This indicator is the proportion of female Indigenous regular clients aged 20–74 who have not had a hysterectomy and who had cervical screening within the previous 2, 3 and 5 years.
It is collected for females in age groups:
- 20–24
- 25–34
- 35–44
- 45–54
- 55–64
- 65–69
- 70–74.
Why cervical screening is important
Cervical screening aims to detect and treat precancerous abnormalities that might otherwise progress to cervical cancer. Indigenous women generally experience a high burden from cervical cancer compared with non-Indigenous women (AIHW 2019).
The National Cervical Screening Program (NCSP), which aims to reduce mortality from cervical cancer, was originally targeted at women aged 20–69 for a 2-yearly Papanicolaou (Pap) smear, or ‘Pap test’, to detect precancerous abnormalities of the cervix. From 1 December 2017, the NCSP changed to 5-yearly cervical screening for women aged 25–74 using a primary human papilloma virus (HPV) test with partial HPV genotyping and reflex liquid-based cytology triage.
A National HPV Vaccination Program was introduced on 1 April 2007 to immunise girls (and extended in 2013 to also immunise boys) against HPV types 16, 18, 6 and 11 (with an HPV vaccine against 9 HPV types introduced from 2018). While the HPV vaccine is very effective at protecting against the 2 most common cervical cancer-causing types of HPV, it doesn’t protect against all types of HPV that can lead to cervical cancer. This means that both HPV-vaccinated and unvaccinated women are recommended to have regular Cervical Screening Tests (the Pap test replacement) to reduce their risk of developing cervical cancer.
From the June 2018 collection, this indicator was revised to align with the new NCSP. This resulted in additional screening points (at 2, 3 and 5 years) being collected, along with continuing to collect for clients aged 20–24, for an interim period until all women could be expected to have moved across to the new requirements under the NCPS.
At June 2019, 34% of female Indigenous regular clients aged 20–74 who have not had a hysterectomy had cervical screening within the previous 3 years. However, this is affected by a change in cervical screening guidelines and the way it was collected in the national Key Performance Indicators (nKPIs) (see Technical notes for more information).