Summary

The National Cervical Screening Program (NCSP) aims to reduce cervical cancer cases, illness and death in Australia. Cervical screening in Australia 2019 is the last monitoring report for the previous NCSP, presenting key data for women screened using Pap tests between January 2016 and June 2017 (prior to the renewed NCSP from 1 December 2017). The following data are for women aged 20–69, screened under the previous NCSP.

Cervical cancer cases and deaths were low by international standards

In 2015, 727 women aged 20–69 were diagnosed with cervical cancer, and 140 died from the disease in 2017. This is equivalent to 9 new cases of cervical cancer diagnosed, and 2 deaths, per 100,000 women. These rates are similar to those for previous years.

Both incidence and mortality halved between the introduction of the NCSP in 1991 and the year 2002 and have since remained at 9–10 new cases, and 2 deaths, per 100,000 women.

More than 5 in 10 women participated in cervical screening

Between 1 January 2016 and 30 June 2017, 2,973,370 women participated in cervical screening. This was estimated to be around 54%–56% of women aged 20–69. (This estimate does not include the final 4 months of the previous NCSP and should not be extrapolated for the period 1 January 2016 to 30 November 2017.)

Participation varied across remoteness areas—it was highest in Inner regional areas at 57% and lowest in Very remote areas at 46%. There was a clear association between participation and socioeconomic group—at 50% for women living in the lowest socioeconomic areas and 62% for women living in the highest socioeconomic areas.

Relatively few women rescreened early, and a third responded to a reminder

Only 10% of women with a negative screen (that is, no abnormalities were detected) in 2015 rescreened earlier than the recommended 2 years, continuing a favourable downward trend. Of the more than 1 million women sent a 27-month reminder letter by a cervical screening register in 2016, 31% rescreened within 3 months, similar to the figure for previous years.

High-grade abnormality detection rate continued to decline in young women

Between January 2017 and June 2017, for every 1,000 women screened, 7 had a high-grade abnormality detected by histology, providing an opportunity for treatment before possible progression to cancer.

The rate of detection of high-grade abnormalities for women aged under 30 has declined. This effect is most likely a result of girls who were vaccinated against human papillomavirus (HPV) under the National HPV Vaccination Program moving into the screening cohort, leading to declines in the occurrence (and hence detection) of high-grade abnormalities.

Indigenous women had lower screening rates and poorer outcomes

Incidence of cervical cancer in Aboriginal and Torres Strait Islander women is more than 2 times that of non-Indigenous women, and mortality more than 3 times the non-Indigenous rate. National cervical screening rates for Indigenous women are not available, as Indigenous status information is not collected on pathology forms in all jurisdictions, however there is evidence from a range of sources that Indigenous women are under-screened.