In the United Arab Emirates, October is marked by a plethora of breast cancer awareness initiatives, with landmarks illuminated in pink, clinics offering screenings, and social media platforms filled with reminders to check, book, and share. These efforts have successfully reached women across the country, where breast cancer is the most prevalent form of cancer among women. Despite the widespread awareness, delayed diagnoses remain a concern, often stemming from systemic issues rather than a lack of awareness. A woman in Dubai is unlikely to be unaware of the importance of breast cancer screening, yet the interval between initial consultation and specialist assessment can be lengthy.
Identifying the sources of delay
Dr. Ksenia Butova, founder and CEO of Longevium, has examined the interval between a woman’s initial breast consultation and her first specialist assessment. From her perspective in preventive medicine, Butova observes that women often mention breast concerns at the end of unrelated visits for hormone management or weight loss. A common sequence involves a woman in her early 40s discovering a lump, consulting a general practitioner, and being advised that the symptom is likely hormonal, with a follow-up visit scheduled after her next menstrual cycle.
Alternatively, she may receive an ultrasound report that is sent to a clinic she does not visit, or a referral letter that is not followed up on. Each step may seem reasonable in isolation, but collectively, they can lead to a lack of accountability for the time gap between identifying a potential issue and a specialist’s assessment.
The UAE’s highly mobile population exacerbates this issue, as patients frequently change healthcare providers, insurers, and cities. The stage at diagnosis significantly influences both the treatment required and the patient’s prognosis, making timely assessment key. Primary care is well-positioned to drive improvements in this area, particularly after a woman raises a concern. Butova proposes establishing a single, measurable benchmark: the time to first specialist review. To achieve this, clinicians should treat new breast symptoms as urgent referrals with deadlines.
Related Post: Molecular Switch Found Behind Triple-Negative Cancer Spread
A lump, nipple discharge, skin or nipple changes, or new swelling in the armpit should trigger a referral to a breast service for triple assessment. Triple assessment exists because each test misses things on its own. Closing the loop on every referral is also essential, requiring a named person, a tracking list, and a phone call when an appointment has not happened.
Transforming the response to breast cancer
Assessing risk is equally important as considering age. Women in the UAE tend to be diagnosed with breast cancer at a younger age than those in Europe or North America, making it essential to initiate risk assessments earlier. A family history of breast or ovarian cancer, or a known BRCA variant, should prompt earlier or more frequent surveillance. Primary care providers can systematically record these factors and utilize validated risk tools when available.
Utilizing shared health records
The UAE has already established the necessary infrastructure for shared health records, including health information exchanges like Malaffi in Abu Dhabi and NABIDH in Dubai. These systems enable a patient’s medical history to follow her, ensuring that healthcare providers have access to relevant information. Clinics can make uploading imaging reports a routine step, preventing subsequent doctors from starting from scratch. Most of these changes can be implemented with minimal additional equipment, requiring only a protocol and a named person to oversee the process.
Leave a Reply