Overview

Key policy priorities in summary

• Promote participation in the national HPV Vaccination Program among adolescents
  • Optimise vaccine uptake in populations with higher incidence of cervical cancer such as Indigenous communities
• Promote participation in cervical cancer screening 
  • Increase participation among women in under-screened populations, including collaboration with Indigenous and culturally and linguistically-diverse communities
• Support a national HPV surveillance program 
  • Strongly encourage routine recording of HPV status as well as Indigenous status and country of birth on vaccine consent forms and pathology collection forms

Cervical cancer is one of the most preventable cancers. In Australia, cervical cancer incidence and mortality rates halved between 1991-2002 after the introduction of a national cervical screening program in 1991.^[1] However, since then incidence rates in women aged 25-69 have been stable.^[2]

It has been established that persistent infection with human papillomavirus (HPV) causes nearly all cervical cancers. This knowledge has led to two important clinical advances: vaccines for primary prevention of cervical cancer, and HPV testing to improve secondary prevention. The introduction of the National HPV Vaccination Program in 2007, delivering the prophylactic vaccine to adolescent girls, is expected to further reduce cervical cancer in Australia. In 2013, the program was extended to include adolescent boys.^[3]

Developments in HPV vaccination and screening technologies, along with new evidence on the optimal screening age range and interval led to the need to evaluate the optimal combination and integration of vaccination and screening. A review of Australia’s National Cervical Screening Program led to recommendations to replace Pap tests every two years with HPV testing at an interval of five years and the starting age for screening to be increased from 18 to 25 years. These recommendations were implemented in December 2017.

This chapter discusses the impact of cervical cancer, discusses the policy context in Australia in which both vaccination and screening take place and outlines Cancer Council's policy priorities to reduce the burden of cervical cancer in Australia. Lastly, it discusses the causes, provides information on HPV vaccination and cervical cancer screening.

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