Summary
The National Cervical Screening Program (NCSP) aims to reduce cervical cancer cases, as well as illness and death from cervical cancer in Australia, through an organised approach to cervical screening aimed at detecting and treating high-grade abnormalities before possible progression to cervical cancer. This report is the latest in the Cervical screening in Australia series, which is published annually to provide regular monitoring of the NCSP.
The following data are for women aged 20–69.
Cervical cancer cases and deaths are low by international standards
In 2013, 692 women aged 20–69 were diagnosed with cervical cancer, and 149 women died from the disease in 2014. This is equivalent to 9 new cases of cervical cancer diagnosed per 100,000 women and 2 deaths per 100,000 women. These rates are similar to previous years. Both incidence and mortality halved between the introduction of the NCSP in 1991 and the year 2002, and have since remained at 9 to 10 new cases, and 2 deaths, per 100,000 women.
Around 6 in 10 women participate in the National Cervical Screening Program
In 2014–2015, more than 3.8 million women participated in cervical screening. This was 56% of women aged 20–69. The age-standardised participation of 57% is similar to previous years, with age-standardised participation in 2012–2013 and 2013–2014 at 58%.
Participation varied across remoteness areas, ranging from 52% for Very remote areas to 58% for Inner regional areas. There was a clear association between participation and socioeconomic group, with participation rising from 51% for women in the lowest socioeconomic group to 63% for those in the highest socioeconomic group.
Relatively few women rescreen early, and a third respond to a reminder letter
Only 11% of women with a negative screen in 2014 rescreened earlier than the recommended 2 years, continuing a downward trend. Of women who were sent a 27-month reminder letter by a cervical screening register, 32% rescreened within 3 months—similar to previous years.
High-grade abnormality detection rate continues to decline in young women
In 2015, for every 1,000 women screened, 8 women had a high-grade abnormality detected by histology, providing an opportunity for treatment before possible progression to cancer. This is similar to previous years, for which the age-standardised rate was between 8 and 9.
There has been a decline in the rate of detection of high-grade abnormalities for women under 25, which has shifted the historical peak age of high-grade abnormalities from 20–24 to 25–29. This is likely to be due to girls being vaccinated against HPV under the National HPV Vaccination Program. It is expected that, as this vaccinated cohort continues to age, older age groups will experience a similar decline in the detection rate of high-grade abnormalities.
Indigenous women have lower screening rates and poorer outcomes
National participation rates for Aboriginal and Torres Strait Islander women are not available, due to Indigenous status information not being collected on pathology forms in all jurisdictions, but there is strong evidence that this population group is under-screened. Incidence of cervical cancer in Aboriginal and Torres Strait Islander women is more than twice that of non-Indigenous women, and mortality is 4 times the non-Indigenous rate.
Preliminary material: Acknowledgments; Abbreviations; Report card
1 Introduction
- Cervical cancer
- The primary cause of cervical cancer is HPV
- Cervical cancer is a largely preventable disease
2 Moving towards a new National Cervical Screening Program
- Cervical screening from 1991 to 2017
- Cervical screening from 1 December 2017
3 Key qualities of the National Cervical Screening Program
- Screening behaviour
- Characteristics of the screening test
- Detection of high-grade abnormalities
- Safety of clinical management guidelines
- Expenditure on cervical screening
4 Key cervical cancer outcomes
- Incidence of cervical cancer
- Survival after a diagnosis of cervical cancer
- Prevalence of cervical cancer
- Mortality from cervical cancer
- Burden of cervical cancer
5 Cervical screening and cervical cancer outcomes in Indigenous women
- Cervical screening in Indigenous women
- Cervical cancer outcomes in Indigenous women
Appendixes
Appendix A: Supporting data tables
Appendix B: National Cervical Screening Program information
Appendix C: Data sources
Appendix D: Classifications
Appendix E: Statistical methods
End matter: Glossary; References; List of tables; List of figures; List of boxes; ;Related publications; Supplementary online data tables