Australia Close to Eliminating Cervical Cancer Despite Declining Screening & Vaccination Rates

Australia is making remarkable strides toward eliminating cervical cancer, a disease that affects women globally. A latest report from the NHMRC Centre of Research Excellence in Cervical Cancer Control details the progress made through decades of HPV prevention and cervical cancer screening programs. While the outlook is promising, recent declines in vaccination and screening rates pose a challenge to sustaining this momentum.

A History of Prevention

Australia’s success story began in 1991 with the launch of the National Cervical Cancer Screening Program. This program initially relied on Pap tests, also known as cytology, to identify precancerous cell changes. Early detection and treatment through this program led to an approximate 50% reduction in cervical cancer cases and deaths. You can learn more about the connection between HPV and cervical cancer here.

In 2007, Australia became the first country in the world to implement a national HPV vaccination program. This initiative significantly reduced HPV infection rates and the incidence of cervical precancers. The HPV vaccine targets the human papillomavirus, a common sexually transmitted infection that can cause cervical cancer.

Further advancements came in 2017 with the transition to HPV testing as the primary screening method. Unlike Pap tests, HPV tests specifically detect the presence of high-risk HPV types, particularly types 16 and 18, which are responsible for the majority of cervical cancers. Positive results trigger closer monitoring by healthcare providers. This shift is projected to further decrease cervical cancer rates by 20–30%.

The country continued to innovate in 2018 by introducing a nine-valent HPV vaccine, offering protection against nine HPV types linked to cancer. This expanded coverage built upon the foundation of the earlier four-valent vaccine, which already included protection against types 16 and 18.

National Elimination Strategy and Current Progress

Building on these successes, Australia launched a national cervical cancer elimination strategy in 2023. The plan sets ambitious five-year goals: achieving a 90% HPV vaccination rate for both girls and boys, screening 70% of women aged 25–75 every five years, and effectively treating 95% of detected precancers and cancers.

The recent report indicates that Australia is making headway toward these objectives. Key findings include:

Declining Cancer Rates: Cervical cancer rates are gradually decreasing. In 2020, there were 6.6 cases per 100,000 women, dropping to 6.3 cases in 2021. Experts anticipate this trend will continue.
No Cases in Young Women: Remarkably, no cases of cervical cancer were diagnosed in women under 25 in 2021. This age group likely benefited from early vaccination before becoming sexually active, strongly suggesting the vaccine’s effectiveness.
Reduced HPV Infections: HPV infection rates, particularly among younger women, are declining. Only 1% of women aged 25–29 tested positive for HPV types 16 or 18, a direct result of widespread vaccination.
High Screening Uptake: A substantial proportion of women have been screened at least once, with approximately 85% of women aged 35–39 having undergone HPV testing. This initial screening significantly reduces an individual’s cervical cancer risk.

Challenges to Continued Success

Despite the encouraging progress, vaccination and screening rates have been declining in Australia since the onset of the pandemic. In 2020, 85.7% of young people were vaccinated against HPV, but this figure dropped to 79.5% by 2024. This decline is a cause for concern, as it could hinder the nation’s progress toward elimination.

Julia Brotherton, Professor of Cancer Prevention Policy at the University of Melbourne and a co-author of the report, emphasizes the safety and effectiveness of the vaccine. She urges parents to view vaccination as a protective gift for their children and encourages young people who missed school-based vaccinations to consult with their healthcare providers about catch-up doses.

Screening rates are also experiencing a downturn, with more than one in four women now overdue for cervical cancer screening. Megan Smith, co-author and Associate Professor at University of Sydney’s Cancer Elimination Collaboration, highlights improvements in some areas, including among women aged 35–39, even in remote regions. However, she stresses the need for tailored strategies, such as HPV self-collection, to address the fact that 15% of women in that age group have never been screened and only 50% of women aged 25–29 are up to date with screening.

Addressing Health Inequities

The report also reveals disparities in access to prevention efforts. Indigenous people and those residing in remote areas experience higher rates of cervical cancer and mortality from the disease. Indigenous Australians have nearly double the cervical cancer rate compared to the national average, and their death rate is significantly higher.

Dorothy Machalek, an epidemiologist at the Kirby Institute and another co-author, underscores the importance of achieving cervical cancer elimination for all Australians. She emphasizes the need for improved data collection and analysis to develop effective solutions for vulnerable populations.

Looking Ahead

The report proposes several recommendations to sustain progress, including revitalizing school vaccination programs, enhancing access for Aboriginal and Torres Strait Islander adolescents, piloting innovative screening methods, and strengthening national health data systems.

Cervical cancer is a preventable disease, and Australia’s success demonstrates the impact of sustained investment and consistent messaging on women’s health. Elimination is within reach, but the recent declines in vaccination and screening rates are concerning and mirror trends observed in other countries, including the United States. Similar concerns are being raised globally, as highlighted in this recent report regarding falling vaccination rates.

Continued emphasis on vaccination and screening efforts by public health experts worldwide is crucial to maintain momentum in the fight against cervical cancer. Regular check-ups with a healthcare provider are essential for staying informed about recommended screening schedules and vaccination options. For more information on cervical cancer prevention, consult resources from reputable organizations like the American Sexual Health Association.