Women need alerts for Pap smear tests

Every woman in the UAE should be sent a reminder to have an annual pap smear to protect them against cervical cancer, the second most common form of cancer among females.

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ABU DHABI // All women should receive text notifications to have a Pap smear to reduce the risk of one of the most common cancers, say doctors.

Cervical cancer is one of the world’s deadliest but most easily preventable forms of cancer for women, yet many still put off having the life-saving Pap smear test.

UAE health authorities should emphasise the importance of such checks by making the test free and sending SMS alerts, and letters to women’s’ homes, said Dr Rami Mahaza, an obstetrician and gynaecologist at Dubai’s Canadian Specialist Hospital.

“Many women unfortunately do not do a Pap smear – maybe due to lack of awareness, financial reasons, fear of the test, embarrassment, being busy and an underestimation of the importance of such tests,” said Dr Mahaza. “Yet Pap smears are so important.”

According to the World Health Organisation, regular Pap smears can help to prevent up to 90 per cent of the most common type of cervical cancer. Early detection is vital since most women do not report noticeable symptoms until after the cancer has spread to other organs.

“Cervical cancer is usually preceded by many stages and a Pap smear picks up the disease, or the stage before it develops to cancer, and so can be treated easily,” Dr Mahaza said.

While there has been an uptake in women having the test, the number is too low, he said.

Dr Rosalie Sant, a specialist obstetrician and gynaecologist at Primavera Medical Centre, in Dubai Healthcare City, said patients needed a push to come for regular Pap smears.

“It is people who care who come back, because we don’t remind them. We don’t do anything. So that is a bit of a concern.”

Notifications and reminders would work – but would be easier to implement among Emiratis because of the high turnover of expatriate patients and doctors.

“In a country that is very fluid it is very difficult to have a recall system,” said Dr Sant. “It is difficult to maintain a list.

“The best would be for whoever last performed a Pap smear to get in touch with the patient and remind them.”

However such a system would benefit Emiratis – especially because many do not recognise the importance of the test.

“They think if they have just been married to one man and they have never been with anyone else they don’t need it,” said Dr Sant. “They don’t particularly like being examined.

“Also, I find people are scared that it is going to be painful. Which is a great shame because it doesn’t have to be.”

If the doctor gives the patient time to relax before performing the test – and does not rush – it is a two-minute job that can save a life, said Dr Sant, 48.

The specialist, who has worked in the emirate for 11 years, said education was also vital.

“Wc are very, very fortunate that we have one cancer where changes start about ten years before the cancer actually happens and it is so easy accessible to examination,” she said. “Even if you have precancerous cells, who cares? You remove them and you will never come close to cancer.

“It is such a shame therefore to miss this opportunity.”

How regularly a Pap smear should be performed depends on each country, said Dr Sant, of Malta.

In the UK, for example, it is every three years, while in some countries it is every six months.

“In my opinion every year in the younger age group is probably wise, but every two years is fine,” said Dr Sant.

Human papillomavirus (HPV) checks in conjunction with Pap smears are also important, she said.

Nearly all cases of cervical cancer can be attributed to the HPV, but the majority of people carry the virus without suffering any ill health.

The HPV vaccine – which fights the human papillomavirus that causes most cases of the disease – is now given free to Emirati and expatriate pupils aged 15 to 17 at government and private schools in Abu Dhabi.

The other emirates should follow suit, said Dr Sant.

Dr Nada Altabara, obstetrics and gynaecology specialist at Wellbeing Medical Centre, said in spite of the well-known benefits of the Pap smear test, a very small number of women come in for cervical screening.

“Our aim is to generate more awareness and to promote early detection of cervical cancer, which has been on the rise in recent years.”