Screening for cervical cancer – the experience of the United Arab Emirates

Abstract

In most Arab countries, including Algeria, Lebanon, Libya, Morocco, Oman, Tunisia, Sudan and the United Arab Emirates (UAE), cervical cancer is the second most common malignancy seen in women. The objective of this study was to ascertain whether or not cervical cancer screening (CCS) is important in the detection of precancer and early cervical cancers, and if so, to understand how it can most effectively be implemented in the UAE. Before introducing any CCS programme, it is important to determine [1] the knowledge, attitude and practice (KAP) of physicians involved in the screening programme, [2] the actual prevalence of the precancer and cancer of the cervix, and [3] the choice of treatment modalities available. These factors will determine the likely effectiveness of screening. As in other Arab countries, women in the UAE have little awareness of Papanicolaou's stain test (also known as the Pap smear), and so many have never undergone this test. This is critical, as many patients present with advanced-stage disease in countries where awareness is low. Our observations indicate that there are significant gaps in the KAP of primary health care physicians with regard to CCS. Additionally, standards in colposcopy and cytology services are severely lacking, despite good treatment modalities. Based on this study, it is imperative that physicians receive training and that quality control measures be implemented prior to the introduction of CCS, to ensure that the programme can succeed in the UAE. In this way, the experience of the UAE should serve as a learning model for other countries in the Arab world, where CCS and prevention programmes have yet to be initiated.