The Costa Rican Social Security Fund (CCSS) confirmed that starting in the first quarter of 2024, women will be able to undergo the HPV test.It is a high-performance test that detects the human papillomavirus that causes cancer in cells, with an effectiveness rate of 98%.
Every year in Costa Rica, 133 people die from this disease. Most of the victims of this disease are women between 30 and 59 years old. This is the fourth type of cancer with the highest incidence.
In the world, cases are around 700,000 and, of them, more than 600,000 are women, but it is a virus that also affects men and can cause multiple types of cancer.
Since November 15, 2023, the Ministry of Health updated the “National Standard for the Prevention and Management of Cervical Cancer”, which had not been updated since 2006.Currently, women in the country undergo cytology or Pap smears, which are positive, but only manage to detect 40% of cases.
“It has been identified that it is a disease that affects more in coastal areas. For this reason, the first area to offer it will be the Central Pacific region. “We are working on purchasing them so that they can be carried out in May,” explained Alejandro Calderón, researcher at the CCSS.
According to the CCSS implementation plan, for the other regions the schedule will be:
Chorotega: second quarter of 2024
Huetar Norte: third quarter of 2024
Brunca: third quarter of 2024
HuetarAtlántica: first quarter of 2025
North Central: second quarter of 2025
South Central: third quarter of 2025
“In the Single Digital Health Record (EDUS) there is already a space for these results to be entered and for patients to receive the results. If it is positive, we will call to provide timely treatment,” Calderón clarified.According to studies, this virus can also cause cancer of the anus, vulva, vagina, penis and throat.
Pap smear screening will only be done in the following cases:
Women over 20 years old
Sexually active
Also excluded from screening:
People who are not sexually active
Who have a total hysterectomy for benign causes
People 65 years or older, with two negative results in routine HPV screening and more than 25 years without a high-grade lesion
Thus, women between 20 and 29 years old, with the capacity to produce a normal immune response, will have a normal Pap smear every two years.
At age 30 or older, with the ability to produce a normal immune response, HPV testing is every five years.
While in the case of immunocompromised women – a person’s natural immune defenses against infections are weakened – the application will be:
20 to 24 years: normal pap smear every two years
25 or older: HPV test every three years
According to research, vaccination, screening and treatment can reduce mortality by 80%. Also, experts point out that if actions are not taken, deaths will increase by 29% by 2030.
Vaccine
According to experts, the vaccine administered in health centers protects against four strains of the papillomavirus. Two are against cancer and two against the formation of warts.In Costa Rica, at the public level, the vaccine is applied to girls 10 years old, while at the private level it can be found for women up to 45 years old.
According to CCSS data, in 2023 the coverage was:
80% the first dose
69% the second dose
In addition, the World Health Organization (WHO) set a goal of 90% coverage in girls before turning 15 by 2030.
Likewise, HPV experts emphasize that this is a preventive vaccine and not a curative one. A woman who has been vaccinated should not stop undergoing screening.
“We have identified that types 16 and 18 are responsible for 70% of cases of cervical cancer and 90% of cancer in other areas,” mentioned Carolina Porras, the Costa Rican Agency for Biomedical Research (ACIB). FUNIN).
Studies
“Our studies in Costa Rica have generated important evidence for decision-making by the World Health Organization (WHO),” Porras highlighted.Currently, the WHO recommends that people aged 20 years or younger receive one or two doses, depending on the vaccination programs of each country. 32 countries around the world have already decided to apply only one dose.
According to Porras, the decision was made after a 2004 study of more than 7,000 women in Guanacaste, where they were given three doses over a period of four years. When they finished, some put on one, others two, and another group all three, which allowed them to verify that there was no difference.
“The women who applied only one, at the end of the study, none had an infection with types 16 and 18,” she highlighted.“To now give the definitive recommendation that a single dose is effective,” added the expert.
Now, we are waiting for two studies on girls aged 12 and 16, which began in 2018 with 20,000 girls from different parts of the country and half were given one and the other two. We hope to present the results at the end of this year,” said the doctor.For people 21 years of age and older, two doses should be applied, according to the recommendation of the international organization.
