Screening editorial costs Cox position

Brian Cox.
Brian Cox.
A University of Otago cancer-screening authority has been sacked from a national committee for going public with concerns about a change to the cervical screening programme.

Associate Prof Brian Cox was sacked from the National Screening Advisory Committee two weeks ago after co-writing an editorial published in the New Zealand Medical Journal in March.

"I held my position [after the editorial was published]. [The committee] then felt that was untenable for whatever reason," Prof Cox said.

The editorial said the decision to change the test for cervical cancer was taken without proper consideration and was a potential risk to women’s health.

"The lack of wide consultation and haste in which this major change in policy is to be introduced is cause for disquiet," the editorial said.

In 2018, the test will change from liquid-based cytology to human papillomavirus (HPV) screening.

Prof Cox was unhappy the committee endorsed the change last November.

He had not agreed, and the committee was supposed to operate by consensus, he said.

New Zealand should consider a phased approach to the new test, he said.

"We’ve decided to go the whole hog and go to a completely different test and do it five-yearly, instead of three-yearly.

"Though that may prove to be not a bad way to go in the future, my initial look at it suggests that it’s got rather large risks.

"I don’t think the Ministry [of Health] have been as interested in differing views as they should have been."

He had been a committee member for one year.

Prof Cox spoke at the annual Cartwright Forum in Auckland yesterday.

The theme this year was the cervical screening change.

Keynote speaker Prof Marshall Austin, a pathology specialist from the University of Pittsburgh, US, travelled to New Zealand for the forum.

He  told the Otago Daily Times the new test used relatively unproven technology. 

Clinical trial data suggested it was less sensitive than the cytology-based system, he said. New Zealand should be cautious about changing a proven cervical screening programme, Prof Austin said.

"There are some countries that are thinking about going in this direction. None of them have actually started doing it yet.

"The irony, in a way, is that they are really proposing an experiment, and that has special meaning in New Zealand because everybody knows that there was another experiment in New Zealand," Prof Austin said, referring to the Cartwright Inquiry into the treatment of cervical cancer at National Women’s Hospital.

National Screening Advisory Committee chairman Prof Ross Lawrenson said in a statement the committee "collectively agreed" to endorse the HPV decision last November.

"The committee expects and promotes robust debate in reaching its decisions, but once decided, the committee expects its members to publicly support them."

"Unfortunately, Associate Prof Brian Cox has been unable to abide by the terms of reference, despite the committee seeking an assurance from him in May. In light of that, the committee agreed unanimously to replace Prof Cox."

National Screening Unit clinical director Jane O’Hallahan said HPV primary screening would save lives.

Other countries were moving to HPV primary screening, as it was safer and more sensitive at detecting cancer.

eileen.goodwin@odt.co.nz

Comments

It's gratifying to know that someone is looking after women's health because it's definitely not the National Screening Advisory Committee and they have removed any dissension by sacking the only voice of reason.

HPV is not cancer and as women we need to stand up and demand that cervical screens are in place to detect cancer and then perhaps add HPV when women show abnormalities in their cancer smear screening.

 

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