Cancer screening: Cervical cancer screening
About cervical cancer
Cervical cancer affects the cervix. As the lowest part of the uterus (womb), the cervix connects the uterus to the vagina.
Cervical cancer is now one of the most preventable cancers in Australia. This is mostly due to the success of the National Cervical Screening Program (NCSP), and the vaccination program for the human papillomavirus (HPV).[36]
Since the NCSP started in 1991, the number of women diagnosed with, and dying from, cervical cancer has halved.[36]
The role of health professionals
Around 75% of Australian women diagnosed with invasive cervical cancer (cancer that has spread to tissue deeper in the cervix, or to other parts of the body) have never had cervical screening, or have not returned for screening within the recommended time.[37]
General practitioners (GPs) are the main providers of cervical screening, and play an important role in reaching women, especially those who are not screening regularly.
The Cervical Screening Test
The NCSP changed on 1 December 2017 from Pap test screening to a new Cervical Screening Test every five years. This new test looks for HPV in the cells of the cervix. If the sample tests positive for HPV, the laboratory automatically retests the sample to look for any changes to cells of the cervix. It is recommended that women aged 25–74 years have the new test every five years, if their previous Cervical Screening Test result was negative.[37]
Refer to the NSCP website for more information on the changes to the program. Those aged under 25 years should discuss cervical screening with their GP.[37]
National Cancer Screening Register
A National Cancer Screening Register (NCSR) commenced in late June 2018. The NCSR sends invitations and reminders to participants, provides notification when a person is overdue for follow-up tests and/or treatment, and provides a history of screening test results.
The NSW Cervical Screening Program is focusing on under‑screened and never screened communities, including Aboriginal women and women from culturally and linguistically diverse communities.
Cervical cancer and HPV
Almost all cervical cancers are caused by HPV.[38] For this reason, Australia introduced a school‑based HPV Vaccination Program in 2007. It started with females and extended to males in 2013.
The vaccine has been shown to reduce:
- HPV infection rates
- the number and severity of cervical abnormalities in young women who have been vaccinated.[39]
A new HPV vaccine was introduced into the program in 2018. It protects against seven HPV subtypes, which cause around 93% of cervical cancers. This protection is an increase from the previous vaccine’s protection against two subtypes that cause around 70–80% of cervical cancers.[40] Both vaccines also protect against two subtypes that cause genital warts.
The National Immunisation Program provides free catch‑up vaccinations, including HPV, for individuals up to 19 years of age. The program includes refugees and humanitarian entrants to Australia.[41]
Over time, this program is expected to further reduce cervical cancer rates, and deaths from the disease.[39]
It is important that women participate in cervical screening, even if they have received HPV vaccination, because the vaccination does not provide protection against all types of HPV that can cause cervical cancer.
Overall key findings:
There are no cervical screening participation data in this report. The National Cancer Screening Register is working on developing standard state and national reporting.