Poland Replaces Traditional Cytology with HPV HR Tests Funded by NFZ

Starting August 1, Poland’s Ministry of Health has replaced traditional cytology with the more effective HPV HR test as the standard screening method for cervical cancer.

Introduction of the HPV HR Test

A long-awaited change for millions of Polish women has finally come into effect. Starting August 1, traditional cytology has been phased out and replaced by the modern HPV HR test. The Ministry of Health introduced these changes because the new test is twice as effective at detecting precancerous cervical lesions. According to statistics, a shocking diagnosis is heard by 2,700 women every year, and 1,600 die from cervical cancer.

Since August 1, the HPV HR test has served as the screening examination for early detection of cervical cancer. Registrations for cytology ended on the last day of July, while the National Health Fund (NFZ) will continue to finance the testing of collected samples until the end of August. Following their settlement, contracts for performing cytology will expire. A good change for women, this test is modern and more accurate.

How to Schedule and Undergo the Examination

The HPV HR test can be booked through the Patient Internet Account (IKP), mojeIKP, or directly at facilities providing the service. No referral is required. The examination can be performed in a gynecological clinic, as well as in primary care (POZ) facilities where midwives who have completed appropriate courses are authorized to take swabs.

If the screening molecular HPV HR test yields a positive result, another examination will be performed on the same collected material—liquid-based cytology (LBC), which allows for the identification of precancerous or cancerous states in the cervical cells.

Screening Intervals and Further Diagnostics

Screening applies to women aged 25 to 64. The HPV HR test will be conducted every 5 years if the HPV HR result is negative, or after a year in the case of a positive result, as well as for women burdened with risk factors. Three-year intervals are also provided for specified groups.

If abnormal, precancerous cells are found in the tissue during the examination, patients will be referred for further diagnostics, namely a colposcopy or a colposcopy with a biopsy for histopathological examination. This is the stage of advanced diagnostics.

Medical Effectiveness and Risk Factors

The HPV HR test is nearly twice as effective as cytology in detecting precancerous cervical lesions, according to a study by Polish scientists. The pilot involved over 33,000 women. The research was led by a team under the direction of Prof. Andrzej Nowakowski from the Cervical Cancer Prevention Clinic of the National Research Institute of Oncology, and the results were published in May by the journal “The Lancet Regional Health – Europe”.

Approximately 1,600 women die from cervical cancer in Poland annually. It is the ninth most frequent malignant cancer among women in the country. The main risk factor for the development of this cancer is a persistent infection with high-oncogenic human papillomavirus (hrHPV). Screening for cervical cancer involves taking swabs from the external os of the canal and the cervix to perform the HPV HR test in triage with liquid-based cytology (LBC).

A negative HPV HR test result indicates a minimal risk of developing cervical cancer over the next few years. A positive HPV HR test result, meaning the detection of viral nucleic acid in the tested material, does not mean the person has cancer, but rather that they belong to a high-risk group. Cytological examination can detect precancerous changes and cancer at an early stage of the disease. In the case of dysplastic changes, a colposcopy with targeted biopsies for histopathological examination must be performed to verify the preliminary diagnosis, as stated in the NFZ president’s ordinance regarding the financing of this service.