ABU DHABI // A leading UAE doctor is offering to stand as an “expert witness” for any resident who wants to press charges against insurance companies for not paying for their cervical cancer treatment.
Dr Saad Ghazal-Aswad, head of the gynaecological oncology department at Tawam Hospital in Al Ain, is appalled at the refusal of many insurance companies to cover cervical cancer treatment because it is caused by a sexually transmitted disease.
He said that, in Abu Dhabi, the main insurance supplier is Daman and doctors never get asked any questions related to HPV but, in Dubai, when applying for authorisation for a pap smear test, because of pre-cancer cells, most insurance companies ask that the patient be tested for HPV.
“If the results are positive, they refuse to cover treatment because it’s an STD,” Dr Aswad said, adding that HPV has no treatment.
“We treat the abnormal cells that lead to cancer. We are treating the consequences of HPV. When you [insurance companies] tell a patient that I am not covering you because of HPV, then you are implicating the patient in an STD.”
He said this is unethical and unfair to women, whom in most cases have contracted the virus from their partners.
“They [insurers] should not ask for HPV results,” he said. “If insurance companies fail to pay for the treatment of pre-cancer of the cervix because it is HPV, I will challenge this in the courts because we are treating the cancer, not the HPV.”
Many patients, he said, will not pay for an HPV test because they are aware that if they test positive, their treatment will not be paid for. “This is wrong. This is a serious matter. It is cancer and must be covered,” he said.
However, Dr Sherif Mahmoud, regional head of healthcare operation at AXA Insurance, said that rarely is cervical cancer treatment not covered because doctors are smart enough to utilise a loophole that insurers turn a blind eye to.
There is a two per cent chance that cervical cancer is not caused by HPV and this is the loophole that most doctors use to get their patient’s treatment paid for.
“Doctors keep silent and insurance companies play along,” Dr Mahmoud said, who did agree that treatments for STDs are not covered.
“Insurance will not encourage or cover anything that has resulted from an illegal act. We are simply following the law,” he said.
Proof of an STD could also lead residents to face legal charges and deportation for sex outside of wedlock, which is illegal in the UAE, Dr Aswad added.
For patients without health insurance, cervical cancer treatment costs range from less than US$2,000 for a procedure to remove pre-cancerous or cancerous cells from the cervix, to $100,000 or more in advanced cases.
Dr Nazura Siddiqi, specialist gynaecologist at Bareen International Hospital said: “The fact that insurance companies don’t cover STDs and routine pap smear screen , unlike other countries, means that it [cervical cancer] goes undiagnosed and untreated.”
She said that pap smears, which screen for the cancer, cost anywhere between Dh200 and Dh300, which is a “high amount” for many patients. Pap smears are only covered by insurers if there is an infection but not in a regular check-up.
According to international guidelines, women should have pap smears every three years but, Dr Siddiqi said, “many will refuse to go because of the cost”.
salnuwais@thenational.ae
