At the end of April, the piloting of the new screening began in the health centers of Cascajos, La Guindalera and Alberite and, gradually, it will reach the total of La Rioja until reaching 90,000 women in Rioja, between 25 and 65 years old, the target population of the program.
The Government of La Rioja, through the Ministry of Health, extends the new early detection program for cervical cancer to the health zones of Haro and Santo Domingo. This screening began at the end of April in the health centers of Cascajos, La Guindalera and Alberite and, last July, it was extended to the health zones of Nájera and Navarrete. It is expected to reach all basic health areas in La Rioja in the coming months and reach 90,000 women in La Rioja, aged 25 to 65, the program’s target population.
In the new reorientation of the program for the early detection of cancer of the cervix (neck of the uterus), it is the midwives of first resort, associated with the professionals of the services of gynecology and pathological anatomy of the Hospital, who lead the new cervical screening. And this new orientation follows the recommendation of the Ministry of Health which integrates the human papillomavirus (HPV) detection test as a primary screening test in part of the target population of the National Health System (35 to 65 years old). In addition, the WHO published in 2020 a global strategy whose objective is the elimination of cervical cancer as a public health problem.
The La Rioja Public Health System has already modified, at the end of 2018, the test carried out in the program, the traditional cytology, for another in liquid medium, with fewer false negatives; which allows the detection of the human papillomavirus without the need to repeat the sample twice and thus improves the diagnosis.
Participation in screening
To participate in the new program, which begins with the age group between 25 and 35, women receive a text message on their mobile phone providing them with information to book an appointment with the midwife at their health centre.
The early detection test for cervical cancer is simple and painless. The midwife takes the sample from the cervix and sends it to the laboratory for study. Once there, they are prepared for cytology (in women between 25 and 34 years old) or for an HPV assay (women between 35 and 65 years old).
The woman receives an SMS when the test result is normal and a call from the midwife if abnormalities are detected. Women in whom abnormal cells or the presence of HPV are detected will be referred by the Health Center midwife to the Gynecology Department to complete the study.
Regarding the interval between normal tests: women between the ages of 25 and 34 will have a cytology performed every 3 years, while women between the ages of 35 and 65 will have an HPV determination every 5 years. The information will be available in the citizen file and in the APP Riojasalud. The campaign was funded by the the European Union through of the European recovery fund Next Generation EU- Mechanism for Recovery and Resilience.
Incidence and risk factors
Regarding the incidence of this tumor in La Rioja, in 2020, 15 new cases were diagnosed.
Cancer of the cervix or cervix begins when healthy cells on its surface begin to divide uncontrollably. These changes condition cellular alterations, called dysplasias, not necessarily cancerous but which require information and follow-up. These are the first steps that can lead to the formation of cancer and can be diagnosed and treated at a precancerous stage.
The most important risk factor for cervical cancer is human papillomavirus (HPV) infection.
There are over 100 types of HPV, some high risk (causing cervical cancer) and some low risk, which can cause a type of lesion called condyloma, more commonly known as a wart.
HPV infection is usually transient, but in about 10-15% of cases this infection becomes persistent and it is then that it can cause cell changes in the cervix and precancerous lesions which, along with over time, can develop into cervical cancer.
The risk factors for this persistence are:
- Early age at onset of sexual intercourse
- Risky behaviors
- Immunosuppression (transplants, autoimmune diseases, HIV, etc.)
- History of co-infection with sexually transmitted diseases
- Use of the birth control pill, as it is usually associated with not using barrier methods
- Lack of adherence to the population screening program
- Smoking, the risk is doubled compared to non-smokers
- Multiparity and early pregnancy
- Type of HPV infection, depends on subtype risk
Cervical cancer can be prevented
Human papillomavirus infection is mainly acquired during sexual intercourse; therefore, the use of condoms is a general measure of primary prevention.
The vaccination against the human papillomavirus is considered the best strategy as a primary prevention measure to reduce the risk of developing cancer, both in girls before the start of sexual relations (included in the vaccination campaign), and in adult women.