PANDEMIC BEHIND DROP IN BREAST CANCER SCREENINGS
Medical workers in the UAE say the situation has been exacerbated by a shortage of radiologists
Delays to breast cancer screenings during the Covid-19 pandemic have left some women with a reduced chance of beating the disease.
Last year, doctors at NMC Royal Hospital in Sharjah, one of the country’s largest private hospitals, examined fewer than half the number of women they would normally see.
The breast cancer treatment centre at the hospital typically screens 2,000 women a year.
Breast cancer is the most common form of the disease diagnosed in the UAE.
“Last year, we screened just under 1,000 patients, which is a big number for the UAE, but considerably lower than what we would usually see,” said Dr Menatallah Tawfik, 40, a breast cancer radiologist at the hospital.
“Only now are we seeing the effect of this, with more women with stage three and four breast cancer who skipped their screening last year during Covid.
“If we had seen them earlier, their breast cancer would have been 100 per cent curable. Their chance of recovery is now considerably reduced.”
Dr Tawfik said those with stage three cancer had a 50 to 70 per cent survival rate on average, with the survival rate dropping to 10 to 20 per cent for those with stage four.
Concerns about contracting Covid-19 during a visit to the hospital were among the reasons given for why fewer women went for screenings.
The trend was reported across NMC hospitals.
At the height of the pandemic between March and September last year, 43 women received a mammogram at NMC Royal Hospital in Dubai.
In the corresponding period this year, 63 women were scanned – an increase of about 50 per cent.
It was a similar situation at NMC Speciality Hospital in Al Nahda, where 89 women were scanned for breast cancer from March to September last year.
But 107 women were checked in the corresponding period this year.
Dr Tawfik, who recovered from Covid-19 last year, said a shortage of radiologists was also contributing to delayed diagnoses.
“Breast cancer radiologists are few around the world, maybe less than 1,000,” she said.
“It has taken a lot of personal sacrifice and 15 years of work to be in my position. Not everyone wants to go though this.
“I am one of just five or six breast radiologists in the UAE, and the only one in Sharjah and the Northern Emirates. If there were more of us, more women would have their breast cancers detected earlier.”
It is about 10 years since Zulekha Hospital in Dubai launched its Pink It Now awareness programme, which offered free breast cancer screenings.
More than 13,000 women have since been checked for the disease.
A year before the pandemic began, the hospital screened 2,423 women but that number fell to 1,446 last year.
It is a similar situation around the world, with UK figures showing about 12,000 women live with undiagnosed breast cancer.
Screening remains below pre-pandemic levels, the UK charity Breast Cancer Now said.
Since checks resumed last summer, about 500,000 fewer women have been screened compared with 2018 and 2019, the charity said.
Clinical guidance that warrants a cancer referral includes blood in a person’s urine, a breast lump, problems swallowing, anaemia caused by iron deficiency and post-menopausal or rectal bleeding.
One woman who had cancer diagnosed early was Abu Dhabi resident Thamara Noori.
She is recovering from stage two breast cancer.
She said she was having a shower one morning in 2015 when she felt something unusual on a breast.
“I thought it was just a spot as it was just like a pimple on the outside,” said Ms Noori, 47, who is from Sri Lanka.
“I didn’t give it too much thought, but my family forced me to go to the doctor.
“I said I didn’t want to go, but when I came in from work they had already made the appointment.”
It was a move that probably saved her life.
Ms Noori was successfully treated at Tawam Hospital in Al Ain and her cancer is in remission.
She said she would always be grateful to her family for insisting she had the spot checked, because the lump under the skin turned out to be the size of a golf ball.
“You don’t know what would have happened if I had just ignored it or I didn’t mention it,” Ms Noori said.
“As women, we don’t think of ourselves. We put our families first or we put something we have to do before everything else. So we come last.
“But this is a huge mistake. If we are stable and healthy we can take care of the rest.”
Breast cancer is responsible for 21.4 per cent of all cancers in the UAE.
About 85 per cent of breast cancers occur in women who have no family history of the disease.
These occur because of genetic mutations that take place as a result of the ageing process and are not inherited.
Those with a family history of the disease are likely to carry the BRCA1 or BRCA2 gene mutations, which cause 5 to 10 per cent of breast cancers.
On average, women with a BRCA1 mutation have a 72 per cent chance of developing breast cancer during their lives.
For women with a BRCA2 mutation, the rate is 69 per cent.
Mary Joy Villanueva Balagot, 51, is another woman who was given a new lease of life thanks to a routine check-up.
Ms Balagot, a former smoker, felt a lump in her left breast in June last year, but did not get herself checked out until March this year.
She was examined by Dr Sai Babu Jonnada, a consultant oncologist at NMC Royal Hospital in Sharjah.
Ms Balagot has since had a mastectomy to remove her cancerous breast and had 16 chemotherapy sessions.
“Dr Sai helped me with my journey of treatment and recovery throughout,” said Ms Balagot, whose treatment was paid in part by a charity because her insurance did not fully cover the costs.
“Most importantly he helped me deal with my stress as I became emotionally drained between treatments.
“I am grateful to him for his understanding of not only the disease but also of the emotions of a troubled soul, playing behind the scenes.”
Last year, we screened under 1,000 patients, which is a big number in the UAE, but lower than we would normally see DR MENATALLAH TAWFIK
NMC Royal Hospital in Sharjah