Building the foundations for an organized population-based cervical cancer screening program with primary HPV self-sampling in Catalonia, Spain: findings from a pilot implementation study

Introduction As part of the transition from opportunistic cytology-based screening to an organized, population-based HPV screening program, Catalonia, Spain, launched an implementation pilot in 2021.Methods The pilot combined home-based HPV self-sampling with pharmacy-based distribution, coordinated...

Descripción completa

Detalles Bibliográficos
Autores: Peremiquel Trillas, Paula, Roura Fornells, Esther, Rangel Sarmiento, Valentina, Morey, Francisca, Font, Rebeca, Carvajal Restoy, Maite, Robles, Claudia, Ibáñez, Raquel, Pijuan, Lara, Tamarit, Lourdes, Cortasa, Dolça, Fernández, Daniel, Alfons Espinàs, Josep, Bruni, Laia, The Catalan Cervical Cancer Screening Program Working Group
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2025
País:España
Institución:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/223112
Acceso en línea:https://hdl.handle.net/2445/223112
Access Level:acceso abierto
Palabra clave:Càncer de coll uterí
Papil·lomavirus
Cribratge
Cervix cancer
Papillomaviruses
Medical screening
Descripción
Sumario:Introduction As part of the transition from opportunistic cytology-based screening to an organized, population-based HPV screening program, Catalonia, Spain, launched an implementation pilot in 2021.Methods The pilot combined home-based HPV self-sampling with pharmacy-based distribution, coordinated by a screening office using an SMS-based invitation and reminder system, alongside structured follow-up of HPV-positive cases by midwives.Results From July 2021 to December 2023, 6,355 women seeking cervical cancer screening were invited to participate in HPV self-sampling via SMS, with high participation (80.9%). Among HPV-positive women (11.8%), compliance with triage cytology was high (98.7%), as with colposcopy referrals when indicated (97.2%). CIN2+ detection rates (3.6% overall, 13.1% in HPV-16 positive) aligned with international studies, reinforcing the value of genotype-specific risk stratification and risk-adapted follow-up pathways in our setting. This organized approach facilitated timely case management and demonstrated the feasibility, acceptability, and effectiveness of the model.Discussion While conducted in an opportunistic screening context with a relatively short follow-up time, these findings support HPV self-sampling as an effective primary screening strategy, including women who regularly attend cervical cancer screening, and provide key insights for its scalability within a population-based program, which began its pilot phase in 2024 and is set for full implementation in 2025.