Cervical cancer (CC) is the seventh leading cause of death
among women in the United Arab Emirates (UAE), with most deaths attributed to
late detection of this cancer. The UAE lacks a national CC screening programme.
Thus, cervical screening is only performed opportunistically during women’s
visits to health facilities. CC screening rates in the UAE are as low as
16.9 %, and little is known about the perspectives of the nation’s educated
Muslim women regarding screening. Consequently, the aim of this study is to
explore Muslim women’s perspectives towards cervical screening in Dubai to
promote strategies for increasing its uptake, thereby leading to a decrease in
morbidity and mortality associated with CC.
Interpretivist and social constructivist epistemological
approaches were applied for this qualitative study. Data were obtained through
13 in-depth interviews. Purposive and snowballing methods were used to recruit
six South Asian women and seven Emirati women living in Dubai. Thematic content
analysis was concurrently applied with comparative analysis to the data.
Four themes regarding women’s perceptions of CC emerged from
the data. First, CC was considered a ‘silent disease’ that could be detected
with early screening. However, it was also associated with extramarital sexual
relations, which negatively influenced screening uptake. Second, women’s fear,
pain and embarrassment, along with cultural influences, deterred them from
undergoing screening. Third, a growing mistrust of allopathic medicine and
impersonal healthcare promoted a negative view of screening. Last, women became
aware of screening mainly when they were pregnant or receiving fertility
treatment.
The study highlighted a number of important factors relating
to cultural, religious and sexual behaviour that shaped educated Muslim women’s
perspectives on CC screening. Evidently, the current opportunistic approach to
screening is flawed. A national awareness programme on CC screening should be
developed, tailored to the sociocultural norms of the Muslim community, to
promote knowledge regarding the causes of CC and the importance of screening.
Table 2
| Perspectives on cervical cancer and its influence on screening uptake |
| ● CC was considered a ‘silent’, curable disease with a precancerous stage, which was detectable early through screening. Despite this knowledge two expatriates had never been screened due to lack of perceived risk. |
| ● CC was associated with sexual relations and promiscuity, which had a negative impact on screening. Most participants believed CC was caused by poor hygiene. |
| ● ‘Evil eye’ could be responsible for causing CC but did not prevent women from seeking medical help. |
| Perspectives on cervical cancer screening and its influence on screening uptake |
| ● CC screening was considered a routine procedure that was uncomfortable, embarrassing and possibly painful, which discouraged screening, in some cases. |
| ● Religion did not deter women from being screened, however cultural norms could dissuade women from being screened. |
| Other factors influencing cervical cancer screening uptake |
| ● Most women preferred being screened by female doctors, however nationality and religion of the doctor was not a major consideration. |
| ● All women preferred experienced, friendly doctors with whom they could communicate with in their preferred language. |
| ● There was growing distrust of allopathic medicine, which had a negative influence on CC screening. |
| ● Without health insurance, CC screening would be not be a priority for most women |
| Awareness of cervical cancer, screening and future needs |
| ● Awareness of CC and screening was lacking in Dubai; gynaecologists, friends and family were the commonest sources of information. |
| ● All women would surf the internet for information on CC |
| ● General agreement was that awareness programmes should target the younger generation in schools and universities. Some participants felt schoolgirls were too young to be exposed to CC awareness. |
| ● The government has an important role in increasing cervical screening uptake, possibly through pre marital screening and education. |
College of
Sustainability Sciences and Humanities, Zayed University, PO Box 19282, Dubai,
United Arab Emirates
Department of
Public Health and Policy, University of Liverpool, Liverpool, L69 3GL United
Kingdom
