Misread smear test at St Helier Hospital results in delayed cervical cancer diagnosis and hysterectomy

Julia* attended hospital for a routine smear test at St Helier Hospital in Sutton in 2017. She had never missed a test previously or received an abnormal result. She was told this test was also clear.

Three years later, when the next routine smear test was due, high-grade abnormalities were found. She underwent a colonoscopy where a biopsy was taken. She was told she had a cancerous tumour on her cervix, measuring 2.4cm.

Her oncology team attempted to treat the cancer with a surgical procedure, but unfortunately no clear margins were achieved and Julia was referred to the Royal Marsden where she underwent a radical hysterectomy (removal of all reproductive organs). During this surgery, it was discovered that her cancer had spread to her lymph nodes meaning she also required chemotherapy. 

Fertility maintenance was discussed with Julia but she felt that prioritising her own life was her focus at that time. She was left with overwhelming tiredness following the chemotherapy and struggled to regain 'normalcy' in her life. Her relationship and work life were badly affected by everything that had happened to her.

Meanwhile, Julia was told by her treating surgeons that there was no way her tumour could have grown so quickly that it could not have been detected on an earlier smear test.

 Earlier that year, the hospital conducted an internal audit that involved retesting her previous smear tests at a different lab. The conclusion was that the smear test in 2017 had in fact demonstrated borderline abnormal cells. It was clear that the hospital had failed to pick up abnormal changes at that time.

Had they done so, Julia would have undergone annual rather than three-yearly tests and would most likely have received laser therapy to eradicate any abnormalities before the cancer developed further.

Sadly, Julia is no longer able to have children. In addition to the physical consequences of the hysterectomy and chemotherapy, she continued to suffer psychiatric injury.

Julia also experienced menopausal symptoms because of the hysterectomy including tiredness and anxiety. She was advised to begin HRT treatment. She unfortunately continues to experience anxiety and depression because of a fear that the cancer will return.

Epsom and St Helier University Hospitals NHS Trust admitted that the reporting as negative of the smear test in 2017 fell below a reasonable standard of care. It accepted that had the test been correctly reported, further investigation would have indicated a positive result and Julia would have had pre-cancerous cells removed and would have avoided cervical cancer.

Jonathan has worked very closely with Julia on her case and she is very pleased with the outcome.  She said:

'Jonathan is a very perceptive, sympathetic and transparent professional; he and his team are meticulous with detail and are very thorough professionals while also taking time to explain things clearly.

'Jonathan is personable, listens, is understanding and compassionate. He has been reassuring and honest and has endeavoured to achieve the best outcome for me.' 

*Names changed

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