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Australia set for world-first cervical cancer elimination
Vaccination programs have played a key role, and GPs remain ‘instrumental’ in boosting screening rates to reach the 2035 target.
HPV vaccination was a key contributor to zero cervical cancer cases being diagnosed in women under 25 in 2021 – the first time since records began almost 40 years earlier.
Australia is on course to meet a target of eliminating cervical cancer by 2035, which, if achieved, will make it the first country to do so.
The latest report from the Centre for Research Excellence in Cervical Cancer Control reveals rates of the cancer among Australian women continue to fall, and progress is being made towards elimination ‘across most indicators’.
The national cervical cancer rate decreased to 6.3 per 100,000 in 2021, compared to 6.6 per 100,000 in 2020, but the report highlights that continuous monitoring is needed to confirm this is the beginning of a downward trend.
In 2021, there were no cervical cancer cases diagnosed in women under 25 for the first time since records began in 1982 – with the report stating ‘this remarkable achievement is almost certainly due to the impact of HPV vaccination’.
The Gardasil vaccine to protect against human papillomavirus (HPV) is offered for free to people aged 9–25 years under the National Immunisation Program.
GP and women’s health expert Associate Professor Magdalena Simonis told newsGP these findings are ‘a huge success’ for Australia’s screening program – with GPs at the forefront.
‘The GP role has been instrumental in achieving this excellent result,’ she said.
‘This was preceded by our world-class pap smear program which GPs conducted.
‘GP recall systems coupled with person-centred preventive care consultations around women’s health, perimenopause and menopause, provide opportunity to have these discussions.’
Health and Aged Care Assistant Minister Rebecca White said ensuring cervical screening is ‘inclusive, accessible and effective’ is key to reach the elimination target.
‘Australia is leading the world in cervical cancer elimination, but we must maintain momentum to make this goal a reality,’ she said.
‘We must continue to improve equitable access to maintain rates of HPV vaccination and make sure everyone has access to cervical screening.’
Leading the charge for cervical screening equity is the self-collection option, in particular for the most under-screened groups.
But the report shows HPV vaccination rates and cervical screening participation have both declined slightly from previous years, which it says needs to be urgently improved to achieve elimination.
The report outlines recommendations to ensure the 2035 target is met, including:
- addressing ongoing HPV vaccination coverage declines
- addressing declining screening participation rates
- improving school-based immunisation approaches to better suit the current environment
- prioritising vaccination equity for Aboriginal and Torres Strait Islander adolescents
- resolving gaps in screening data for Aboriginal and Torres Strait Islander women
- enabling better use of existing data
- developing a cervical cancer treatment monitoring framework.
Building on findings from 2024, the report finds the proportion of women aged 35–39 years who have had at least one HPV test in their lifetime continues to increase, with this proportion now 85% nationally.
Survival rates are also improving, with the five-year survival rate at 76.8% in 2017–21, compared to 73.9% in 2012–16.
Sitting on the National Cervical Elimination Strategy Expert Advisory Group, Associate Professor Simonis says with the elimination of cervical cancer a
World Health Organization recommendation, Australia’s strategy is ‘leading by example’.
‘Kudos to our public awareness campaigns, the collaboration across the health sector, the breadth of reach that self-testing has helped us achieve, and the engagement of community leaders who are conveying the importance of cervical screening to marginalised, culturally and linguistically diverse, and First Nations people,’ she said.
And GPs’ role continues in boosting screening participation rates and educating patients, Associate Professor Simonis said.
‘Opportunistic self-testing is welcomed for those who have avoided screening due to embarrassment and lack of awareness, for example, “I don’t have a partner therefore I don’t need to be screened” or who have had previous trauma,’ she said.
‘We have to also continue to convey the importance of
screening older women [who] have not had the benefit of Gardasil vaccinations.’
The report also notes that outstanding barriers to access screening also need to be addressed, including out-of-pocket fees to access primary care, and a shortage of availability of providers in many areas.
‘Innovative and flexible models of cervical screening delivery will be required to turn these declines around,’ the report states.
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