Clinical Guidance: Supporting the introduction of the HPV test in cervical cancer screening in Belgium

In Belgium, 641 women were diagnosed with invasive cervical cancer in 2022 (1) and 231 women died due to cervical cancer (2). Cervical cancer is mostly caused by the human papillomavirus (HPV), which is mainly transmitted through sexual contact. There are more than 150 types of HPV, a dozen of which can cause cervical cancer and are therefore called high-risk. High-risk HPV types (hrHPV) can be detected with DNA- or RNA-based HPV testing. The screening for cervical cancer in Belgium was performed until the end of 2024 by a 3-yearly cytological examination of a cervical smear. The HPV test was reimbursed only after an abnormal cytology result.

In December 2022, the Interministerial Conference decided (in line with the IMC's earlier decisions during the previous reign) to switch from cytology to primary HPV screening for cervical cancer (from the age of 30 onwards) (3). This decision is based on available scientific evidence ranging from the 2015 KCE report 238 (4) to very recent analyses conducted by the World Health Organisation (WHO) (5, 6) and the International Agency for Research on Cancer (IARC) (7).

Moreover, adolescents (girls and boys) are vaccinated against the human papillomavirus through vaccination programmes organised by the federated entities. HPV vaccines are also reimbursed by the NIHDI for catch-up vaccination of adolescents up to the age of 19.