The Department of Health has incorporated the human papillomavirus (HPV) detection test into the screening of women between 30 and 65 years old to prematurely detect lesions that may lead to cases of cervical cancer. Starting next year, this population will be called upon to pick up at a pharmacy the device with which they can extract a sample of cells from the cervix at home, easily and painlessly, and return it to the pharmacy, which will send the tests to the laboratory.
The program – similar in mechanics to colorectal cancer screening – will reduce the incidence of cervical cancer by between 60% and 70% compared to conventional cytology – which will continue to be applied in women between 25 and 29 years old –, according to the Health Minister, Manel Balcells. In this way, Catalonia aligns itself with European countries in the WHO strategy for the elimination of these tumors. The screening test, opportunistic since the 1980s and until now (practiced in health centers at the request of the patient or specialist), will become population-based (all target people will be called in a structured way). The deployment of the population phase began in January in El Prat de Llobregat and will continue in May in various towns in this area. In 2025 it will be extended to all of Catalonia.
“Until now we performed cytology to detect alterations in the cells. With the new detection of HPV we locate a greater number of precancerous lesions and we can monitor that persistent infections do not turn into lesions. It is a higher quality and more effective screening, and one of its advantages is that the tests do not have to be repeated as frequently: we go from three years of Pap smears to five-year intervals for HPV tests,” explained Laia Bruni. , responsible for the early detection program for cervical cancer at the Institut Català d'Oncologia (ICO). Although peaks of HPV infections occur in the 20s, persistent infections occur in the 30s and beyond, when the screening program will begin.
It is estimated that 80% of sexually active people will be infected with HPV at some point. In most cases it will be a transient infection that will be eliminated spontaneously, but in a small percentage it can become persistent, can cause changes in the cells and can progress to a tumor. Almost all cases of uterine cancer are due to HPV. In Catalonia, opportunistic screening has been carried out since the eighties and since 2008 there has been a school vaccination program for girls that has recently been extended to boys as well.
In 2022, 700,000 cases of cervical cancer will be diagnosed in the world, and the death of 350,000 women will be recorded. In Catalonia the incidence is very low (5 cases per 100,000 inhabitants), but it has increased by 25% in ten years due to HPV infections. The different communities are adapting the type of screening to their specificities, in order to meet the objectives set by the UN.
