A new study in Bahrain is exploring whether self-testing for cervical cancer is as effective as the traditional clinician-collected Pap smear, aiming to provide women with an alternative, more accessible screening option.
Royal College of Surgeons in Ireland (RCSI) – Medical University of Bahrain family medicine associate professor Ghufran Jassim revealed that few women currently request traditional Pap smears due to a lack of education, awareness or embarrassment about how the sample is taken.
A Pap smear, or Pap test, is a procedure to screen for cervical cancer by collecting cells from the cervix to be examined under a microscope for abnormalities. While quick, some women experience discomfort.
While most human papillomavirus (HPV) infections clear on their own, a persistent infection with high-risk strains such as HPV-16 and HPV-18 can cause cellular changes that may lead to cancer over time.
Early detection can saves lives. When cervical cancer is diagnosed at an early stage, the five-year relative survival rate is 91 per cent. When cervical cancer is diagnosed after it has spread to nearby tissues, organs, or lymph nodes, the five-year relative survival rate is 60pc.
“There has been a significant shift towards HPV primary screening and the availability of self-testing options in many countries,” said Dr Jassim. “Self-testing aims to improve accessibility and reduce barriers, such as fear or discomfort during a pelvic exam, while using HPV as a more direct marker for early detection and prevention.”
Dr Jassim raised her concerns during the Bahrain International Public Health Conference, which was recently held at the Gulf Convention Centre.
The ongoing study involves 80 women aged 24 to 64 during routine check-ups at King Hamad University Hospital (KHUH) and Primary Healthcare Centres.
An additional enriched sample of human HPV-positive cases from the colonoscopy clinic at KHUH was included to improve the study’s sensitivity.
Women were provided with a take-home testing kit to collect a swab themselves. Of the participants, 60 women had unknown HPV status and 20 were HPV positive.
Results showed 81.4 per cent of participants were married and educated, with an average of 3.64 children per woman, and 88pc had not received the HPV vaccine.
“The test correctly identified all people who do not have the disease and there were no false positives,” she said, adding that it also correctly identified 60pc of people who actually have the disease, a lower number so far because the enriched sample has not yet been analysed.
“Most participants favoured self-testing, finding it private and easy, and many would recommend it to family and friends, although some still lacked full confidence in the method.
“Implementing self-testing in Bahrain would require a complete system, including sample drop-off points and digital integration of results into patient health records,” Dr Jassim noted.
She also highlighted that awareness about cervical cancer is low in Bahrain, and self-testing could encourage more women to get screened.
“Many women are afraid to undergo any cervical cancer test,” she said. “While there are strong campaigns for diseases like breast cancer, we need more education about cervical cancer, which is the fourth most common cancer among women globally.”
She added that screening in Bahrain currently depends on patient requests, with no reminders in place. “If we educate women about the risks of cervical cancer and the importance of screening, participation would likely increase,” she said.
In the US, cervical cancer screening with a Pap smear usually begins at 21. Individuals aged 21 to 29 should have a Pap test every three years.
For those aged 30 to 65, the recommended frequency is to have a Pap test and HPV test every five years, or either a Pap test every three years or an HPV test every five years. However, it can range depending on the individual.
HPV vaccines can prevent infection with the high-risk HPV types that cause most cervical cancers.
Bahrain officially introduced the vaccine into its national immunisation programme in 2024, with the rollout beginning in public and private schools targeting adolescents aged 12-13.
This policy is a key part of the Health Ministry’s strategy to prevent HPV-related cancers, such as cervical cancer.
julia@gdnmedia.bh
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