Emirati women must have breast scan

Emirati women aged between 40 and 69 will be required to have annual mammograms to renew their Thiqa health insurance.

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ABU DHABI // Emirati women aged between 40 and 69 will be required to have annual mammograms to renew their Thiqa health insurance, in the latest move to cut breast cancer rates in the emirate. The Health Authority - Abu Dhabi (HAAD) said the move is likely to save "many women's lives". Breast cancer is the most common cancer in the UAE, accounting for 22.8 per cent of the total number of cancer cases, according to the National Cancer Registry.

Despite the high incidence, only 30 per cent of breast cancer cases are diagnosed in the early stages, before the cancer has spread, when survival rates are much higher. The disease is fatal in 44 per cent of cases in the UAE, according to HAAD. Between 1998 and 2007 the National Cancer Registry, based at Tawam Hospital in Al Ain, recorded 2,121 cases of breast cancer, although not all hospitals reported figures.

Of the reported cases, 76 were in patients under 30 years old. The most common age for diagnosis was between 45 and 49. A HAAD official said: "Using local data we have been able to estimate that for every 600 women who undertake mammography screening, one woman's life is saved from breast cancer. "By asking women to make appointments for mammography screening before renewing their Thiqa card, many women's lives will be saved.

"Screening with mammography remains the only single intervention shown in randomised controlled trials to significantly reduce death rates from breast cancer." More than 580,000 people have enrolled in the Thiqa programme, which is managed by the national insurance company Daman, since its launch last summer, although it is not known how many of these are women. According to the American Cancer Society, 61 per cent of cases in the US are diagnosed at an early, localised stage.

These women have a 98 per cent five-year survival rate. The society also said that mammography in women aged between 39 and 74 reduced death rates by between 16 and 32 per cent. If these figures were applied to the UAE, the percentage of deaths could fall from 44 to as low as 12. According to HAAD, the disease will affect one woman in eight at some point in her life. According to the Breast Cancer Care group in the UK, the rate there is one in nine.

Everyone signing up for Thiqa originally was required to undergo a medical test - Weqaya - that included height, weight, blood pressure and glucose and cholesterol checks. "While in its first year Weqaya screening was for the risk factors of cardiovascular disease," a HAAD official said, "this year it has been extended to include mammography screening as breast cancer is one of the top public health priorities of HAAD."

Women who are eligible for a mammogram will be contacted by HAAD directly by telephone or SMS. The authority has asked the public to "respond positively", reminding them that the mammogram is required for a Thiqa card. One of the biggest stumbling blocks to reducing the number of late-diagnosis breast cancer cases is the social taboo. Dr Arati Shirali, an oncoplastic breast surgeon who has worked in the UAE for seven years, said the health authority's decision to make mammograms compulsory should help lift the taboo in the long term.

"This is a major event and a very great idea," she said. "By making it something normal, and something not to be ashamed about, it will help get rid of the social taboo. "It will be just like getting a blood pressure test." Dr Shirali said it was essential that the compulsory mammograms be combined with information about how to self-examine and monitor one's own breast health. In October 2007 the UAE was chosen as one of 10 nations to take part in an international campaign to raise awareness about breast cancer.

The Global Initiative for Breast Cancer Awareness explored areas of research, diagnosis and treatment of the disease. Mammogram appointments can be booked at www.simplycheck.ae, or by calling Weqaya on 80061116.
munderwood@thenational.ae