Thursday 20 March 2014

UAE should follow Abu Dhabi’s lead on cervical cancer screening, experts say

The condition is the second-most commonly diagnosed form of cancer among women in the UAE, but is preventable.
Medical experts have urged other emirates to follow Abu Dhabi’s lead on screening and also to implement a public-awareness campaign to eradicate the disease.
“This should be a disease of the past. It should not happen,” said Dr Karim Elmasry, chief of gynaecological oncology at Mafraq Hospital, Abu Dhabi.
“We have this vital screening of pap smear and vaccinations of the human papilloma virus (HPV) in the emirate of Abu Dhabi but it doesn’t apply to the other emirates. It should be a nationwide thing.”
In developed countries, such as the US, the prevalence of the disease, especially those with late-stage cervical cancer, is falling because of successful awareness campaigns highlighting the importance of pap smears and the HPV vaccine.
But there are still far too many new cases being diagnosed in developing countries, such as those in the Middle East, said Dr Elmasry, a British expatriate, speaking on the sidelines of the International Conference of Al Noor Hospital in Abu Dhabi on Thursday.
About 80 per cent of cervical cancer cases are found in developing countries.
There is a lack of understanding and awareness about the disease, he said. “Most women believe ‘it is never going to happen to me’.”
But the disease does not prejudice, said Dr Elmasry, who is also chief of obstetrics and gynaecology at Mafraq Hospital and Al Rahba Hospital in Abu Dhabi.
“This affects everyone. We need more public awareness,” he said.
“We don’t need to be talking about radiotherapy, chemotherapy and hysterectomies if we prevent the disease in the first place. It is a crime to have this disease in this day and age.”
With pap smears, cell samples are taken from the outer opening of the cervix and studied by pathologists to detect abnormal, precancerous and cancerous cells.
HPV causes more than 99 per cent of cervical-cancer cases and another tool in the battle against the disease is vaccination. HPV vaccination prevents 70 per cent of cases and it is recommended that women receive the vaccine before getting married and becoming sexually active.
The HPV vaccine is given free to all Emiratis and expatriates between the ages of 15 and 17 in Government and private schools in Abu Dhabi.
To help those who “missed the boat”, an emirate-wide programme will now target Emirati women between the ages of 18 and 26, Dr Elmasry said.
But the other emirates need to catch up, he added.
Every year, more than 500,000 women globally have cervical cancer diagnosed, while one will die from the disease every two minutes.
“This is from a disease that is completely and utterly preventable,” said Dr Elmasry. “It is a crying shame. You can cure these women if caught early.”
Many women in the UAE, however, are found to have late-stage cervical cancer, which is far harder to treat.
“The saddest thing about it when it happens in the UAE is that most are advanced. Things I would not see in the UK because of screening.”
Dr Nada Sedeeq, consultant in pathology at Al Noor, Khalifa street branch, said cervical cancer was most commonly diagnosed between the ages of 30 and 55. It is rarely seen in women under the age of 20, while 20 per cent of cases are found in the over-65 age group.
“Catching cervical cancer in the early stages – the cure rate is high,” she said.
Women up to the age of 29 should have a pap smear every three years, she said. After 30, the preferred way to screen is with a pap smear combined with an HPV test every five years, she said.
In addition to HPV, family history, age, smoking, HIV infection and long-term use of oral contraceptives are all risk factors.
Signs of cervical cancer include bowel pain, bladder problems, fatigue, weight loss and irregular bleeding.

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