Invasive cervical cancer audit: What lessons can we learn locally and where would we stand with regard to duty of candour?

Abstract

To identify lessons learned locally from the invasive cervical cancer audit. To estimate the impact that the application of 'Duty of Candour' may have upon our future service provision. Retrospective cohort study with interval analysis of all women diagnosed with cervical cancer at Sheffield Teaching Hospitals NHS Foundation Trust between 1 April 2007 to 31 December 2019. Data were collected prospectively with retrospective categorisation by screening history and invasive cervical cancer audit outcomes as satisfactory, satisfactory with learning points, and unsatisfactory. Statistical analysis was performed using the chi-squared test and paired t-test. Cervical cancer was diagnosed in 344 women. Seventy-eight (23%) had no record of prior cervical cytology, 108 (31%) had delayed attendance to the screening programme, 102 (30%) were detected by routine screening, and 56 (16%) were screening programme compliant. Satisfactory management was undertaken in 301 (87.5%) cases, 26 cases (7.5%) were satisfactory with learning points, and 17 cases (5%) were considered as unsatisfactory. Seventeen cases were applicable to the Duty of Candour process equating to 1.3 cases per year, incurring minimal impact upon future service provision. Invasive audit categorisation is subject to bias, however, with the potential for considerable intra- and inter-observer variation; the authors accordingly recommend that a further study be conducted to investigate both the consistency and reproducibility of the invasive cervical cancer audit categorisation.