[Estimated number of procedures for implementing organized screening with HPV-DNA testing in BrazilEstimaciones de procedimientos para la implementación del rastreo organizado con pruebas de ADN del VPH en Brasil].

OBJECTIVE

Using real-world parameters, to estimate the number of procedures associated with cervical cancer to be incorporated with the implementation of organized screening with HPV-DNA testing, and to project these estimates within Brazil's Unified Health System (SUS).

METHODS

This is a descriptive study using data from the PREVENTIVO program in Indaiatuba, a municipality in the state of São Paulo (2017-2023), which used HPV-DNA testing to screen women aged 25 to 64 years. Based on data regarding test performance, reflex cytology, colposcopy, biopsy, cervical excisions, and referral to high-complexity care, the annual need for these procedures was estimated considering national guidelines and coverage by the supplementary private health system. These estimates were compared with the number of procedures performed nationwide in 2024 in the context of opportunistic screening with cytology (Pap smear).

RESULTS

HPV-DNA test positivity was 12.7% (3.4% for HPV16/18 and 9.3% for other high-risk HPV types). The estimated number of annual procedures to implement the program in Brazil in 2025 included: 8.2 million HPV DNA tests, 759,000 reflex cytology tests, 506,000 colposcopies, 355,000 biopsies, and 127,000 excisional procedures. Considering the current supply, there were shortfalls in all states and regions, especially for colposcopy, biopsy, and excision, with differences of up to -96.5% relative to estimated demand.

CONCLUSION

The transition to screening with HPV DNA testing requires restructuring the supply of procedures in the SUS. The parameters presented here support regionalized planning, promoting efficient resource allocation and reducing inequities in access.