DOCTORS are furious at a recommendation not to extend Medicare funding to new cervical cancer screening techniques widely used in other countries, saying ”outmoded technology” means women are being retested needlessly for harmless cell changes.The decision by the Federal Government’s Medical Services Advisory Committee – which could also derail a planned revision of the entire national cervical screening program – was a missed opportunity to improve women’s health care, said the Royal College of Pathologists of Australasia’s spokeswoman, Gabriele Medley.”For many women it would reduce the need for invasive and possibly unnecessary further investigations and treatment, with their attendant costs and stress,” Dr Medley said.At issue is liquid-based cytology, in which cells are preserved in a liquid sample instead of the glass slide used in conventional Pap smears. Australian research has shown the $35 ThinPrep version of the technology detects abnormal cells more accurately than regular Pap testing, which is offered free through the national screening program.Another advantage is that the sample can be preserved for further testing if it shows initial abnormalities, meaning women need not return to the doctor.The committee also rejected a funding proposal for $90 human papilloma virus (HPV) testing. This can determine whether cell changes are likely to be cancer without the need for colposcopy – an invasive direct microscope viewing of the cervix.The committee – whose advice must be accepted by the Health Minister, Nicola Roxon, to become official policy – said both tests were useful, but too expensive for public funding.But Dr Medley said this ignored potential savings from removing the need to recall women for follow-up smears.Neville Hacker, the director of the Gynaecological Cancer Centre at the Royal Hospital for Women, said research suggested women who were free from HPV could safely go without further tests for several years, saving money. ”I think we are way behind the times … we are doing screening too frequently and using outmoded technology,” Professor Hacker said.Liquid samples – processed by machine instead of having to be viewed by technicians – would become additionally important as more young women received the cervical cancer vaccine, Professor Hacker said.This was because laboratories would encounter fewer abnormal samples, and might lose the skills to detect them.Doctors are also concerned that the committee’s decision could hobble a wider redesign of the cervical screening program, to take account of changing technologies and patterns of disease.A draft plan for the review stated its recommendations would be consistent with Medicare funding decisions.But a spokeswoman for the Department of Health and Ageing said yesterday the plan was ”only a draft aimed at providing health officials with a broad picture of how the renewal could go forward”.Holly Simmonds, managing director of ThinPrep’s manufacturer, Hologic, said yesterday the company could not control the final price of testing, because pathologists set their own fees, but wider use of the tests would push costs down.
Nanjing Night Net