Heavy smokers in the UAE should start yearly CAT scans to screen for lung cancer from the age of 55 at the latest, medical experts have said.
The disease is ranked number two among the most common causes of UAE cancer deaths, behind breast cancer.
The Department of Health guidelines advise that people aged between 55 and 75, who have a history of smoking at least one pack every day for 30 years, and who still smoke or who have quit smoking within the last 15 years, should have a yearly low-dose CAT scan.
The US Preventive Services Task Force, an independent volunteer panel of national experts in prevention and evidence-based medicine, recently recommended screening should start from the age of 50.
In the UAE, there's an added provision that advises those who have smoked shisha and medwakh for 20 years or more to have a yearly scan.
"Shisha or hookah involves a tremendous amount of direct and second-hand smoke, since it's a social activity," Dr Ali Wahla, medical director of the lung cancer programme at Cleveland Clinic Abu Dhabi, told The National.
"This is something that we recognise rather early on, which is why the Department of Health guidelines cut down the number of years somebody smoked shisha to 20 years to be eligible for lung cancer screening. So we do know that there is significant exposure and probably more so than regular [smoking of] cigarettes, because the nature in which it's consumed."
Dr Arun Warrier, consultant oncologist at Aster Hospital, Mankhool, said people tend to be largely unaware of the impact of shisha smoking.
“Because it passes through the water bubble, many people believe that the harmful effects are less,” said Dr Warrier.
“But it's not like that, because tobacco is the main culprit in lung cancer. One of the main issues with hookah is the amount of toxic gas is more. The carbon monoxide and these toxic fumes are actually more in hookah smoking.”
Increased smoking in UAE
Dr Wahla said smoking continues to be popular in the UAE, and stressed the importance of education about the dangers of lung cancer.
“What we have noticed, and this is data coming to us from the Department of Health, is that over the years smoking has become more prevalent in the UAE and it's becoming more popular, especially among the male population,” said Dr Wahla.
“The result has been that even though the overall prevalence [of smokers] in the UAE is in the 20 per cent range, it is higher than among younger people.
“This is the reason why we believe that every lung cancer screening programme should be tied in with a smoking cessation programme, because obviously if we're able to get people to quit smoking, then the cumulative risk will be significantly less of developing lung cancer.”
Dr Warrier also said he expected to see an increase in the number of lung cancer cases in the years to come.
“The number of lung cancer cases is not very high, because of the young population. Lung cancer tends to [appear in] those aged around 60 and it affects more males.
“In the future, we should expect more because more and more young people have started smoking.”
The UN’s International Agency for Research on Cancer’s latest statistics on cancer cases in the UAE (2020) show that lung cancer is the third most common form of the disease found in males, and seventh most popular in females.
E-cigarettes no alternative
Dr Wahla dismissed e-cigarettes as an alternative to quitting smoking.
“There have been reports in the US of people developing adverse reactions to certain e-cigarettes, sometimes fairly significant reactions,” said Dr Wahla.
"Another problem with e-cigarettes is that since they're not well regulated, it's difficult for us to say what the patient is smoking. In terms of smoking cessation, probably the best bet is to go to a smoking cessation clinic, where they will use a combination of either nicotine patches or medications, along with available therapy. This is in line with guidelines from both the European and American prevention societies."
Cleveland Clinic was designated as the official pilot lung cancer screening centre for Abu Dhabi by the Department of Health in January this year.
It means the Abu Dhabi hospital will have access to the latest lung cancer screening technology, leading to much earlier diagnosis in high-risk patients. The lung cancer screening programme is designed to find the disease in patients before they experience symptoms, when it is easier to treat.