Women in Abu Dhabi leaving cervical cancer screening too late, doctors say

Despite the cervical screening test being able to detect one of the world’s deadliest but most easily preventable forms of cancer, shyness, fear and lack of awareness are causing women to delay getting tested.

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ABU DHABI // Shyness, fear and lack of awareness are causing women to delay getting their first Pap smear test – sometimes for decades after experts recommend they should begin.

This is despite the cervical screening test being able to detect one of the world’s deadliest but most easily preventable forms of cancer.

Dr Sandhya Areekara Kunhiraman said she had seen one patient who did not get her first smear test until she was 47.

International guidelines recommend that women should begin cervical cancer screening at the age of 21 and continue with Pap smear screening every three years until the age of 65.

“Regarding the number of patients who come forward, it is not sufficient,” said the obstetrics and gynaecology expert at Abu Dhabi’s Medeor 24x7 Hospital. “It may be because of ignorance, lack of awareness, fear and shyness.

“Yet it is a simple test. It it takes less than five minutes and no prior preparation is needed. The only problem is the willingness of the patient.”

Although it is the most preventable type of cancer, each year cervical cancer kills about 270,000 women worldwide, according to the World Health Organisation.

Dr Georgeta Stocia Liscan, a specialist in obstetrics and gynaecology at Abu Dhabi’s Brightpoint Royal Women’s Hospital, said cervical cancer in many of these cases occurred in women who had not been screened.

“It is estimated that more than half of women every year who have cervical cancer diagnosed had never, or rarely, been screened with a Pap smear,” Dr Stocia Liscan said.

“I’ve had patients in their 40s, well educated and informed, who never had a Pap test.

“I have also had older women in their 60s or even 70s who first had a Pap test when brought by a daughter or niece.”

Fear of pain or discomfort, embarrassment, anxiety related to gynaecological examination, women being too busy and not making the time, and a financial barrier because of the absence of national programmes to cover costs are also reasons women are not having the tests.

“Yet cervical cancer is a preventable and treatable condition,” Dr Stocia Liscan said.

The cancer is a slow developing, progressive disease that can be easily detected by a Pap smear. In its early stages it is 100 per cent treatable.

According to the WHO, regular Pap smears can help to prevent up to 90 per cent of the most common type of cervical cancer.

Dr Stocia Liscan said women over the age of 65 could stop screening but only if they did not have a history of moderate or severe abnormal cervical cells.

She said they should also have either three negative Pap test results in a row or two negative co-tests (Pap and human papillomavirus) in a row within the past 10 years.

The obstetrician said in some countries women have access to DIY-home self-smear test kits designed to help those too busy or embarrassed to visit a doctor.

This could be a solution to increase the uptake of screening in the UAE, she said.

Dr Fady Georges Hachem, a consultant in obstetrics and gynaecology at Burjeel Hospital in Abu Dhabi, believes between 10 and 20 per cent of women in this country have not have Pap smears.

He said he had also seen women in their mid-40s inquiring about their first Pap smear.

Dr Monica Chauhan, a specialist in obstetrics and gynaecology at Prince Medical Centre in Abu Dhabi, said: “Common misconceptions on Pap smear tests include the notion that it is a cumbersome, painful and time-consuming test.

“But the Pap smear test is not painful and can be quickly performed in clinics and hospitals.”

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