 of the women had been read as normal by Dr Bottrill but were later found to be high-grade or cancerous.

She said if not for rereading the findings, these women would have been falsely reassured there was nothing wrong with their cervix.

The women would have been told to return for another smear in three years, instead of being referred for a colposcopic examination to confirm whether there was an abnormality.

In response to questions, Dr Farnsworth told the inquiry that figures from the rereading indicated Dr Bottrill had a very high level of under-reporting.

"If one wanted to grade it, with 10 being the highest level, I'd give him an 8," she said.

"Would you describe the under-reporting as unacceptable?" asked panel chairwoman Ailsa Duffy.

"Absolutely," Dr Farnsworth replied.

Dr Farnsworth revealed that, of 216 women with high-grade and cancerous conditions confirmed by a biopsy, Dr Bottrill picked up just 37 - a total of 17 per cent. He found another 111 (51 per cent) had atypical cells.

In comparison, the Sydney laboratory found 60 per cent of the slides high-grade and 40 per cent in a category which meant an abnormality could not be excluded - a total of 100 per cent in the "right basket."

The Sydney laboratory found that about 2.5 per cent of the 23,000 slides were high-grade or cancerous, compared with Dr Bottrill's finding of 0.5 per cent.

"You are screening for these high-grade lesions.

"Both the New Zealand and Australian Governments spend a lot of money trying to look after their women.

"If you are picking up such a small percentage of the disease, then basically you shouldn't have a screening programme at all because it isn't doing any good," said Dr Farnsworth.

"Would you say [Dr Bottrill's rate of reporting] was unacceptably low?" asked Ms Duffy.

"Yes, I would," replied Dr Farnsworth.

The lawyer for women affected, Stuart Grieve QC, questioned Dr Farnsworth about her opinion of Dr Bottrill's practice, asking if she was surprised his laboratory was not accredited and he was not involved in an external quality assurance programme.

"He obviously chose to practise like that and that's his choice," she said.

"It put women at risk?" asked Mr Grieve.

"Well, unfortunately it has," Dr Farnsworth answered.