Colorectal cancer screening is extended up to 74 years of age

He Ministry of Health published this Monday in the Official State Gazette (BOE) the modification of different regulations, reinforcing public health surveillance, updating the common portfolio of the National Health System, and expanding, among other prevention, diagnosis, treatment and rehabilitation care activities, the ‘heel test’ that now covers 21 diseases; he population screening for colorectal cancer up to age 74; and the age of access to in vitro fertilization (IVF) with donated eggs in cases of premature ovarian failure

Order SND/356/2026, which modifies annexes I, II and III of Royal Decree 1030/2006 and Order SND/606/2024, which will come into force this Tuesday, also updates the public health annex to deploy the State Public Health Surveillance Networkreinforces early warning systems and the participation of Primary Care and specialized in risk notification within the portfolio of common public health services, and modifies the composition of the Advisory Committee for the Common Portfolio of Services in the Area of ​​Genetics, incorporating two members representing federations or groups of patient associations.

Finally, redefine the rehabilitation of patients with functional deficit to guide it to maintain maximum autonomy and quality of life, in coherence with Law 3/2024 on ALS and other highly complex diseases; incorporates a new population-based prenatal screening program for preeclampsia in pregnant women, and requires the development of state information and evaluation systems for neonatal and prenatal screening programs, with annual reports published by Health.

They are modified and include new screenings

In order SND/356/2026 of April 13, the prenatal, neonatal and cancer screening of the National Health System, starting with the ‘heel test’which is now officially known as the Heel Test Neonatal Screening Program for Congenital Diseases and incorporates a total of 21 pathologiesby adding, among others, propionic acidemia, primary carnitine deficiency, very long chain acyl-CoA dehydrogenase deficiency, various forms of methylmalonic acidemia, isovaleric acidemia, severe combined immunodeficiency, spinal muscular atrophy, 3-hydroxy-3-methylglutaric aciduria and X-linked adrenoleukodystrophy.

Forced to develop a state information system to follow and evaluate the program, with an annual technical Health report accessible to citizens and administrations. The CCAA must adapt their programs within the period established by the order that indicates one year.

In colorectal cancer, population screening is expanded and the target population is set at men and women from 50 to 74 years oldthrough fecal occult blood test every two yearsin line with European recommendations on early detection. The order provides for a progressive implementation calendar (horizons of 5 and 10 years so that all the Autonomous Communities have expanded the program and reach almost total coverage in 70-74).

In the prenatal area, the specific order as population programs of the basic portfolio the screening for chromosomal abnormalities through a combined first trimester test and, in the second line, free fetal DNA in maternal blood; In addition, the infection screening such as syphilis, HIV, hepatitis B and group B streptococcus for all pregnant women, in addition to hepatitis C, Zika virus, Chagas, rubella or chickenpox.

And, as a novelty, it incorporates a population program of preeclampsia screening in pregnant women through a combined test in the first trimester (biochemical markers, Doppler of uterine arteries and mean arterial pressure), forcing administrations to assess individual risk, establish monitoring protocols and implement information and evaluation systems with annual technical reports of these screening programs. In this case, there is a period of two years for adaptation from its entry into force.

Changes in service portfolio: IVF and rehabilitation

In assisted reproduction, Annex III of RD 1030/2006, of September 15, the order eliminates the specific restriction that prevented access to ‘in vitro’ fertilization with donated eggs to women with premature clinical ovarian failure after 36 yearswhich generated inequity with respect to other assumptions; From now on, in these cases the same general criteria will be applied as in the rest of the indications for IVF with oocyte donation, so that the age of the woman or transsexual person with the capacity to conceive must be less than 40 years at the time of treatment indication.

In rehabilitation, the standard adapts the portfolio of services to the modifications introduced by Law 3/2024, of October 30, in line with RD 1030/2006, of September 15, clarifying that rehabilitation in patients with functional deficits must be aimed at facilitating, maintaining or returning the highest possible degree of functional capacity and independence, with the aim of preserving maximum autonomy, improving quality of life and promoting reintegration into their usual environment, in coherence. with what is planned for people with amyotrophic lateral sclerosis (ALS) and other diseases of high complexity and irreversible course.

It includes the rehabilitation of conditions of the musculoskeletal system, the nervous system, the cardiovascular system and the respiratory system, through physiotherapy, occupational therapy and speech therapy directly linked to a pathological process that is being treated in the National Health System, as well as through technical methods (orthoprostheses regulated in Annex VI of the portfolio of common orthoprosthetic provision services).

SNS portfolio, surveillance and Genetics Committee

The order profoundly modifies Annex I of Royal Decree 1030/2006, which regulates the portfolio of public health services. Thus, among other additions, it redefines the general approach and explicitly introduces the “social model of health”underlining that health does not depend only on biological factors and health care, but also on social, economic, cultural and environmental conditions, and that public health policies must promote intersectoral action to reduce inequities.

In public health surveillance, the order updates Annex I of Royal Decree 1030/2006 to align it with the Public Health Surveillance Strategy and the State Surveillance Network, defining specific systems for non-communicable diseases (cancer, cardiovascular, mental health, drugs and addictions, rare diseases), communicable diseases, occupational health and environmental health, and establishing early warning and rapid response systems operational 24 hours a day, along with the obligation to develop state plans and regional preparation and response to threats to public health.

As for the surveillance systems, They must analyze results disaggregated by axes of inequality, including disability, with specific indicators of social inclusion and equity; and, in the case of alert systems, they must provide accessible information channels and strategies against the infodemic and disinformation.

Finally, in incorporating the participation of patients in genetics, the order modifies Order SND/606/2024 to change the composition of the Advisory Committee for the Common Portfolio of Services in the Area of ​​Geneticsincorporating two members representing federations or groups of patient associations, in order to reinforce the participation of affected people in decisions on the common portfolio of genetic services.