THE records of just under 200,000 women are to be individually examined to check if they were wrongly excluded from Scotland's cervical screening programme.

Public health minister Maree Todd revealed a further two women may have developed cervical cancer after being incorrectly removed from the list for smear tests.

In June, she said a small number of women wrongly excluded had subsequently developed cancer, one of whom had died.

Ms Todd offered her "sincere apologies to all those affected by these errors".

The minister initially blundered when she announced the review in Holyrood, saying 2,000 records were to be checked.

After being contacted by staff, Ms Todd told MSPs that she had "inadvertently said 2,000 records were to be reviewed when actually I should have stated 200,000".

Following an audit of those who were excluded from the cervical screening programme, health boards have already written to around 600 women whose records show they have, or may have had, "sub-total hysterectomies", meaning they should still have been checked.

While most patients undergoing a hysterectomy have their uterus and cervix removed completely, some women have a sub-total hysterectomy where part of the cervix can be left behind. These women still require to be screened for cervical cancer.

A team of expert clinicians set up to address inappropriate exclusions from screening has now recommended that everyone who has been permanently excluded from the cervical screening programme over several decades should also have their records reviewed.

The Scottish Government said it is likely more people will have been wrongly excluded.

It said this wider review is likely to take at least 12 months to complete, based on the complexity and numbers involved.

Ms Todd said clinical teams had also completed a review of the cancer registry to find out if there were other cases where an exclusion may have contributed to a diagnosis of cervical cancer. 

She said there is a "high level of clinical suspicion" that in one case, a woman may have developed cervical cancer as a result of an inappropriate exclusion from screening. 

Separately, there was another "very complex case where several factors may have contributed to a diagnosis of cervical cancer, including an incorrect exclusion from cervical screening". 

In both cases, the women have died.

Ms Todd revealed that "more limited reviews" had revealed issues with women being wrongly removed from the list for smear tests in 2006, 2015, 2016 and 2017.

As a result of this, the minister said she had instructed Healthcare Improvement Scotland to look at the processes, systems and governance for when women are permanently removed from the list for cervical screening.

She said: "We must consider whether opportunities were missed to identify the wider issues now being investigated."

Scottish Labour health spokeswoman Jackie Baillie said the Scottish Government has "serious questions to answer" but welcomed the wider review.

She said: “This is a welcome development and my thoughts are with all of the women affected.

“The health and wellbeing of the women involved must be uppermost in all of our minds.

“Nonetheless, this SNP Government still has serious questions to answer over why this scandal went uncovered despite concerns being flagged repeatedly over a number of years.

"Time and time again, this Government allowed this scandal to go uncovered and as a result lives have been put on the line."

She added: “The Government must take responsibility for their continued oversight on this matter and act to put this right as soon as possible.”

Conservative MSP Annie Wells said the review should be "a full inquiry into why these women were excluded unnecessarily and the effect this has had".

She said: "This error has had a profound effect on the women involved and they deserve answers as soon as possible."

Scottish Liberal Democrat leader Alex Cole-Hamilton accused the Government of waiting until after the Holyrood election "to tell Parliament that a woman had died after wrongly being excluded from screening".

In a statement, Ms Todd said: “I once again offer my sincere apologies to all those affected by these errors. 

"In particular, I extend heartfelt apologies to the women who were excluded from the programme who went on to develop cancer, and to their families. 

"I also recognise the anxiety this will have caused to all those wrongly excluded from screening."

She added: “I know this further review will also concern people, however, I hope I can offer some reassurance. 

"Firstly around 95 per cent of hysterectomies carried out in Scotland are total, and women who have had total hysterectomies do not need to be screened.

“Secondly, the risk of cervical cancer in general is fewer than one in every 100 women in Scotland across their lifetime. 

"Thirdly, there are dedicated NHS staff who are committed to completing this work as quickly as possible, and to bringing all their considerable expertise to doing so.

“I recognise that people whose records are being reviewed will want and need to know how long they will have to wait for the outcomes of this review. 

"The NHS will make sure those affected are informed about progress, and I will update Parliament as often as required.”

She stressed the cervical screening programme "continues to be the best way to prevent cancer before it starts".

Samantha Dixon, chief executive of Jo’s Cervical Cancer Trust, said: “This additional review is very welcome and every effort must be made to ensure that no woman will slip through the gaps during the investigations; this includes those who may have left Scotland since their surgery and those who have not yet responded to letters.

"While it is important to understand if opportunities to prevent this incident were missed, we must not lose sight of those affected, notably those who have lost loved ones or who are feeling anxious as a result of these announcements."