Do Misread Pap Smears Contribute to Cervical Cancer Death Rates?

A new study published in the journal Cancer reveals that the death rate from cervical cancer in the United States is considerably higher than previously estimated. Prior analysis didn’t account for women who had their cervixes removed in hysterectomy procedures. As a result of the adjustment, the empirical data now reveals that black women are dying from cervical cancer at a rate 77% higher than previously thought and white women are dying at a rate 47% higher.

This rise in cervical cancer stats may be due to methodology but one glaring question still remains unanswered. WHY are thousands of women dying each year from a form of cancer that is largely avoided through early detection and proper preventative care???

According to Anne Rositch, assistant professor of epidemiology at Johns Hopkins Bloomberg School of Public Health in Baltimore and lead author of the study, “We can’t tell from our study what might be contributing to the differences in cervical cancer mortality by age and race.”

One factor that may be contributing to the cervical cancer mortality rate are medical errors caused by mis-read Pap smears. If a woman has been getting regular Pap tests and is diagnosed with cervical cancer or other abnormalities, there is a high chance there was a misread Pap smear in her medical history.

Here are THREE reasons WHY Pap smear results may fail to diagnose and prevent cervical cancer:

1. New Screening Methods Limit a Technicians Field of View when examining the results of a Pap smear.

Cervical cancer can go undetected when the results of a Pap smear are not properly screened. For many years the procedures that labs followed to interpret the results of a Pap smear involved a manual process in which technicians viewed slides under a microscope without computer assistance. The potential for medical errors is present now because technicians are not viewing all the cells on the slides anymore, simply those that are pre-selected by the computer. A high tech “image guided” method provides lab technicians with a partial selection of the cells on a particular slide to examine under a microscope, focusing their attention to a limited range and sometimes neglecting the areas that actually show cancerous cells.

1. Unreasonable Demands on Lab Technicians Lead to Errors

Major national medical laboratories assume that computers have made the process more efficient, allowing lab techs to process a higher volume of slides each day. Labs across the country operate with an eye on the bottom line, which means maximizing the number of slides its employees screen to generate the highest possible return. When slides were screened manually, some lab technicians reviewed approximately 80-90 slides per day. Now, those technicians may screen upwards of approximately 130-140, almost a 50% increase from the previous workload.

1. Decreased Frequency of Recommended Pap smears

New guidelines by the American Society of Obstetricians and Gynecologists (ACOG) recommends that certain women (based on their age, past medical history) decrease the frequency of Pap smears from annually, to every two years starting at age 21, and every three years if a patient has had three normal Pap test results in a row after age 30. The reduced frequency means that in the event that the first test was misread, years may pass before another test is conducted allowing the precancerous cells to develop into invasive cancer cells.

These factors can play heavily into the misdiagnosis of cervical cancer, and have proved to be the cause of death in cases of medical malpractice. A lab’s failure to detect precancerous cells on a Pap smear slide can result in a patient missing a crucial window of opportunity and lead to tragic consequences. Ignoring these three factors is only going to add to rising death rates for cervical cancer patients. The disparity in demographic groups is further understood when we consider how limited access to quality healthcare in marginalized communities can also result in increased medical errors. If reversing the trend for this highly preventable form of cancer is truly a goal for the medical community, acknowledging and addressing these factors is key to progress.

Women should insist on having a pathologist review their past lab results if they receive a diagnosis of cervical cancer to identify if a medical error occurred.