The Madrid region is preparing to launch a large-scale program for the early detection of cervical cancer. For this, they chose the test that turned out to be the most affordable among the five proposed options. However, this decision has sparked mixed reactions among specialists: some believe that the selected test is less informative than others and may be less accurate if the sample is collected by the woman herself rather than by a healthcare professional.
The issue of the chosen method’s quality has now extended beyond the medical community. Opposition representatives in the regional parliament are demanding explanations from the Madrid government as to why cost-saving was prioritized over technical specifications. In the tender for supplying the tests, the financial criterion was decisive: the lowest price earned a company 70 out of 100 possible points. As a result, the American company Hologic was selected, even though its test was technically inferior to its competitors.
The new program expands the pilot Cervicam project, which began back in 2023 at twenty medical centers in the eastern part of the city. It will now cover women aged 25 to 65 who have been sexually active. Previously, such screenings were carried out only occasionally. The purpose of the test is to detect the human papillomavirus (HPV), which can lead to cancer. Unlike traditional DNA tests, Hologic uses an RNA-based analysis which, according to some experts, provides less information about virus types and may complicate decisions regarding further treatment.
A notable feature of the new approach is that women can collect their own samples. However, the World Health Organization does not recommend using RNA-based tests with this method of sample collection, citing concerns about reduced accuracy. Madrid authorities are not ruling out this option for now, as participation in screenings remains low despite sending out invitations. During the pilot phase, only about a third of invited women took part.
Interestingly, just last summer officials from Madrid’s health department criticized the Hologic method when the company challenged the terms of the tender. At the time, the test was noted as being of lower quality, and the attempt to change the rules was deemed unfair. Nevertheless, after scores were calculated with pricing in mind, Hologic outperformed all competitors by offering tests at almost half the expected cost — €4.20 each instead of €8. This allowed the region to nearly halve its annual program expenses.
The opposition insists on a parliamentary inquiry, arguing that cost savings should not come at the expense of women’s health. At the same time, regional authorities emphasize that the selected test is approved by the WHO and can reduce the number of false positives, which is important for patient peace of mind and for optimizing healthcare system expenses.
The World Health Organization aims to reduce the incidence of cervical cancer to minimal levels by 2030. In Spain, thanks to vaccination and prevention, the rates are already lower than in most countries. In 2024, just over two thousand new cases were detected, amounting to eight per hundred thousand women. Regular screenings are considered a key tool in reducing mortality — early detection can save up to 70% of lives.
