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Ministerio de Salud de Brasil implementa prueba de ADN-VPH en el SUS para detectar cáncer de cuello uterino
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El pasado 15 de agosto, el Ministerio de Salud puso en marcha un nuevo modelo de cribado organizado para la detección del cáncer de cuello uterino, tercera neoplasia más común entre las mujeres en Brasil. La prueba molecular de ADN-VPH, desarrollada por el Instituto Paraná de Biología Molecular (afiliado a Fiocruz), permite identificar 14 genotipos del virus, incluso en mujeres asintomáticas, antes de que aparezcan lesiones precancerosas.
El ministro de Salud, Alexandre Padilha, destacó que el país aprovecha la infraestructura de biología molecular creada durante la pandemia de COVID-19:
“A partir de hoy, implementamos este nuevo método de diagnóstico y prevención del cáncer de cuello uterino en 12 estados brasileños. Esta infraestructura se utilizará ahora para el diagnóstico del VPH, lo que nos permitirá reducir los tiempos de espera e iniciar el tratamiento lo antes posible”.
Impacto epidemiológico y proyección
El Instituto Nacional de Cancerología (INCA) estima que entre 2023 y 2025 se registrarán 17.010 casos nuevos anuales de cáncer de cuello uterino en el país, con una incidencia de 15 casos por cada 100.000 mujeres. La enfermedad provoca alrededor de 20 muertes diarias, especialmente en la región nordeste, donde continúa siendo una de las principales causas de mortalidad femenina.
El plan nacional prevé que la nueva prueba de ADN-VPH permitirá el tamizaje de 5,6 millones de mujeres en cinco años. En su fase inicial, se aplicará en Río de Janeiro, São Paulo, Minas Gerais, Ceará, Bahía, Pará, Rondônia, Goiás, Rio Grande do Sul, Paraná, Pernambuco y el Distrito Federal. El objetivo es llegar a 7 millones de mujeres entre 25 y 64 años cada año para diciembre de 2026.
Ventajas frente a la prueba de Papanicolaou
La innovación no solo radica en la sensibilidad diagnóstica, sino también en la reducción de exámenes innecesarios y en la ampliación de intervalos de tamizaje. Mientras la citología vaginal requiere repetición cada tres años, la nueva metodología permite espaciar las pruebas cada cinco años cuando los resultados son negativos.
El ministro Padilha explicó que:
“Con la prueba de Papanicolaou, es necesario repetirla cada tres años. Con esta nueva tecnología, el intervalo ahora es de cinco años. Además, elimina la necesidad de repetir la prueba cuando el resultado no es concluyente: se puede utilizar la misma muestra para todas las pruebas necesarias”.
El modelo también garantiza mayor equidad, pues llegará a mujeres en zonas remotas y con menor acceso a servicios de salud.
Implementación gradual y detección organizada
La estrategia se enmarca en las Directrices Brasileñas para la Detección del Cáncer de Cuello Uterino, elaboradas por el INCA con participación de 81 expertos, la OPS y 37 instituciones académicas y médicas. Este marco establece la detección organizada: el SUS invitará activamente a las mujeres de 25 a 64 años a realizarse la prueba, priorizando a quienes no estén vacunadas o no tengan antecedentes recientes de tamizaje.
Los equipos de Salud Familiar y Agentes Comunitarios tendrán un rol clave en identificar y convocar a las pacientes. En cada estado, la implementación inicia en un municipio y se expandirá progresivamente a nivel regional.
Inclusión y acceso en el SUS
El público objetivo incluye mujeres cisgénero, hombres transgénero, personas no binarias, de género fluido e intersexuales con sistemas reproductivos femeninos. El acceso se realizará mediante una cita ginecológica en las Unidades Básicas de Salud (UBS).
Para ampliar cobertura, el Ministerio de Salud habilitará la autocolección de muestras, orientada a mujeres en situación de vulnerabilidad o resistencia a los exámenes ginecológicos, como migrantes, privadas de libertad, población en calle o comunidades quilombolas y gitanas. El procedimiento será explicado por personal de salud y las muestras entregadas en las UBS.
Innovación diagnóstica y fortalecimiento oncológico
La implementación contará con apoyo del Supercentro de Diagnóstico de Cáncer, que reducirá el tiempo de entrega de informes de 25 a cinco días gracias a telepatología y reportes remotos. Además, se reforzará la capacidad instalada con la provisión de kits, suministros y capacitación a los equipos del SUS.
En paralelo, se desarrollarán cursos de citopatología en alianza con el INCA y el Hospital Israelita Albert Einstein. El programa también contempla la ampliación de tratamientos: en Recife, se anunció un nuevo acelerador lineal para radioterapia en el Instituto de Medicina Integral Prof. Fernando Figueira, con un valor de R$10 millones, lo que permitirá incrementar en 133 % la oferta de servicios en 12 meses.
Un hito en la lucha contra el cáncer de cuello uterino
Con esta iniciativa, Brasil se coloca entre los países que implementan pruebas de ADN-VPH como estándar para la prevención del cáncer de cuello uterino, siguiendo los pasos de Reino Unido, España y Portugal. La diferencia, subraya el Ministerio de Salud, es que el país latinoamericano busca hacerlo “en tiempo récord” y con una cobertura nacional garantizada por el Sistema Único de Salud (SUS).
El reto ahora será sostener la inversión, fortalecer la logística y garantizar que las poblaciones más vulnerables accedan a este avance, en un esfuerzo que puede redefinir la prevención oncológica en América Latina.
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