<![CDATA[FACT SHEET: SPAIN www.hpvcentre.net]]>

Human Papillomavirus and Related Cancers, Fact Sheet 2019 (2019-06-17)

COMMENT
Cervical cancer is the 15th most frequent cancer among women in Spain. Screening for cervical cancer is mainly opportunistic and is performed by cytology tests in women between 25 and 65 years of age. Taking into account both public and private health care, the overall coverage of cytology screening every 3 years is around 73%.

Between 60% and 74% of new cases of cervical cancer are diagnosed in the subgroup of women who do not undergo screening or in whom inadequate screening is performed.¹ Since 2014, scientific societies recommend primary screening with the HPV test every 5 years in all women between 30 and 65 years of age. In 2018, the Ministry of Health ordered the transition from opportunistic screening with cytology to population screening with the HPV test every 5 years to take place and become fully implemented over a period of 10 years.² However, to date, very few regions have initiated pilot screening programs with HPV testing.

The HPV vaccine was introduced in 2007 and is free of cost for girls between 11 and 14 years old included in the program. In 2018, vaccine coverage with one or two doses in this cohort was 89.4% and 79.4%, respectively.³

In 2018, the Spanish Ministry of Health established that the HPV vaccine would also be provided for both men and women in the following risk groups:
1.WHIM syndrome (primary immunodeficiency),
2.HIV infection (up to 26 years of age),
3.men who have sex with men (up to 26 years old),
4.sex workers (up to 26 years old)
5.women with cervical excisional treatment for premalignant lesions (any age).⁴

References

1. Castillo M, Astudillo A, Clavero O et al. Poor Cervical Cancer Screening Attendance and False Negatives. A Call for Organized Screening. PLoS One. 2016;11(8):e0161403. https://pubmed.ncbi.nlm.nih.gov/27547971/

2. Spanish Ministry of Health. Common Services Portfolio of the National Health System. https://www.boe.es/boe/dias/2019/04/27/pdfs/BOE-A-2019-6277.pdf

3. HPV vaccine coverage in Spain in 2018. http://www.mscbs.gob.es/profesionales/saludPublica/prevPromocion/vacunaciones/docs/CoberturasVacunacion/Tabla11.pdf

4. Vaccination in risk groups of all ages and in certain situations. Public Health Commission of the Interterritorial Council of the National Health System. Spanish Ministry of Health. July 2018. https://www.mscbs.gob.es/profesionales/saludPublica/prevPromocion/vacunaciones/VacGruposRiesgo/docs/VacGruposRiesgo_todas_las_edades.pdf

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 (www.hpvcentre.net). 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.

Spain has a population of 20.5 million women aged 15 years and older who are at risk of developing cervical cancer. Current estimates indicate that every year, 1942 women are diagnosed with cervical cancer and 825 die from the disease. Cervical cancer ranks as the 15th most frequent cancer among women in Spain and the 4th most frequent cancer among women between 15 and 44 years of age. About 2.7% of women in the general population are estimated to harbour cervical HPV-16/18 infection at a given time, and 63.1% of invasive cervical cancers are attributed to HPVs 16 or 18.

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 Spain. Summary Report 17 June 2019. Available from: https://hpvcentre.net/statistics/reports/ESP_FS.pdf

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Aureli Torné, MD
Head of Gynecologic Oncology Unit, Clinical Institute of Gynecology, Obstetrics and Neonatology (ICGON), Hospital Clínic, Biomedical Research Institute August Pi i Sunyer (IDIBAPS), University of Barcelona, Spain.
aureli@comb.cat

Gina Albero MSc, MPH, PhD
Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO)-IDIBELL, Barcelona, Spain. Centro de Investigación Biomédica en Red-CIBERESP, Madrid, Spain. ICO-IARC HPV Information Centre.
g.albero@iconcologia.net

Laia Bruni MD, MSc, MPH, PhD
Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO)-IDIBELL, Barcelona, Spain. ICO-IARC HPV Information Centre.
lbruni@iconcologia.net

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