last updated: March 2021

Comment:

The link of Portugal to the benefits of vaccines begins with Jenner's Variolae Vaccinae in the early nineteenth century (1803). During 1817 there was an impressive number of 20000 people vaccinated. Since 1965, the Portuguese National Vaccination Programme (PNV, the jewel of the crown of Portugal’s public health system) is universal, free and accessible to everybody. The recommended vaccination schedule is a universal prescription, to be used by all health services dependent on the Ministry of Health. We can find vaccination services in all health centres where the vaccines are administered daily by nurses or in hospitals for newborn-recommended vaccines. A recent study showed that 98% of Portuguese considered vaccines important for children’s health, while 96.6% thought they were effective and more than 95% said they were safe (highest level of trust within the EU).¹

For cervical cancer, in 2020 it was estimated an incidence and mortality rates of 10.7 and 3.2 per 100,000 women, respectively. In October 2008 the HPV vaccination was introduced in the PNV for 13 year-old girls, born from 1995. From 2009 to 2011 a catch-up vaccination campaign was run for girls 17 years old or younger. According to available data, the HPV vaccine coverage is 93%, and reaching 98% in some regions. It is planned by the PNV to include boys for this vaccine after october 2020.²

After 2017, HPV DNA testing is being introduced as the primary screening test, followed by cytology as a secondary test. The process is led by the Northern Region of Portugal reaching an impressive number of over 100.000 women screened per year (HPV prevalence ranging from 6.2 to 17.1%). However, at national level the cervical cancer screening coverage is 87%, needing a boost after the COVID-19 crisis.

References

1. Medeiros R, Ramada D. Knowledge differences between male and female university students about human papillomavirus (HPV) and cervical cancer: Implications for health strategies and vaccination. Vaccine. 2010 Dec 16;29(2):153-60. Available from: https://pubmed.ncbi.nlm.nih.gov/21055494/

2. Portugal National Vaccination Program. Bulletin nº3, April 2020. Available from: https://www.dgs.pt/documentos-e-publicacoes/boletim-n-3-do-programa-nacional-de-vacinacao-abril-2020-pdf.aspx

The Catalan Institute of Oncology (ICO) in Barcelona, Spain and the International Agency for Research on Cancer (IARC) in Lyon, France jointly lead the HPV Information Centre, a web-based resource that compiles, processes and disseminates published information on HPV infection and HPV-related diseases for all countries of the world.

Country-specific Fact Sheets are standardized summaries of HPV-related disease burden and associated risk factors, prevention strategies, screening activities, and immunization programs for each of the 194 WHO member states. Fact Sheets include concise, self-explanatory graphs and tables to offer a quick overview of the situation in the designated population. The system allows queries to generate statistics for individual countries, groups of countries, geographical regions or worldwide summaries.

More elaborated supplementary tables and comments can also be found in country-specific, regional and worldwide Full Reports from the original database. The HPV Information Centre publishes internationally recognized review monographs and targeted scientific publications to address relevant questions in the path to the cervical cancer elimination campaign. The HPV Information Centre is an open access, publicly funded resource to support the work of the scientific HPV community worldwide.

Portugal: key data on HPV and HPV-related cancers¹

Portugal has a population of 4.73 million women aged 15 years and older who are at risk of developing cervical cancer. Current estimates indicate that every year 865 women are diagnosed with cervical cancer and 379 die from the disease. Cervical cancer ranks as the 8th most frequent cancer among women in Portugal and the 3rd most frequent cancer among women between 15 and 44 years of age. About 5.6% of women in the general population are estimated to harbour cervical HPV-16/18 infection at a given time, and 81.5% of invasive cervical cancers are attributed to HPVs 16 or 18.

Portugal: complementary data on cervical cancer prevention¹

References

1. Bruni L, Albero G, Serrano B et al. ICO/IARC Information Centre on HPV and Cancer (HPV Information Centre). Human Papillomavirus and Related Diseases in Portugal. Summary Report 17 June 2019. Available from: https://hpvcentre.net/statistics/reports/PRT_FS.pdf?t=1611427917287

OTHER HPV INFORMATION CENTRE FACT SHEETS PUBLISHED IN HPW

Fact Sheet: Argentina

Fact Sheet: Brazil

Fact Sheet: Italy

Fact Sheet: Japan

Fact Sheet: Mexico

Fact Sheet: Republic of Korea

Fact Sheet: Spain