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Australia moves toward eliminating cervical cancer
Australia moves toward eliminating cervical cancer (Australia, 2018). What changed, who is affected, and what it does and doesn't mean.
Original commentary from the Cancer Explained editorial team.
Please note: this page is educational only — it is not medical advice, and it does not speculate about anyone’s health beyond reliable public reporting. For questions about your own health, talk with your healthcare team.
The two changes that did the work
Australia did not do one thing. It did two, twenty-six years apart, and they multiply.
The first was screening. Cancer Council Australia dates the National Cervical Screening Program to 1991, when a free Pap smear was offered every two years to women aged 18 to 70. Incidence and death rates from cervical cancer in Australia have halved since then.
The second was vaccination. A national human papillomavirus (HPV) vaccine program started in 2007 for girls, and boys were added in 2013.
Then, on 1 December 2017, the Pap smear was retired. In its place came the Cervical Screening Test, offered to most people aged 25 to 74 every five years.
Why swapping the test was not a downgrade
At first glance, going from every two years to every five looks like less care. It is the opposite.
A Pap smear looks at cervical cells under a microscope and asks whether they already look abnormal. The newer test looks for HPV itself, the virus that causes nearly all cervical cancer. It asks an earlier question: is the cause even present?
Because the HPV test picks up risk years before cell changes appear, a negative result stays reassuring far longer. That is why the interval can stretch while safety goes up rather than down. The same logic drives the shift in many countries, and our guide to cervical cancer screening sets out how the two tests differ.
From 1 July 2022, people aged 25 to 74 in Australia could choose to collect their own vaginal sample instead of having a clinician use a speculum. Self-collection is offered only to people without symptoms.
What the modelling projected
A 2019 modelling study in The Lancet Public Health, led by Michaela Hall at Cancer Council NSW, asked when Australia's rate might fall below the thresholds people call elimination.
At the time of the study the age-standardized rate was about seven new cases per 100,000 women a year. The model projected fewer than six per 100,000 by 2020, with a range of 2018 to 2022. It projected fewer than four per 100,000 by 2028, with a range of 2021 to 2035.
Four per 100,000 matters because the World Health Organization sets that as the level a country must reach and hold to have eliminated cervical cancer as a public health problem. WHO pairs it with three targets for 2030, often written 90-70-90: 90% of girls fully vaccinated by age 15, 70% of women screened with a high-performance test by 35 and again by 45, and 90% of women with pre-cancer or invasive cancer treated or managed.
What is being prevented
Cervical cancer is still a serious disease where it is not caught early. In the United States, American Cancer Society projections give 13,490 new cases and 4,200 deaths in 2026. Five-year relative survival across all stages, for cases diagnosed in 2016 to 2022, is 68.8%.
Stage drives that number. When the cancer is localized, meaning it has stayed in the cervix, 5-year relative survival is 91.8%. When it is regional, having reached nearby lymph nodes, it is 64.0%. When it is distant, having spread to organs further away, it is 20.5%. Only 41% of US cases are found while localized. The stage breakdown and the survival figures both come from the 2016 to 2022 cohort. These figures describe groups of people over past years, not any one person's outlook.
Treatment depends on that stage. NCI describes cone biopsy, in which a cone of tissue is cut from the cervix, for very early disease. Larger tumors may need a radical hysterectomy, which removes the uterus, cervix, upper vagina and surrounding tissue. Locally advanced disease is usually treated with chemoradiation, meaning radiation given alongside chemotherapy. Screening changes which of those a person needs, because pre-cancer found early can be removed in a clinic. Our page on cervical cancer covers types and staging.
Signs worth a same-week appointment
Cell changes before cancer rarely cause anything you would notice. Cancer Council Australia lists these as the symptoms to raise promptly:
- Vaginal bleeding between periods
- A period that is longer or heavier than usual
- Bleeding after sex, or pain during sex
- Any vaginal bleeding after menopause
- Pelvic pain
- A change in vaginal discharge, including a strong or unusual smell
Other conditions cause all of these. That is a reason to get them checked, not a reason to wait.
What to keep in perspective
- A model is a projection, not a measurement. Hall and colleagues gave wide ranges, and the result depends on vaccination and screening rates holding up.
- Elimination as a public health problem means a very low rate, not zero cases. People in Australia will still be diagnosed with cervical cancer.
- National averages hide gaps. Groups with lower screening and vaccination coverage reach the threshold later, or not at all.
- Screening ages and intervals differ by country. Australia's schedule is not guidance for anywhere else. Follow your own national program, and read about the HPV vaccine for who it is offered to.
Sources
- Lancet Public Health (record via PubMed), The projected timeframe until cervical cancer elimination in Australia — https://pubmed.ncbi.nlm.nih.gov/30291040/
- Cancer Council Australia, Cervical cancer — https://www.cancer.org.au/cancer-information/types-of-cancer/cervical-cancer
- WHO, Cervical Cancer Elimination Initiative — https://www.who.int/initiatives/cervical-cancer-elimination-initiative
- SEER Cancer Stat Facts, Cervical Cancer — https://seer.cancer.gov/statfacts/html/cervix.html
- NCI PDQ, Cervical Cancer Treatment (Patient Version) — https://www.cancer.gov/types/cervical/patient/cervical-treatment-pdq
- NCI, Cervical Cancer Screening (PDQ) — https://www.cancer.gov/types/cervical/patient/cervical-screening-pdq
How this article was prepared
An AI-assisted editorial system helped prepare this page. No named medical reviewer has reviewed it unless one is listed.
The National Cancer Information Foundation publishes Cancer Explained. This page is for learning. It is not medical advice and does not suggest a test or treatment.
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Put the story in context
Prevention, possible warning signs, screening, and diagnosis
This story relates to Cervical cancer. The information below is general: it does not reveal anything else about a public person’s health, and not every point applies to every cancer. Personal advice depends on age, symptoms, family history, exposures, and medical history.
Prevention and risk reduction
Not every cancer can be prevented. Avoiding tobacco, protecting skin from ultraviolet radiation, limiting alcohol, staying active, and receiving recommended HPV or hepatitis B vaccination can lower the risk of certain cancers. A risk factor is not a prediction or a cause in one individual.
Symptoms and possible early signs
Possible signs vary and are often caused by conditions other than cancer. Changes worth discussing include a new lump, unexplained bleeding or weight loss, a persistent cough, lasting bowel or bladder changes, a changing skin spot, or symptoms that persist or worsen. Some early cancers cause no symptoms.
Screening and early detection
Screening looks for certain cancers before symptoms begin. Recommended tests exist only for some cancers and depend on age and risk. Screening can have benefits and harms; it is not the same as evaluating a new symptom, and there is no single routine scan or blood test that reliably screens for every cancer.
How cancer is diagnosed
Diagnosis may involve a history and exam, imaging, laboratory tests, and often a biopsy. Pathology can identify the cancer type and may test biomarkers that guide treatment. Symptoms, screening results, tumor markers, or online stories alone cannot confirm cancer.
Learn about this story’s cancer topic
A public story may encourage questions, but it should not be used to estimate your risk or choose testing. Contact a healthcare professional about a persistent or concerning change. Seek urgent care for severe or rapidly worsening symptoms.