Technical notes

Terminology

This report uses the terms ‘participants’ and ‘invitees’ when referring to data collected under the NCSP. These data are not restricted by sex or gender, with all cervical screening participants and invitees included in these data. For NCSP data, participants and invitees may include women, transgender men, intersex people, and non-binary people.

This report uses the term 'women' to mean ‘female' when referring to cancer incidence data and cancer mortality data as these data sources are based on sex assigned at birth. However, it should be noted that some people may not identify with this term.

Abbreviations

Table Technical notes 1: Abbreviations

Abbreviation

Description

ABS

Australian Bureau of Statistics

ACD

Australian Cancer Database

ACT

Australian Capital Territory

AIHW

Australian Institute of Health and Welfare

AIS

adenocarcinoma in situ

AS

age-standardised

ASC

adenosquamous carcinoma

ASGS

Australian Statistical Geography Standard

CALD

culturally and linguistically diverse

CIN 1

cervical intraepithelial neoplasia grade 1

CIN 2

cervical intraepithelial neoplasia grade 2

CIN 3

cervical intraepithelial neoplasia grade 3

CST

Cervical Screening Test

d

definite

ERP

estimated resident population

DNA

deoxyribonucleic acid

HPV

human papillomavirus

HPV NAT

human papillomavirus nucleic acid testing

HSIL

high-grade squamous intraepithelial lesion

ICD

International Classification of Disease

ICD-O-3

International Classification of Diseases for Oncology, 3rd Edition

LBC

liquid based cytology

LSIL

low-grade squamous intraepithelial lesion

NACCHO

National Aboriginal Community Controlled Health Organisation

NCSP

National Cervical Screening Program

NCSR

National Cancer Screening Register

NHMD

National Hospital Morbidity Database

nKPI

national Key Performance Indicator

NMD

National Mortality Database

NOS

not otherwise specified

NIP

National Immunisation Program

NSW

New South Wales

NT

Northern Territory

p

possible

PPV

positive predictive value

Qld

Queensland

RA

remoteness area

RDE

raw data extract

SA

South Australia

SCC

squamous cell carcinoma

SEIFA

Socio-Economic Indexes for Areas

Tas

Tasmania

Vic

Victoria

WA

Western Australia

Symbols

Table Technical notes 2: Symbols

Symbol

Description

. .

not applicable

n.a.

not available

n.p.

not publishable because of small numbers, confidentiality, or other concerns about the quality of the data

<

less than

>

greater than

Performance indicator definition and/or methodology changes in this report

As identified in Table Data 1: Summary of National Cervical Screening Program performance indicators, specifications and/or methodology have changed in 2025 for some performance indicators.

These are summarised in Table Technical notes 3 below.

Table Technical notes 3: Specification and/or methodology changes to performance indicators

Performance indicator

Specification/methodology change

PI 1 - Participation

Participation and coverage have been replaced with a new, single measure of participation.

This new definition of participation includes all HPV tests rather than only screening HPV tests (participation) or all HPV and LBC tests (coverage); the most recent test is selected instead of the first test; and it is measured over 5.5 years instead of 5 years.

PI 10 - Adherence to recommendation for follow-up

Definition of first follow-up and second follow-up have been modified to more accurately capture these episodes.

PI 11 - Follow-up results

Definition of first follow-up and second follow-up have been modified to more accurately capture these episodes.

PI 12 - Colposcopy rate

Higher risk category First follow-up test HPV 16/18 + any LBC or HPV (not 16/18) + high-grade/glandular LBC now also includes first follow-up test HPV (not 16/18) + negative/low-grade LBC in participants who are under-screened, Aboriginal and/or Torres Strait Islander, or aged 50 or over.

Definition of first follow-up and second follow-up have been modified to more accurately capture these episodes.

PI 13 – Time to colposcopy

Higher risk category First follow-up test HPV 16/18 + any LBC or HPV (not 16/18) + high-grade/glandular LBC now also includes first follow-up test HPV (not 16/18) + negative/low-grade LBC in participants who are under-screened, Aboriginal and/or Torres Strait Islander, or aged 50 or over.

Definition of first follow-up and second follow-up have been modified to more accurately capture these episodes.

PI 15 - Yield of high-grade abnormalities on biopsy among participants who attend colposcopy after higher risk screening results

Higher risk category First follow-up test HPV 16/18 + any LBC or HPV (not 16/18) + high-grade/glandular LBC now also includes first follow-up test HPV (not 16/18) + negative/low-grade LBC in participants who are under-screened, Aboriginal and/or Torres Strait Islander, or aged 50 or over.

Definition of first follow-up and second follow-up have been modified to more accurately capture these episodes.

PI 16 – Positive predictive value of colposcopy

Higher risk category First follow-up test HPV 16/18 + any LBC or HPV (not 16/18) + high-grade/glandular LBC now also includes first follow-up test HPV (not 16/18) + negative/low-grade LBC in participants who are under-screened, Aboriginal and/or Torres Strait Islander, or aged 50 or over.

Definition of first follow-up and second follow-up have been modified to more accurately capture these episodes.

PI 17a – High-grade cervical abnormality detection rate

Definition of high-grade histology has been changed to remove endocervical dysplasia, and denominator is now only participants with an HPV test (instead of participants with an HPV or LBC test).

PI 17b - Cervical cancer detection rate

Definition of cervical cancer has been changed to incident cervical cancers, and denominator is now only participants with an HPV test (instead of participants with an HPV or LBC test).

Impact of COVID-19

Coronaviruses are common viruses that cause respiratory diseases, ranging from the common cold to more severe illnesses. COVID-19, caused by the novel coronavirus SARS-CoV-2, was first reported to the World Health Organization (WHO) in December 2019 and declared an international pandemic on 11 March 2020 (WHO 2020).

The COVID-19 pandemic disrupted many aspects of life, including access to health services like cancer screening programs. In Australia, COVID-19 restrictions introduced in March 2020 led to the suspension or modification of healthcare services. This likely influenced access to cervical screening.

Cancer screening and COVID-19 in Australia reports (AIHW 2020; AIHW 2021) examined the impact of COVID-19 on Australia’s national cancer screening programs, revealing a drop in cervical screening tests in April and May 2020. Later reporting demonstrated that this was lower than what would be expected compared to the number of cervical screening tests in April and May 2021. This decrease aligns with the strict restrictions in place during that period, which began to ease in late April 2020.

Additionally, the pandemic may have impacted the Estimated Resident Populations (ERPs) used for participation, incidence, and mortality calculations. This is outlined in more detail in the box below.

Box Technical notes 1: Impact of COVID-19 on Estimated Resident Populations

The COVID-19 pandemic and the resulting Australian Government closure of the international border from 20 March 2020, caused significant disruptions to the usual Australian population trends. This report uses Australian Estimated Resident Population (ERP) estimates that reflect these disruptions.

In the 12-month period July 2020 to June 2021, the overall population growth was much smaller than the years prior, and in particular, there was a relatively large decline in the population of Victoria. ABS reporting indicates these were primarily due to net-negative international migration (ABS 2021).

This change in the usual population trends may complicate interpretation of statistics calculated from these ERPs. For example, rates and proportions may be greater than in previous years due to decreases in the denominator (population) of some sub-populations.