Women’s Preventive Care Service

Understanding Pap SMEAR what to expect, procedure and results.

A Pap smear, or Pap test, is a crucial screening for women, detecting cervical cancer or pre-cancerous conditions early. Women should start at age 21 and continue regularly. This quick procedure improves treatment success rates and helps maintain reproductive health by allowing timely intervention.

What is Pap Smear?

Pap Smear is a test done to detect cervical cell abnormalities to prevent and cancer.

What is the purpose of a Pap Smear?

A Pap smear detects cervical cell abnormalities early, helping to prevent and diagnose cervical cancer, which is highly curable if caught early. Cervical cancer, often caused by high-risk strains of the Human Papilloma Virus (HPV), develops when cells grow uncontrollably in the cervix and can spread if untreated. Early detection is key to successful treatment.

Who needs to have a Pap Smear?

A Pap smear is recommended annually for all women aged 21-65 years. However, the frequency of the screening is advised by our gynaecologist and may vary.

In the early stages of cervical cancer, a women may not experience any symptoms, which is why regular PAP smears, to detect any abnormal cells in the cervix, are so important.  During the test, a sample is taken from the cervix to check for any abnormalities in the cells. In addition, HPV testing done at the same time as the Pap smear; this increases the sensitivity 

HPV vaccination protects against the Human Papillomavirus, which causes most cervical cancers and other related conditions. The vaccine is highly effective in preventing infections from high-risk HPV types. Recommended for preteens, teens, and young adults, it significantly reduces the risk of developing HPV-related cancers and diseases.

What is HPV Vaccination?

HPV vaccination refers to a vaccine that is designed to protect against certain types of human papillomavirus (HPV) infection.

Who is HPV Vaccination for?

The HPV vaccine is typically recommended for preteens and teenagers (both girls and boys) and is usually given in a series of two or three shots over a period of several months. It is important to get the vaccine before becoming sexually active, as it is most effective when given before exposure to the virus. However, even if someone has already been exposed to HPV, the vaccine may still offer some protection against the strains that they have not yet been exposed to, so it is recommended at later stage of life up till age 45 as per advised by your gynaecology consultant.

Breast cancer is the most common cancer in the UAE. According to the World Health Organization, breast cancer accounted for 21.4 percent of all cancer cases recorded in the UAE last year, totalling 1,030 new diagnoses. With this knowledge Mediclinic wants to support breast cancer screening to increase early detection of breast cancer via performance of screening mammography. This allows small tumours to be detected before we are able to see or feel them.

Mediclinic offers breast cancer screening for everyone eligible for this screening.

To check if you are able to proceed with breast cancer screening, please answer the below questions before making an appointment:

• Are you female?
• Are you aged 40 year and above?
• Have you had a mammogram in the last 12 months?
• Are you pregnant or breastfeeding?
• Are you already seeing a doctor for any breast problems?

If the answer is Yes, Yes, No, No, No, then you are eligible for the breast screening programme, and you can proceed to make an appointment. If you are not currently eligible, please discuss with your family/gynaecology doctor or breast surgeon who may request any further tests as necessary.

Screening packages rates:

• Breast cancer screening - AED 375

Includes:

• Appointment with a Family Medicine physician in Mediclinic’s Virtual Clinic
• Mammogram at the radiology department at the Mediclinic hospital of your choice

Screening selection criteria

For all woman aged 40 and above, with an average risk, breast cancer screening should be offered every year.

Screening mammograms are carried out for healthy women who have no symptoms of breast cancer.

Women at an increased or high risk of breast cancer will have a different screening pathway; please discuss this with your family/gynecology doctor or breast surgeon. Some examples are women who have undergone previous chest radiation treatment at age younger than 30, previous history of breast cancer, abnormalities on previous breast biopsies, strong family history of breast and/or ovarian cancer or genetic predisposition.

The breast screening process

If you are eligible for breast cancer screening, then you can make an appointment with one of the Family Medicine doctors at Mediclinic’s Virtual Clinic by calling 800 2033. You will then receive an appointment confirmation and payment link.

During the virtual consultation your Family Medicine doctor will go through a questionnaire with you, answer any of your questions and proceed with ordering the mammogram for you at the radiology department of the hospital of your choice.

Frequently asked questions/ more information

What is a mammogram?

A mammogram is an x-ray image of your breasts. It can be used either for breast cancer screening or for diagnostic purposes, such as to investigate symptoms or unusual findings on another imaging test.

How can I prepare for a mammogram?

We understand you may feel nervous before your mammogram appointment. In order to prepare for your mammogram, please follow the advice below:

• Schedule the test for a time when your breasts are least likely to be tender. If you menstruate, this is usually during the week after your menstrual period.
• Bring any prior mammogram images. If you are going to a new facility for your mammogram, request to have any prior mammograms placed on a CD. Bring the CD with you to your appointment so that the radiologist can compare past mammograms with your new images
• Avoid using deodorants, antiperspirants, powders, lotions, creams or perfumes under your arms or on your breasts. Metallic particles in powders and deodorants could be visible on your mammogram and alter image quality

How is a mammogram performed?

Before the mammogram you’re asked to remove neck jewellery and clothes from the waist up, covering your upper body with a hospital gown.

During the mammogram procedure our mammographer (a female technician specialised in performing mammography), will take you through the process step-by-step.

The mammographer will position your head, arms and torso in a way to allow an unobstructed view of your breast.

Your breasts are then gently compressed between two firm surfaces to spread out the breast tissue.

Pressure is applied for a few seconds to spread out the breast tissue. The pressure is not harmful, but it can cause some discomfort. Please communicate with our staff if the discomfort becomes too much.

Your breast must be compressed to even out its thickness and permit the x-rays to image the breast tissue. The pressure also holds your breast still to decrease blurring from movement and to minimise the dose of radiation needed. During the brief x-ray exposure, you'll be asked to stand still and hold your breath.

An x-ray then captures black-and-white images that are displayed on a computer screen and examined for signs of cancer.

Once the images are acquired, our mammographer may ask you to wait while she checks the quality of the images. If the views are inadequate for technical reasons, you may have to repeat part of the test. The entire procedure usually takes less than 30 minutes.

Can I do everything after the mammogram?

There are no restrictions after the mammogram is performed, and you can resume normal activities.  

Mammogram results

You will receive the result of the test within three weeks (15 working days) from the date the mammogram was performed. The Family Medicine doctor from the Virtual Clinic will call you with the results.

What are the possible outcomes?

To give an overview of the possible outcomes of the mammogram, we have listed the categories below:

Normal mammogram

Requires no further follow up. You are advised to follow the breast cancer screening programme and undergo the next screening mammogram every year.

What happens if the mammogram detects something?

Abnormal mammogram

You may be recalled directly to the radiology department for further investigations such as further mammographic views and/or breast and axillary ultrasound.

This does not necessarily mean there is a cancer present, but that further imaging is required in order to complete breast screening assessment.

• If you require even further investigation, you may be offered an appointment with a breast surgeon. In this appointment you will undergo a clinical examination and a more detailed history will be taken from you
• You may then be referred as necessary for any further investigations such as:
• Ultrasound examination (useful in younger patients and to identify cysts particularly)
• Breast Fine-needle Aspiration (FNA)
• Breast image-guided biopsy

How often do I need a mammogram?

Based on the international and national guidelines for breast cancer screening all females from age 40 years and above are advised to have a screening mammogram every year if there are no symptoms. 

Colorectal cancer screening is vital for women as they age, aiming to detect early signs of cancer or precancerous conditions in the colon or rectum. Regular screenings, such as colonoscopies or stool tests, can significantly increase the chances of successful treatment by identifying abnormalities before symptoms develop.

What is Colorectal cancer screening?

Colorectal cancer screening is a test helps to detect cancer of the colon and rectum early when it is most treatable.

Who gets colorectal screening?

Colorectal cancer screening is important for both men and women, as colorectal cancer affects both sexes equally. The American Cancer Society recommends that women begin regular screening for colorectal cancer at age 45, although some guidelines recommend starting at age 50.

It is recommended for all women aged 50-75 years, and can be done every 10 years.

There are several different screening options for colorectal cancer, including:

Fecal immunochemcical test (FIT): This test checks for hidden blood in the stool, which can be a sign of colorectal cancer or other problems. FIT is a simple, non-invasive test that can be done at home.

Colonoscopy: This is a more invasive test that involves a doctor using a long, flexible tube with a camera to look inside the colon and rectum. Any polyps or abnormal tissue can be removed during the procedure.

Flexible sigmoidoscopy: This is a similar test to a colonoscopy, but only looks at the lower part of the colon. Like colonoscopy, any abnormal tissue can be removed during the procedure.

It is important to discuss the various screening options with your healthcare provider to determine which one is right for you based on your individual risk factors and preferences. 

What is Genetic Screening?

Genetic screening for women can be an important tool in identifying hereditary conditions and making informed decisions about reproductive health.

Who is Genetic Screening for?

There are several types of genetic screening tests that may be recommended for women based on their individual risk factors and medical history. 

What is NIPT?

NIPT stands for Non-Invasive Prenatal Testing, which is a blood test that screens for certain chromosomal abnormalities in a developing fetus. The test analyses cell-free DNA (cfDNA) fragments that circulate in the pregnant woman's blood, which come from the placenta and contain genetic material from the developing fetus.

Who is NIPT for?

NIPT is typically recommended for pregnant women who are at higher risk of having a baby with chromosomal abnormalities, such as women who are over 35 years old, have a family history of genetic disorders, or have had abnormal results on other prenatal tests.

The test is highly accurate in detecting Down syndrome (Trisomy 21), Edwards syndrome (Trisomy 18), and Patau syndrome (Trisomy 13), as well as other chromosomal abnormalities. However, it is important to note that NIPT is a screening test and not a diagnostic test, and a positive result will need to be confirmed with further diagnostic testing, such as amniocentesis or chorionic villus sampling (CVS).

One of the benefits of NIPT is that it is non-invasive, meaning it does not pose a risk of miscarriage or other complications to the developing fetus. The test is usually done between 10 and 22 weeks of pregnancy and results are typically available within a week.

What BRCA genetic testing?

BRCA genetic testing is a type of genetic test that looks for mutations in the BRCA1 and BRCA2 genes. These genes produce proteins that help prevent the development of certain types of cancer, including breast and ovarian cancer.

Who is BRCA genetic testing for?

Individuals who have inherited a mutated BRCA1 or BRCA2 gene have an increased risk of developing breast, ovarian, and other types of cancer. BRCA genetic testing can help identify individuals who may have an increased risk of developing these cancers. BRCA genetic testing is recommended for individuals who have a personal or family history of breast, ovarian, or certain other types of cancer.

How BRCA genetic testing is done?

The test is usually done using a sample of blood or saliva. The sample is analyzed in a laboratory to look for mutations in the BRCA1 and BRCA2 genes.

It is important to note that a positive result on BRCA genetic testing does not necessarily mean that an individual will develop cancer, and a negative result does not mean that an individual is completely protected from cancer. Mediclinic’s genetic counsellors can provide guidance on the benefits and limitations of BRCA genetic testing and help individuals make informed decisions about their healthcare.

What is Sexual Health Screening?

Sexual health screening refers to the process of getting tested for sexually transmitted infections (STIs) and other conditions that can be transmitted through sexual contact. This screening may include a physical exam, laboratory tests, and other diagnostic procedures to detect infections or conditions such as HIV, chlamydia, gonorrhea, syphilis, herpes, and HPV.

Who is Sexual Health Screening for?

Sexual health screening is important for anyone who is sexually active, as STIs can have serious consequences if left untreated. Regular screening can help detect STIs early, when they are more easily treated, and can also help prevent the spread of infections to sexual partners.

Blood tests are commonly used to diagnose and monitor a variety of women's health problems. Some of the common blood tests used in women's healthcare include:

Complete Blood Count (CBC): A test that measures the levels of different blood cells, including red blood cells, white blood cells, and platelets. It can help detect anemia, infections, or blood disorders.

Hormone Levels: Blood tests can measure hormone levels, including estrogen, progesterone, and testosterone. These tests can help diagnose reproductive disorders, such as polycystic ovary syndrome (PCOS) or menopause.

Thyroid Function Test: A blood test that measures the levels of thyroid hormones in the blood. It can help diagnose thyroid disorders, such as hypothyroidism or hyperthyroidism.

Sexually Transmitted Infection (STI) Testing: Blood tests can detect the presence of antibodies to STIs, such as HIV, syphilis, and hepatitis B and C.

Cancer Markers: Blood tests can detect certain substances, called cancer markers, that are produced by cancer cells. These tests can help diagnose or monitor the progression of certain types of cancer.

Blood Sugar and Cholesterol: Blood tests can measure blood sugar and cholesterol levels, which can help diagnose and monitor diabetes and heart disease.

The specific blood tests recommended will depend on the individual's symptoms, medical history, and other factors. Your healthcare provider can recommend the appropriate blood tests for your specific needs.

What is DUTCH?

DUTCH offers the most extensive profile of sex and adrenal hormones along with their metabolites. Additionally, the daily (diurnal) pattern of free cortisol is included along with melatonin and the Cortisol Awakening Response (CAR) to bring another important piece of the stress axis into focus.

With all this information, a personalized treatment plan can be formed, focusing on the root cause of the patient's symptoms.   

Who is DUTCH for?

It is offered for individuals who is suffering from,

• Depression
• Fatigue
• Low libido
• Menstrual Irregularities
• Mood swings Premenstrual symptoms (PMS)
• Weight gain

How is DUTCH done?

The DUTCH  needs to be done during the luteal phase, or the second half of the cycle. This is because the hormone progesterone is only made during this time. The test requires four dried urine samples and 5 saliva samples collected at different times during the day.

Certain medications, supplements, and foods should be avoided or limited prior to taking the test.

In addition to these preventative screening services, women should also undergo regular check-ups with their healthcare providers. These check-ups can help to detect any health problems early, and ensure that women receive the care and treatment they need to stay healthy. Women should also be aware of their family health history and inform their healthcare providers of any health problems that run in their family.

Preventative screening services are an important part of women's health care. Women should talk to their healthcare providers about which preventative screening services are right for them, and ensure that they undergo regular check-ups to maintain good health.

What is bone density?

Bone density measures the amount of mineral matter in bones, indicating their strength. Higher density means stronger bones, less prone to fractures. It's often assessed with a DEXA scan to help prevent osteoporosis and maintain bone health.

What is bone density test?

Bone density test is done to check for signs of osteoporosis, a condition that causes bones to become weak and brittle. Bone density is measured using a DEXA (dual-energy X-ray absorptiometry) scan. 

What is DEXA scan?

A DEXA scan is a type of low-dose x-ray that is used to measure bone density. The scan is a non-invasive test that can identify whether a person has osteoporosis or is at risk of developing it.

Who is bone density test for?

A DEXA scan is a valuable tool in assessing a person's risk of bone fractures and monitoring changes in bone density over time. It is typically recommended for postmenopausal women, men over the age of 70, and individuals who have a family history of osteoporosis or have other risk factors for bone loss.

How is bone density test done?

Bone density is measured using a DEXA (dual-energy X-ray absorptiometry) scan.  A DEXA scan is a type of low-dose x-ray that is used to measure bone density. The scan is a non-invasive test that can identify whether a person has osteoporosis or is at risk of developing it.

What is the procedure for bone density test?

During the scan, the patient lies on a table while a machine sends two low-dose x-ray beams through the body, typically the hip and spine, measuring the amount of radiation that is absorbed by the bone. The test takes approximately 10-30 minutes to complete and is painless.

The results of the DEXA scan are reported as a T-score, which compares the patient's bone density to that of a healthy 30-year-old of the same gender. A T-score of -1.0 or higher is considered normal bone density, while a T-score between -1.0 and -2.5 indicates low bone density or osteopenia. A T-score of -2.5 or lower indicates osteoporosis.

It is important to note that the radiation exposure from a DEXA scan is very low, typically equivalent to just a few days' worth of natural background radiation. However, women who are pregnant or may be pregnant should avoid DEXA scans due to the potential risk of harm to the developing fetus.