Two thirds of women in the UAE require cervical cancer screening, suggests to a new study by Dubai Health Authority.
Cervical cancer is the fourth most common cancer in women worldwide and accounts for 7.9 per cent of all female cancers, according to the World Health Authority. It is also one of the most preventable forms of cancer with routine screening. But women in the UAE are unaware of the importance of regular screening, health care professionals have warned.
“It’s one of the preventative cancers if you detect it early,” said Dr Mahera Abdulrahman, head of research at Dubai Health Authority. “We all need to insistent on its importance. Women are not aware of the facilities; they don’t have the knowledge.”
The survey found that one in two women had never a Papanicolaou (Pap) smear test and that two out of three women have not had a Pap smear in the last five years.
One in three women were not sure how often to go for routine testing.
The data will be the first step in developing community outreach policy. All primary health care centres in Dubai offer the Pap test. Dr Abdulrahman suggested that insurance companies make regular check-ups mandatory.
As it stands, some insurance policies do not cover Pap tests at all, a practice health care professionals have criticised. Daman, the Abu Dhabi-based health insurance agency, recommends a Pap test every three years for women age 25 to 49 and every five years for women between the ages of 50 to 65. However, the Pap test is only covered on the Thiqa health insurance plan for Emiratis.
Dubai Health Authority's recently-published study surveyed 599 women across the country between September 2016 and March 2017. Women held positive attitudes towards the Pap test, with nearly four out of five women agreeing with the statement that regular screening was beneficial, although only 58 per cent of women were aware that it was for detecting cervical cancer.
About half of the respondents were in their thirties and 72 per cent were Emiratis. Respondents came from all seven emirates, with 53 per cent living in Dubai. Younger women and those with higher incomes were better informed.
About one in five women had not heard of the Pap smear test. Of those who had, most knew of it from their physician.
“We need more marketing and education about the importance of early detection of cervical cancer,” said Dr Vera Beni, an obstetrician and gynaecologist at Burjeel Day Surgery Centre at Reem Island. “Many people don’t know what a Pap smear is.”
Dr Beni recommends all sexually active women be tested regularly for human papillomavirus (HPV), which can be tested more accurately. Nearly all cases of cervical cancer are associated with HPV, a common, symptomless sexually transmitted infection.
“The HPV test is the most important, more important than the pap test,” said Dr Beni, who is a member of the European Cervical Cancer Association. “Unfortunately, there is an increase in HPV and there are many cases.”
“If the HPV test is negative, that means there’s no need to come every year. She can come every three years if she has some stable partner.”
The study urges health care professionals educate patients on the importance of regular testing.
“All women who are sexually active should have this test,” said Dr Beni. “We must explain it to them properly. I haven’t had a patient who’s refused to do that test. It just needs more effort from the doctor's side, nothing else.”
Dr Abdulrahman gives lectures to family physicians to promote their role. “Women trust gynaecologists and they should tell them that this is very important to do once every three years.”
The Department of Health – Abu Dhabi has named January cervical cancer awareness month.
It recommends all women between the ages of 15 and 26 to get vaccinated against HPV and that women who are married take a Pap test every three to five years, regardless of their HPV status. In 2016, cervical cancer was the fourth most prevalent cancer in Abu Dhabi.
"DoH has been working diligently since March 2008 to provide free HPV vaccinations to schoolgirls in grade 11 across the emirate,” said Dr Omniyat Al Hajeri, the department’s director of public health in a statement released by the state news agency this week.
“Later in 2013, DoH launched a follow-up programme for all women between the ages of 18 to 26 who have not previously received the vaccine in addition to launching early detection of cervical cancer awareness campaign."
There are no symptoms of cervical cancer until it is advanced.
Dr Beni says checkups must be routine, like going to the dentist. “An early detected change on the cervix can be sorted out,” she said. “Any delay of going to the gynaecologist puts you at risk.”