Private smear test criticised by doctors

A cervical smear test sold to women with the claim that it is more accurate than that used by the National Health Service has been criticised by doctors and NHS managers who say it is undermining the national screening service.

The computerised test, called Papnet, is being marketed in Britain and across Europe by its United States manufacturer Neuromedical Systems which says its greater accuracy brings "peace of mind". In the United Kingdom, women are being asked to pay a pounds 100 registration fee and pounds 45 for each test and GPs are being offered a pounds 10 fee for each smear they take.

Sales teams are canvassing women in senior company positions offering them the test and signing up GPs prepared to provide it in Scotland, Nottingham, Birmingham, Bournemouth, Hampshire, Avon and Bromley, south London. Women are reminded that the NHS test is sometimes inaccurate, although direct reference to recent screening blunders involving the recall of thousands of women is officially discouraged. More than 1,000 of the tests are being sold each month, the company claims.

In addition to the normal manual check of the smear for abnormal cells, the test involves a computerised screening done by a laboratory in Amsterdam.

Women are being recruited for the test by a marketing company set up to promote it called the Independent Women's Protection Association. GPs are being approached by a separate company called Cytotest.

In Bromley, the health authority is warning all GP practices in the area that women should not use the test as a replacement for the NHS service. Dr Angela Bhan, deputy director of public health, said: "I have had calls from GPs who were unhappy about calling in women for smears that were outside the NHS and they did not feel comfortable about charging for them. I was concerned that women would see it as an alternative to the NHS test. Any screening programme has to be a national programme and it could undermine that."

Julietta Patnick, national co-ordinator of the NHS cervical screening programme, said she was not against automated screening if it could be proved to be of benefit. "What I am uncomfortable with is the way it is being marketed. It will totally upset our programme because we will lose continuity of screening."

She said cases of invasive cancer had fallen from 16 per 100,000 smears to 11.2 in the last decade, beating the target set under the Health of the Nation strategy of 12.8 by 2000. She was worried that the new test could pick up extra transient abnormalities, causing anxiety.

The Papnet test is claimed to provide 30 per cent greater sensitivity in picking up abnormal cells than traditional examination by microscope.

Wayne Taylor, UK manager of Neuromedical Systems, said: "We are very supportive of the NHS screening programme and we are not trying to undermine it. But governments cannot afford to offer this test. We feel women should have the choice of whether to have the NHS test alone or the NHS test plus Papnet. It is a seatbelt and airbag scenario. We are trying not to market it aggressively but we obviously have to justify ourselves to our shareholders. For the price of a hair-do or a pair of shoes women can have peace of mind."