Gaps in fighting breast cancer
COPENHAGEN // The gaps and challenges surrounding breast cancer screening in the UAE were emphasised by doctors from the region at a global cancer conference – they highlighted factors such as insurance cover, cultural issues and a climate of denial.
While cancer is the second biggest killer of women in the UAE – and breast cancer accounts for about 40 per cent of cancer cases in women – the absence of a national screening network, lack of knowledge about family illness history, and reluctance among many women to undergo vital checks were marked out as key issues in tackling it.
Abu Dhabi has a programme allowing Emiratis a free annual screening after they turn 40, but provision elsewhere varies. There is no national screening programme covering expatriates or insurance cover for predictive genetic tests that can detect faulty genes such as BRCA1 and BRCA2.
“There is just ‘ad hoc’ screening,” said Falah Al Khatib, consultant clinical oncologist at City Hospital Dubai, speaking on the sidelines of the Copenhagen conference. “We encourage people to be screened and, because of our awareness activities, it is picking up.
“But most people don’t know whether there is a history of cancer in their family. This comes from fear and a feeling of ‘it doesn’t affect me’. It is basically denial.
“Screening is a curative procedure. If it leads to breast cancer being caught early, surgery gives the patient a survival rate of almost 100 per cent.”
According to Kenneth Seymens, managing partner of MedicaIQ, a health innovation and technology advisory company, the “cultural reality’ in the Mena region is that the high rate of consanguineous marriage means women are more likely to be predisposed to higher rates of inherited cancer, heightening the importance of breast cancer screening.
“We have been attempting to broach this issue, not only with insurers who stand to benefit from identifying these patients and implementing prevention strategies, but with other stakeholders in the health ecosystem,” he said. “Yet no UAE insurer covers genetic screening as part of its health policy plan.
“The problem isn’t just insurers; it’s laboratories who charge for tests, physicians who don’t educate themselves about the benefits of testing, and patient advocacy groups who feel women are not ready to deal with knowing they might get cancer because it may lead to ‘psychological distress’.”
Social aspects affecting take-up of breast cancer screening were highlighted by Dr Mohsen Moktar, consultant oncologist at Cairo University, who said that, in the Arab world, the “appropriate age” for screening is not established, and Arab women can be deterred for fear of “rejection from spouses”.
“This should be replaced with awareness, encouraging women to go for mammograms when there is a suspicion or family history of breast cancer,” he said.
Published: October 10, 2016 04:00 AM