Australia on Track to Eliminate Cervical Cancer, But Screening and Vaccination Rates Raise Concerns

Australia is making significant strides toward eliminating cervical cancer as a public health problem, thanks to decades of investment in HPV vaccination and cervical screening programs. However, recent declines in vaccination and screening rates threaten to undermine this progress, according to the 2025 Cervical Cancer Elimination Progress Report from the NHMRC Centre of Research Excellence in Cervical Cancer Control (C4).

Decades of Progress in Cervical Cancer Prevention

Australia launched the National Cervical Screening Program in 1991, encouraging women to undergo regular Pap tests (cytology) to detect early cell changes before they develop into cancer. This program reduced cervical cancer cases and deaths by approximately 50%.

In 2007, Australia became the first country in the world to implement a national HPV vaccination program. This led to a substantial decrease in HPV infection rates and cervical pre-cancers. The program was further enhanced in 2017 with the introduction of HPV testing, which specifically looks for HPV types 16 and 18, responsible for the majority of cervical cancers. Positive results trigger closer monitoring by healthcare providers, potentially reducing cervical cancer rates by an additional 20–30%.

Further bolstering prevention efforts, Australia introduced a nine-valent HPV vaccine in 2018, protecting against nine types of HPV that can cause cancer, an improvement over earlier vaccines that covered only four types.

National Elimination Strategy and Encouraging Findings

In 2023, Australia launched a national strategy to eliminate cervical cancer, setting ambitious five-year goals: vaccinating 90% of girls and boys, screening 70% of women aged 25–75 every five years, and treating 95% of detected pre-cancers, and cancers.

The 2025 report highlights several positive trends:

• Cervical cancer rates are slowly declining. In 2020, there were 6.6 cases per 100,000 women, dropping to 6.3 cases per 100,000 in 2021.
• In 2021, no cases of cervical cancer were diagnosed in women under 25, likely due to the effectiveness of the HPV vaccination program.
• HPV infection rates are decreasing, particularly among younger women. Only 1% of women aged 25–29 tested positive for HPV types 16 or 18.
• Approximately 85% of women aged 35–39 have undergone at least one HPV test, significantly reducing their individual risk.

Declining Vaccination and Screening Rates: A Cause for Concern

Despite the progress, vaccination and screening rates have been declining in Australia since the onset of the pandemic. HPV vaccination rates among young people decreased from 85.7% in 2020 to 79.5% in 2024.

Julia Brotherton, Professor of Cancer Prevention Policy at the University of Melbourne and a co-author of the report, emphasized the safety and effectiveness of the vaccine, stating, “Parents should think of this as a gift they can give their child to protect them for their lifetime. And I urge all young people who missed out at school, for whatever reason, to talk to their GP, nurse or pharmacist about accessing their free catchup dose.”

Uptake of recommended screening has also fallen, 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, explained, “We are seeing some improvements, including in the 35- to 39-year-old age group, even in very remote areas. But with 15 percent of that age group having never had a screening test in their lifetime, and only 50 percent of 25- to 29-year-olds being up to date with screening, we need to promote tailored strategies such as HPV self-collection.”

Addressing Health Inequalities

The report also reveals disparities in access to prevention services. Indigenous people and those living in remote areas experience higher rates of cervical cancer and mortality. Indigenous people have nearly double the cervical cancer rate of the national average, with a significantly higher death rate.

Dorothy Machalek, an epidemiologist at the Kirby Institute and a co-author of the report, stated, “Our national elimination strategy is centered on achieving cervical cancer elimination for all. But our report continues to show that some groups are at high risk of being left behind unless we act now. We need to focus our efforts on collecting better and more timely data so we can better develop effective solutions.”

The Path Forward

The report recommends several key steps to maintain momentum:

• Revitalizing school vaccination programs
• Improving access to vaccination for Aboriginal and Torres Strait Islander adolescents
• Piloting innovative screening methods
• Enhancing national health data systems

Cervical cancer is a preventable disease, and Australia’s success demonstrates the impact of sustained investment and consistent public health messaging. While elimination is within reach, addressing declining vaccination and screening rates is crucial, a challenge mirrored in other countries, including the United States.