A new study has called for improved human papilloma virus (HPV) screening to ensure that vaccinations consider strains most common among women in Bahrain in order to reduce cervical cancer numbers.
HPV is the leading cause of cervical cancer, with certain high-risk types such as HPV-16, HPV-18 and others able to cause long-term infections that damage cervical cells.
Over time, these changes can develop into cancer if not treated.
The original research, titled ‘Comparative study of pap smear and polymerase chain reaction tests for human papilloma virus screening in Bahrain’, was published in the Eastern Mediterranean Health Journal last month by leading doctors in Bahrain from the University Medical Centre at King Abdullah Medical City and Salmaniya Medical Complex (SMC).
Their research highlights the significance of integrating HPV polymerase chain reaction (PCR) testing with conventional pap smear screening for effective cervical cancer detection in Bahraini women.
[A pap smear, also known as a pap test, is a procedure used to screen for cervical cancer and precancerous changes in the cervix. It involves collecting cells from the cervix and examining them under a microscope. This test can also detect infections and inflammation.]
The study analysed 320 pap smear samples from the SMC laboratory to compare two screening tools – the traditional pap smear and advanced molecular testing using PCR to detect HPV DNA.
The polymerase chain reaction (PCR) is a laboratory method widely used to amplify copies of specific DNA sequences rapidly, to enable detailed study.
“Our findings revealed that out of 56 cases that tested positive for HPV, some were attributed to strains other than HPV-16 and 18, such as HPV 45, HPV 53 and HPV 51,” said the study.
“Other data showed that 62 per cent to 73pc of HPV genotypes detected in abnormal pap smears were not caused by genotype 16 or 18, especially in women younger than 40 years.
“This underscores the importance of comprehensive HPV testing that covers a broad spectrum of high-risk HPV genotypes beyond the commonly targeted strains.”
It recommended future screening programmes to use broad-spectrum HPV tests to detect a wide range of high-risk genotypes and tailor screening protocols based on age groups.
It also suggested implementing educational campaigns to raise awareness about screening benefits and limitations.
“Combining molecular diagnostics with cytologic (the study of cells under a microscope, typically for the purpose of diagnosing diseases) examination can enhance early detection and improve patient management based on clinical history and symptoms, because PCR may detect transient infections that cytology may miss,” the study read.
It said that cervical cancer was the fourth most common cancer among women worldwide.
“Despite advancements in screening and prevention, it remains a leading cause of morbidity and mortality, particularly in resource-limited settings.”
Similar to global trends, cervical cancer ranks fourth among cancers affecting women in Bahrain, with an annual incidence rate of approximately 4.3 per 100,000 individuals and an age-standardised incidence rate of 5.9.
Among the GCC countries, Bahrain has the second highest incidence rate after the UAE, the study noted.
“Timely detection and interventions are critical to addressing this public health challenge,” it added.
“By adopting a holistic approach to cervical cancer screening and leveraging advances in molecular diagnostics, healthcare providers can improve early detection rates and ultimately reduce the burden of cervical cancer in Bahrain,” the study said, adding that integrating HPV PCR testing alongside pap smear screening is recommended, particularly in cases with negative or inconclusive cytologic findings.
Over the past 40 years, pap smear screening has led to a 50pc reduction in cervical cancer cases. Medical professionals suggest that screening should start at 21, considering social and cultural factors.
In September 2023, the Health Ministry introduced HPV vaccination for schoolgirls and boys in middle and high school, in a bid to fight off dangerous HPV strains.
julia@gdnmedia.bh
&uuid=(email))