Report disclaimers and informed expectations about Papanicolaou smears: an Australian view

Abstract

The cervical cancer screening program in Australia has an emerging litigation problem. This paper reviews some recent initiatives taken to address the problem. These initiatives include the establishment of registries of women being screened, education to promote an appreciation of the limitations of screening, and the introduction of outcome standards for laboratories reporting cervical cytology. An international evidence-based definition of the standard of care is the most pressing need in the immediate future. Possible roles of report disclaimers, informed consent, improved information about the average level of accuracy of a cervical cytology report, and the use of a range of differential diagnoses in addressing the medicolegal problems of cervical screening are explored.