A new one report from the NHMRC Center for Research Excellence in Cervical Cancer Control shows the progress Australia has made in cervical cancer prevention. The country has been a leader in HPV prevention and cervical cancer screening for decades. Because of this, Australia is now close to eliminating cervical cancer completely. However, recent declines in vaccination and screening rates threaten this progress.
Decades of Progress
In 1991, Australia launched the National Cervical Cancer Screening Program. The program encouraged women to have regular Pap tests. The test (also called cytology) can find early cell changes that can be treated before they turn into cancer. The program reduced cervical cancer cases and deaths by about 50%.
In 2007, the country launched the world’s first HPV vaccination program. As a result, HPV infection rates have plummeted and so have the number of precancerous cervical cancers.
In 2017, the country updated its screening program. Instead of Pap tests, she started using HPV tests. These tests look for HPV types 16 and 18, which cause most cervical cancers. Health care providers can monitor people who test positive more closely. This change is expected to reduce cervical cancer rates by 20-30%.
In 2018, Australia introduced a newer HPV vaccine. This vaccine protects against nine types of HPV that can cause cancer. Previous versions of the vaccine only protected against four types. (Types 16 and 18 were covered in both versions of the vaccine.)
The plan to end cervical cancer
With these tools in place, experts believed that cervical cancer could be eradicated. In 2023, Australia launched a national elimination strategy.
The plan set five-year targets, including: vaccinating 90% of girls and boys, screening 70% of women aged 25–75 every five years, and treating 95% of detected pre-cancers and cancers.
The new report shows that Australia is getting closer to meeting these targets. It highlights several encouraging findings:
- Cervical cancer rates are slowly decreasing. In 2020, there were 6.6 cases per 100,000 women. In 2021, this dropped to 6.3 cases. Experts expect the trend to continue.
- In 2021, no cases of cervical cancer were diagnosed in women under 25. This age group was probably the first to be vaccinated before becoming sexually active. The researchers say this effect is almost certainly due to the HPV vaccination.
- There are fewer HPV infections, especially in younger women. Only 1% of women aged 25–29 tested positive for HPV types 16 or 18. Again, this is a direct result of widespread vaccination.
- Most women have been tested at least once. About 85% of women aged 35–39 have had an HPV test. Getting tested at least once significantly lowers a person’s risk of cervical cancer.
Declining screening and vaccination rates
Unfortunately, vaccination and screening rates are declining in Australia following the pandemic. In 2020, 85.7% of young people in the country had had the HPV vaccine, by 2024 this had fallen to 79.5%.
Julia Brotherton, Professor of Cancer Prevention Policy at the University of Melbourne and one of the report’s co-authors, noted that the vaccine is safe and effective. He said, “Parents should think of this as a gift they can give their child to protect them for life. And I urge all young people who have missed school, for whatever reason, to talk to their doctor, nurse or pharmacist about accessing their free dose of catchup.”
The number of people aware of their viewing has also declined over the past two years. Today, more than 1 in 4 women delay screening for cervical cancer.
Megan Smith, co-author and associate professor at the University of Sydney’s Cancer Elimination Collaboration, explained: “We are seeing some improvements, including in the 35 to 39 age group, even in very remote areas. But with 15 percent of this age group never having had a screening test in their lifetime and only 2-5 percent. screening, we need to promote tailored strategies such as HPV self-collection.”
Issues of Inequality
The report also shows that not everyone benefits equally from prevention efforts. Indigenous peoples and those living in remote areas face higher rates of cervical cancer and death from the disease.
In fact, Indigenous people have almost double the rate of cervical cancer than the national average. The death rate from cervical cancer is also much higher.
Dorothy Machalek, an epidemiologist at the Kirby Institute and another co-author, said: “Our national elimination strategy is focused on achieving cervical cancer elimination for all. But our report continues to show that some groups are at high risk of being left behind unless we act now. We need to focus our efforts on gathering better and more effective solutions.”
The road ahead
THE the report suggests several steps to ensure continued progress. These include revitalizing school vaccination programmes, improving access for Aboriginal and Torres Strait Islander teenagers, piloting new ways of offering screening and improving national health data systems.
Cervical cancer is a preventable disease. Australia’s success shows that decades of sustained investment and consistent messaging can have a positive impact on women’s health. Elimination is possible there. But the declines in both vaccination and screening are alarming and mirror trends seen in other countries, including the United States.
If we are to see continued success in our fight against cervical cancer, public health experts around the world must continue to emphasize the importance of vaccination and screening efforts.
