Cancer screening in Spain: breast, cervical and colorectal

Key rules

• Regional programmes: Each region runs its own invitation programmes, so ages and tests can differ depending on where you are registered.
• Cervical screening: Cytology every 3 years applies from 25 to 29, then an HPV test every 5 years up to 65.
• Prostate: There is no national prostate screening programme; see your GP if you have symptoms or family history.
• Symptoms: Screening is for people without symptoms, so see your GP rather than waiting for an invitation if something worries you.

How screening works in Spain

Breast, cervical and colorectal screening are regional invitation programmes. Each region sets its own age ranges and intervals, and there is no general programme for prostate cancer. You do not book these tests yourself. Your region invites you by letter or message once you are in its health system. The steps to get on that list are in the process below.

Breast screening

Women are invited for a mammogram every 2 years, usually between ages 50 and 69. Some regions start at 45, and some continue to 74. Some also include women at higher risk. Ask your centro de salud which range your region uses.

Cervical screening

Cervical screening covers women from 25 to 65. The test depends on your age:

• Ages 25 to 29: a cytology (cell sample) every 3 years.
• Ages 30 to 65: an HPV test every 5 years. If it is positive, you follow up with cytology or a colposcopy (a closer look at the cervix).

Regions are moving to this model at different speeds. Some still use cytology every 3 to 5 years for older ages, and some switch to HPV testing at a different age. Your region's programme will tell you which applies.

Colorectal (bowel) screening

Men and women aged 50 to 69 at average risk are offered a stool test at home every two years. You collect a small sample and return it as instructed. A positive result leads to a colonoscopy. Some regions are extending the upper age to 74, and in some regions the programme is being rolled out health area by health area, so your invitation may arrive later than a neighbour's in another area.

If you have symptoms or a strong family history, do not wait for an invitation. Your GP will arrange a separate pathway.

Prostate cancer

There is no population screening programme for prostate cancer. Routine PSA blood tests for men without symptoms are not recommended. If you have symptoms or a family history, your GP can assess you, request a PSA test and refer you to urology if needed.

If you are outside the invited ages or have no invitation

If you are in the age range but nothing has arrived, contact your centro de salud or your regional screening programme. If you use private insurance or a mutualidad, ask them how to book screening.

The checklist below helps you work out which programme and ages apply to you.

How to get invited to a screening programme as a new resident

Getting onto the invitation list

• Register on the padrón at your town hall: First, as soon as you have a home address in Spain

• Show you are entitled to public health care, for example through Social Security affiliation, as a pensioner or dependant of an affiliate, or through a residence-based route: Before you apply for the card

• Apply for your tarjeta sanitaria (health card) at the regional health service or your centro de salud (local health centre), with ID or passport, NIE and padrón certificate: After the padrón and proof of entitlement

• Check that your address and date of birth on the card are correct, and update them at your centro de salud if not: As soon as the card is issued, and again whenever you move

• Wait for your first invitation, which is generated from the regional health database once you hold a tarjeta sanitaria and fall in the target age and sex: Depends on your region's two-year round by health area or postcode. It may come within a few months or take up to a full round.

• Contact your centro de salud (GP or nurse) to check your registration and ask to be included or given an appointment: If you are in the target age range and no invitation has arrived

• Call or use the online portal of your regional screening programme or health authority: If your centro de salud cannot sort it out

• Ask your mutualidad or insurer how to book screening, or arrange it privately: If you have private insurance only, or you are a MUFACE, ISFAS or MUGEJU member who chose a private insurer

Checklist

• Find out which regional screening programme covers the area where you are registered.

• Check whether you are in the age range for breast screening, usually 50 and 69, with a mammogram every 2 years.

• Check whether you are in the age range for cervical screening, which runs from 25 to 65.

• Check whether you are in the age range for bowel screening, 50 to 69, with a home stool test every two years.

• Ask your centro de salud whether your region starts breast screening earlier, at 45, or continues to 74.

• Ask your GP for an assessment if you are a man with symptoms or a family history of prostate cancer, since there is no general prostate programme.

Frequently asked questions

Is there a screening programme for prostate cancer in Spain?

No, Spain has no population-wide prostate cancer screening programme. Systematic PSA blood testing is not recommended for men with no symptoms because of overdiagnosis and overtreatment.

What cervical screening test will I get at my age?

Under the national model, women aged 25 to 29 get a cytology test every 3 years, and women aged 30 to 65 get an HPV test every 5 years. Some regions still use cytology every 3 to 5 years for older ages, and some switch to HPV testing at 35. A positive HPV result is followed up with cytology or colposcopy.

What happens if my colorectal stool test is positive?

A positive result leads to a colonoscopy. The stool test is done at home on a sample you collect yourself. People with symptoms or a high family risk follow a separate pathway through their GP, not the screening programme.

Can I be screened earlier or later if my region differs?

Yes, some regions start breast screening at 45 or run it to 74, and some extend bowel screening to 74. Regions such as Andalucía, Madrid and Cataluña start breast screening earlier. Ask your centro de salud or regional health service which ages apply where you live.