Once the pilot study has been satisfactorily completed in autumn, the Ministry of Universal Health and Public Health in the Valencia region plans to send out mass invitations for women to participate in screening for cervical cancer, which will be extended progressively to all women between 25 and 65 years of age in the Valencian Community (an estimated 1,400,000).
Until the end of 2022, the cervical cancer detection system was based on performing Pap smears either at the request of the woman herself or taking advantage of the visit to the obstetrics service, it was an opportunistic screening.
The strategy that is planned in autumn will be a population screening, that is, extended to all women between 25 and 65 years of age, and contemplates two types of tests depending on age. Those between the ages of 25 and 34 will undergo vaginal cytology, which makes it possible to diagnose cellular alterations indicative of cancer. The first to receive the invitation to participate in the population screening in this age group will be 25,365 women born in 1991. If the result is normal, the cytology is repeated every 3 years.
On the other hand, women between the ages of 35 and 65 (initially 250,000 born in 1958, 1963, 1968, 1973, 1978, 1983 and 1988) will receive a kit to take a vaginal sample that will be used to detect the presence of the human papillomavirus (HPV).
It is a test similar to the self-sampling that is already used in colon cancer screening. The result is within a period of 7 to 10 days and, if it is positive, it does not mean that the person has cancer, since additional tests are undertaken to assess if there is any alteration. When it is not detected (HPV negative), the test is repeated every 5 years.
The different tests are because persistent infection by human papilloma is the most frequent cause of cervical cancer in women not vaccinated against this virus. In fact, the majority of sexually active people (80%) have contact with this virus but are unaware that they are carriers. The infection usually remits spontaneously, but in high-risk genotypes it can cause cancer.
After the first women will receive the invitation to participate in the population screening, the rest will be added in the coming years. The forecast is to invite each year, starting in 2024, a total of 285,000 women (35,000 from 25 to 34 years old and 250,000 from 35 to 65 years old).
With this scheme by population cohorts, it is expected to cover the invitation to the total target population in 5 years. Therefore, the objective is that, in 2029, the coverage, understood as an invitation to participate, is close to 100%. Ultimately, the aim is to reproduce in cervical cancer screening the benefits that are already being obtained with breast cancer screening, that is, to prevent and detect cervical cancer early to reduce mortality and improve quality of life.
In the words of the regional secretary for Public Health and the Public Health System, Ofelia Gimeno, this is one of the measures implemented by the Department of Universal Health and Public Health “to improve prevention and the health of women in all stages of life.
Population screening for cervical cancer, adds Gimeno, is “an effective and efficient prevention strategy to prevent the development of the tumour” that follows the breast cancer screening model, which last year celebrated its 30th anniversary since its implementation in the Valencian Community “as a symbol of progress in health and equity in health of public and universal health”.