Cervical cancer remains one of the most preventable yet most overlooked health threats facing women across the Middle East and the wider region. Despite advances in screening and vaccination, misinformation, cultural stigma, and lack of awareness continue to put lives at risk. In this exclusive interview, Dr. Natasha Shah, a UK-trained Consultant in Family Medicine at Mubadala Health Dubai, leading expert in women’s health, cuts through the noise to deliver clear, evidence-based answers on everything women need to know; from understanding how HPV silently progresses, to the latest 2025 global screening updates, vaccine safety facts, and why waiting for symptoms could already be too late. This is the conversation every woman needs to have.

MedEdge MEA: How would you explain cervical cancer to someone hearing about it seriously for the first time, and why is early detection so critical?

Dr. Natasha: Cervical cancer affects the cervix, the neck of the womb which dilates during childbirth. Being an internal structure, it cannot be seen by the individual, making clinical screening essential.

Most cases are caused by the Human Papillomavirus (HPV), a sexually transmitted infection. HPV is extremely common, and most people clear it naturally, just as the body clears a common cold. However, certain high-risk strains, if undetected, can progress to precancerous cell changes and ultimately cervical cancer.

Early detection is critical because cervical cancer is one of the most preventable cancers we know of. Screening allows clinicians to identify and remove precancerous cells before they progress, effectively stopping the disease from fully developing. This is what makes screening so powerfully life-saving.

ME: Why is cervical cancer often described as a silent disease?

Dr. Natasha: Because the cervix is internal, changes occurring within it cannot be felt or seen. There are no obvious early warning signs in most cases. When early symptoms do appear, they often resemble hormonal fluctuations or routine gynaecological conditions like irregular bleeding or mild discomfort may simply be dismissed as normal.

It is only when cancer reaches a more advanced stage that symptoms become pronounced enough to prompt medical attention, by which point treatment becomes significantly more complex. Relying on symptoms alone as a trigger for seeking care is insufficient. Routine screening remains the single most effective tool we have.

ME: There is still stigma around cervical cancer, with some believing it only affects women with multiple partners. How accurate is this perception?

Dr. Natasha: This perception is completely inaccurate and one of the most harmful myths surrounding cervical cancer. HPV can be contracted from a single sexual encounter; the number of partners a woman has had is not a prerequisite for exposure. This stigma actively discourages women from attending screening, particularly those who consider themselves low-risk, when in reality no sexually active woman is entirely without risk.

A woman’s sexual history does not define her cancer risk. What matters is access to information, access to screening, and a clinical environment where women feel safe taking care of their health.

ME: Not everyone with HPV develops cervical cancer. What other risk factors should women understand?

Dr. Natasha: HPV is extremely prevalent, and the immune system clears the virus in most cases. The concern arises when the immune system cannot eliminate it, allowing the virus to persist and cause cellular changes.

Several factors elevate risk. Smoking directly impairs immune function and is independently associated with HPV persistence and disease progression. Chronic stress suppresses immune function over time, reducing the body’s ability to fight viral infections. Immunosuppressive conditions and medications such as those used in autoimmune disease management or post-transplant care structurally compromise immune defences, placing these women at heightened risk. Understanding these factors allows healthcare providers to assess individual risk and tailor screening frequency accordingly.

ME: How do lifestyle factors like smoking, stress, and nutrition influence cervical cancer risk?

Dr. Natasha: The link between lifestyle and cervical cancer risk is real and clinically significant, even though it tends to be underemphasised in public health messaging.

Smoking is the clearest lifestyle risk factor, tobacco compounds damage cervical cells directly and impair local immune responses. Chronic stress elevates cortisol levels, reducing the effectiveness of the body’s immune surveillance mechanism. While stress alone does not cause cervical cancer, it creates conditions where HPV is harder to clear. Nutrition also plays a supporting role.  A diet deficient in key vitamins and antioxidants can weaken immune function over time. General health and immunity are deeply interconnected with reproductive health, and daily lifestyle choices do bear on cervical cancer risk.

ME: What are the most important screening updates for 2026–2027, especially the shift toward HPV-first testing?

Dr. Natasha: Two significant developments are worth highlighting.

First, both the UK and US updated their guidelines in July 2025, recommending HPV-first testing rather than a traditional cervical smear as the primary approach. If HPV is not detected, screening can safely be extended to once every five years, reflecting evidence that HPV status is a more sensitive indicator of risk than cytology alone. Screening remains recommended for women aged 25 to 65, adjusted based on individual circumstances. For context, the UAE currently follows the older protocol of cervical smears every three years, though many internationally trained physicians follow the updated evidence-based guidelines.

Second, self-sampling HPV kits are being rolled out in the US and UK, allowing women to collect samples at home and send them for laboratory analysis. Since the intimate nature of the examination is one of the most commonly cited barriers to screening, home self-swabbing similar to a home pregnancy test, it has strong potential to significantly increase uptake among women who have historically avoided or delayed screening.

ME: HPV vaccination still faces hesitation around fertility and long-term effects. What does current evidence tell us?

Dr. Natasha: The evidence is clear and reassuring: HPV vaccines are safe, effective, and do not cause infertility. Claims circulating on social media including suggestions that vaccines disrupt fertility or contain tracking devices are entirely without scientific foundation.

While the vaccines do not protect against all HPV strains, they provide strong protection against the high-risk strains most commonly associated with cervical cancer. Vaccination typically begins between ages 11 and 13 two doses for those vaccinated before 15, three doses for those vaccinated at 15 or older. However, adult women can also receive the vaccine and will benefit from its protection.

Importantly, HPV vaccination is not solely a women’s health issue. Boys benefit too, men can contract HPV and face related cancer risks, including penile cancer and genital warts. Protecting young men reduces overall transmission and disease burden across the population.

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ME: How should women navigate health advice online, given that social media both raises awareness and spreads misinformation?

Dr. Natasha: Social media has played a positive role in normalising conversations around cervical health, but the same platforms that amplify awareness also amplify misinformation which often feels authoritative.

Women should verify the credentials of any source before trusting health information online. Prioritise evidence-based content from reputable medical journals, national health authorities, and professional medical bodies over forums or unverified posts. Exercise particular caution when using AI tools for self-diagnosis. AI can help you understand a diagnosis already given by a physician or explore general health topics, but it cannot conduct a clinical examination or interpret test results. AI is a supplement to professional medical advice  not a substitute for it.

ME: What would an ideal future of cervical cancer prevention look like?

Dr. Natasha: An ideal future is one where cervical cancer becomes an increasingly rare diagnosis and we have the tools to make that a reality. Widespread vaccination, accessible screening programmes, and self-sampling technologies together represent a genuinely achievable pathway to reducing this disease significantly.

The mindset shifts women need today is this: preventive screening is not something you do when you feel unwell, it is something you do precisely because symptoms cannot be relied upon as a warning sign. Attending screening, ensuring your children are vaccinated, and accessing accurate information are acts of self-advocacy. Ultimately, the goal is simple: to protect lives.

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