Spain’s Ministry of Health has approved an expansion of the national breast cancer screening programme, extending eligibility to women aged between 45 and 74. The measure broadens the previous age range, which generally covered women from 50 to 69. The decision was adopted through the country’s Public Health Commission, which coordinates preventive health policies across Spain’s autonomous communities.

The change is intended to increase early detection rates and improve consistency in screening coverage nationwide. Under the updated framework, mammograms will continue to be offered within the public health system, with regional authorities responsible for implementing the expanded programme over time.

Change Approved Through Public Health Commission

The reform was agreed by the Ministerio de Sanidad following discussions within the Comisión de Salud Pública, the body that brings together representatives from Spain’s national and regional health administrations. The Ministry confirmed that the screening programme will now include women from age 45, lowering the entry threshold by five years, while also extending the upper limit to 74. Previously, the standard programme targeted women aged 50 to 69, with routine mammograms carried out every two years.

Health authorities have stated that the change is based on updated scientific assessments of breast cancer incidence and detection outcomes. Officials have also emphasised that the expansion aims to ensure more uniform access to screening across Spain’s decentralised health system. Although the policy has been formally approved, its implementation will not be immediate in all regions. Spain’s autonomous communities manage healthcare delivery, meaning the rollout will take place gradually depending on local planning and available resources.

Aim to Improve Early Detection and Coverage

The Ministry of Health has indicated that the expansion is designed to improve early diagnosis of breast cancer, which remains one of the most commonly diagnosed cancers among women in Spain. By lowering the starting age for screening, authorities aim to detect cases earlier in women under 50, a group where diagnoses, while less frequent, can sometimes present at more advanced stages. Extending the upper age limit to 74 is intended to maintain screening access for older women who remain at risk.

Officials have also highlighted the importance of reducing regional disparities. Spain’s health system is managed at regional level, and previous assessments have identified variations in access and participation rates depending on location. The updated programme seeks to standardise eligibility criteria across all regions so that screening is less dependent on where a person lives.

Implementation to Be Phased Across Regions

While the decision establishes a national framework, the Ministry has confirmed that full implementation will be phased. Each autonomous community will adapt the changes according to its own screening infrastructure and scheduling capacity.This means that in some regions, the expanded age range may be introduced earlier than in others. Health authorities have not set a single national deadline for completion, but the expectation is that rollout will take place progressively over the coming years.

The existing screening system will continue operating during the transition. Women currently within the previous 50–69 age bracket will remain part of the programme without interruption. The Ministry has not indicated any change to the two-year interval between routine mammograms, which remains the standard practice in Spain’s public health screening programme.

Context of Breast Cancer Screening in Spain

Breast cancer screening is one of the most established preventive health programmes in Spain’s public healthcare system. It is designed to identify early-stage cancers before symptoms develop, improving treatment outcomes and survival rates. The expansion brings Spain closer in line with evolving recommendations seen in several European health frameworks, which have been reassessing optimal age ranges for population-based screening programmes.

Health officials have stated that the revision reflects accumulated evidence on incidence patterns, particularly the number of cases diagnosed outside the previous screening range. Public health experts have also noted that participation in screening programmes is a key factor in early detection, alongside clinical advances in imaging and treatment.

Gradual Rollout Across Spain’s Health System

The decentralised nature of Spain’s healthcare system means that implementation will depend on coordination between national and regional authorities. Each region will adjust its screening schedules, invitation systems and capacity planning to accommodate the expanded age group.

The Ministry has said it will work with regional health services to ensure that the transition is consistent and that access to screening is maintained throughout the rollout period. Once fully implemented, the programme will cover women from age 45 to 74 across the country, representing one of the widest age ranges in Spain’s national preventive screening system.

In the era before smartphones, monitoring your blood oxygen saturation required bulky, expensive medical equipment. This firsthand account explores a “guerrilla science” experiment conducted on the London Underground, investigating how poor ventilation and stale air on deep tube lines impact fatigue and lethargy. By using an early portable pulse oximeter, we can see exactly how oxygen levels fluctuate during a commute and why modern consumer health tech has changed the way we monitor our well-being.

The mystery of the commuter “coma”

At the start of my career, I worked in central London and commuted home on the Underground. More often than not, I would fall into a deep, almost coma-like sleep during the journey. While I certainly worked hard, I began to suspect that the stale air on the deeper underground lines by the end of the day might also have contributed to my persistent fatigue.

The science of oxygen saturation (SpO2)

Around that time, one of the respiratory clinics attached to where I worked received a delivery of new “portable” oxygen monitors, known as oximeters. These devices work by passing a specific wavelength of red light through a finger; the amount of light transmitted is used to calculate how much oxygen the blood is carrying. We talk about blood saturation, so you cannot have a greater level than 100%. The device performs the necessary calculations and displays the result as a percentage. You have to remember this was pre-iPhone and all things miniature and we all thought it was truly amazing.

As is well known, blood carries oxygen throughout the body, where it is used as fuel for essential functions. When oxygen levels drop, it is comparable to a battery running low – performance declines. The brain is typically affected first, which explains why we often feel drowsy or lethargic in crowded, poorly ventilated spaces. This “stuffy” sensation is usually relieved quickly upon stepping into fresh air.

The £3,500 rucksack experiment

The portable oximeter in question could operate for nearly six hours on its internal battery. However, “portable” was a generous term: it was about the size of a modest hi-fi amplifier and quite heavy. It included a probe attached to a finger via a cable, and a display showing oxygen saturation levels.

Following what may have been a convivial discussion, I ended up borrowing this expensive piece of equipment for an evening – contrary to all regulations, of course. I managed to fit it into a rucksack, with the cable emerging from the top and the probe attached to my finger, as I descended into the Underground. I tried to keep an eye on the display, but my curiosity was no match for my exhaustion. I soon drifted into my usual deep sleep shortly after leaving King’s Cross on my northbound journey.

The following day, I reviewed the recorded data. Unsurprisingly, my oxygen saturation had dropped to 92% at its lowest point, which likely explained my tendency to fall asleep so deeply. Fortunately, the frequent stops and jolts of the train ensured I was regularly roused. Nevertheless, I had demonstrated my point. I returned the undamaged device, relieved to have survived the commute with both my health and the equipment intact.

Modern pulse oximeters: affordable and compact

Today, the landscape of health technology has shifted dramatically. What once required a £3,500 “amplifier” in a rucksack can now be bought as a tiny consumer device from retailers like Lidl for around €20.

Modern pulse oximeters are ultra-compact – small enough to fit on a fingertip – and run on long-lasting batteries. Beyond just oxygen, these modern devices offer a suite of data:

• Heart rate monitoring: Real-time pulse tracking.

• Arterial blood flow: Indications of the volume of blood with each beat.

• Visual waveforms: A visual representation of your circulation.

The danger of “silent hypoxia”

The reason for sharing this story is that we often adapt to discomfort without fully recognising it. Much like weight gain that only becomes apparent when a friend points it out, we may not realise if our oxygen levels are gradually declining. We often attribute breathlessness or fatigue to aging, when a more specific medical cause may be responsible.

This issue became particularly relevant during the COVID-19 pandemic. While many remain asymptomatic, higher-risk individuals – particularly those over 65 – can develop hypoxia (low blood oxygen) without obvious symptoms. This “silent hypoxia” can become severe before it is detected, significantly affecting health outcomes.

Monitoring your health at home

The silver lining is that oxygen saturation can now be monitored easily and inexpensively at home with accuracy that rivals clinical-grade machines. For those in higher-risk categories, investing €20–€30 in a reliable device is a small price for peace of mind.

Key safety guidelines for home monitoring:

• Know your baseline: A quick 30-second check every couple of days can provide reassurance.

• Watch the trend: Seek medical advice if levels show a consistent downward trend.

• The 95% rule: For most people, a reading below 95% should be taken seriously and may constitute a medical emergency.

Note: Individuals with conditions like COPD may have lower baseline levels and should follow their doctor’s specific guidance.

A legacy of better air quality

As a final note, the London Underground implemented a major program in the 1980s to improve ventilation in its deepest tunnels, recognising that train movement alone was insufficient for air quality.

It would be nice to think my unorthodox “rucksack research” contributed to this change, but I think thanks goes to the Underground staff. Their daily exposure to poor air quality eventually forced the improvements that make today’s commute (while still a bit stuffy) far safer than the “coma-inducing” journeys of the past.

The information provided in this column is for educational and informational purposes only, and does not constitute medical advice. It is not a substitute for a professional medical consultation, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health provider with any questions you may have regarding a medical condition.

Dr Marcus Stephan

Avoiding extreme heat, staying well hydrated and consulting a specialist: key measures for controlling headaches

Specialists at Hospital Quirónsalud Torrevieja are highlighting the importance of headache prevention in relation to a neurological disorder that affects nearly 74% of the Spanish population in the form of primary headaches. In addition, around 4% of patients suffer from chronic headache, characterised by pain occurring at least 15 days per month.

Beyond their high prevalence, experts warn of the impact headaches can have on daily life, particularly in the case of migraine, which can be highly disabling and affect work, family and social life, significantly reducing quality of life. This condition is also more common among women.

“Headaches should not be considered normal when they interfere with daily life. It is important to consult a specialist in order to identify the type of headache and establish the most appropriate treatment,” explains Dr Erika Torres, Head of the Advanced Neurology Unit at Hospital Quirónsalud Torrevieja and Quirónsalud Alicante.

Specialists emphasise the importance of identifying the factors that may trigger headaches and adopting migraine prevention measures. These include avoiding exposure to intense heat, sudden changes in temperature, and maintaining adequate hydration and nutrition, particularly during periods of high temperatures.

“These are simple measures that can help prevent migraine and other types of headache,” says Dr Torres.

Migraine: a condition that goes beyond headache pain

Among the most common types of headache are tension-type headache and migraine. The former, with a prevalence of over 60%, is characterised by mild to moderate pain, usually associated with stress or musculoskeletal problems. Migraine, meanwhile, affects approximately 15% of the population, is more frequent in women, and presents with moderate to severe pain accompanied by symptoms such as nausea, dizziness, and sensitivity to light and noise.

“Migraine is a complex neurological disorder that goes beyond pain. In many cases, patients experience disabling symptoms that affect their daily routine,” explains the specialist.

In some cases, migraine may be preceded by aura, a transient neurological phenomenon that includes visual disturbances, speech difficulties or abnormal sensations.

“Aura is a neurological focal symptom that can precede the pain and often causes considerable concern among patients, which is why it is essential to understand and recognise it,” she adds.

Treatments for headache and migraine

The management of headaches includes both symptomatic and preventive treatments. Acute attacks are treated with medications such as anti-inflammatory drugs, triptans or gepants as part of migraine treatment.

In cases of recurrent or disabling migraine, specialists may prescribe preventive migraine treatments, including antidepressants, antiepileptic drugs or beta-blockers.

“In patients with frequent migraines, it is essential to begin preventive treatments that reduce the number of attacks and improve quality of life,” notes Dr Torres.

For patients with chronic or high-frequency migraine, biological treatments may also represent an alternative in certain cases. “There are advanced therapies designed to block proteins involved in triggering migraine attacks, offering new therapeutic options for selected patients,” explains the specialist.

Prevention and comprehensive headache management

Continuous patient follow-up and direct contact with the healthcare team are also essential in ensuring agile, personalised care.

“Having specialised units allows us to provide a comprehensive approach to headache management, combining diagnosis, prevention and follow-up, which ultimately leads to better outcomes,” concludes Dr Torres.

The specialist explains that the dedicated headache treatment programme at Hospital Quirónsalud Torrevieja and Quirónsalud Alicante provides rapid access to Neurology specialists, who carry out an accurate diagnosis from the first consultation and guide patients towards the most appropriate treatment in each case.

In addition, the programme includes neurological nursing consultations, where patients receive education, lifestyle habits are assessed, and key hygiene and dietary recommendations for headache prevention are established.