As many as 33 women in Sweden had their uteruses unnecessarily removed after Uppsala University Hospital wrongly diagnosed them as being at risk of uterine cancer in 2023 and early 2024. An investigation into other cases has now been launched.
The Uppsala University Hospital this week revealed that it had officially informed 33 of its female patients, aged between 38 and 85, that they got misdiagnosed with precancer and their hysterectomies were unnecessary.
The women had seen doctors at the hospital for a variety of problems, including, in some cases, unexplained vaginal bleeding. During their visits between 2023 and the spring of 2024, cell samples were taken and later analysed by the hospital’s laboratory. The 33 women were found to have cell changes that put them at risk of developing cancer, known as endometrial intraepithelial neoplasia (EIN).
However, in these cases, the cell analysis proved incorrect, with pathologists systematically overdiagnosing EIN, the hospital said.
“We deeply regret what has happened. Removing the uterus is a major operation with major and irreversible consequences. It shouldn’t happen, and yet it did, and we apologise to the women affected by this. They have our full support,” Johan Lugnegård, Chief Medical Officer at the Uppsala University Hospital,” stated.
Shocking news
Lugnegård issued a statement on Wednesday evening in which he clarified that 25 out of the 33 women not only had their wombs but also their ovaries removed.
This bigger surgery means that the production of sex hormones in a woman’s body is stopped and that she, in effect, enters menopause if she hasn’t already.
Speaking with Euractiv, Belinda Haraldsdotter, president of the Swedish Gynaecological Cancer Association, expressed her shock at the news.
“A disaster, this is a disaster for the women, who have undergone major operations which have long-term consequences and possibly sometimes also complications,” she said, also pointing to the psychological aspects of the hysterectomies.
The alarm was first raised by medical staff at the Uppsala University Hospital’s women’s clinic in March 2024, who noticed that the number of hysterectomies had doubled in 2023. This prompted the hospital to launch an investigation.
Pathologists from other hospital laboratories were invited to check the cell diagnosis from the Uppsala laboratory, discovering the incorrect cell analysis.
Patchy quality assurance
According to Johan Lugnegård, the hospital had “lost its quality assurance” of cell samples during parts of 2023 and 2024.
“We did not have the quality assurance we normally have in place,” he told the Swedish medical journal without explaining why.
However, in his letter to the media, Johan Lugnegård says that a contributing factor to the faulty cell analysis was that the hospital did not actively participate in the Swedish Society of Pathology’s working group KVAST, where quality control is being discussed collectively at the time.
Tommie Olofsson, the head of operations at the laboratory in Uppsala, states its assessments stack out:
“It is ultimately a matter of subjective judgements, but Uppsala University Hospital stands out in a national comparison. We have been too strict in our judgements, more often convicted than acquitted, which has led to overdiagnosis. There shouldn’t be such big differences, and it’s a shortcoming in our quality assurance.”
The hospital’s investigation into the malpractice is still ongoing.
Wider net for quality assurance
Belinda Haraldsson is now demanding that similar cell analysis operations be quality-assured and that other hospitals in Sweden also check their pathology methods.
“The cell sample assessments need to be made absolutely reliable for women,” she told Euractiv.
The hospital in Uppsala started a random sample survey for 2021 and 2022 to investigate if other similar cases occurred.
It also claimed that measures have been taken since last spring to ensure similar errors do not happen.
“The hospital has ensured its participation in the national network, where pathologists from different laboratories compare cases in order to obtain a uniform assessment,” it said.
The women have now been advised by the hospital to seek compensation from the Swedish Patient Injury Insurance.
[Edited by Vasiliki Angouridi, Brian Maguire]
