Quote this article as:

J. Brotherton, G. Albero, L. Bruni (January 2023). Australia. Human Papillomavirus and Related Cancers, Fact Sheet
www.HPVWorld.com, 219


Comment:

Australia has made cervical cancer prevention a public health priority for many years, with current national incidence and mortality rates low by international standards. HPV vaccination has resulted in very low rates of HPV16 and HPV18 infection in young women, as reflected in HPV screening data.¹ Annual publication of program indicator data for the National Cervical Screening Program (derived from screening registries and cancer registries), which was established in 1991 (cytology) and moved to HPV in December 2017, has documented its success and facilitated monitoring and transparency around the implementation and maintenance of quality in the program.1 Similarly, Australia has monitored HPV vaccination coverage through a national registry with regular reporting since the program’s commencement in 2007.² These data sources have provided valuable information in seeking to identify and address remaining challenges in cervical cancer prevention and control in Australia and in predicting when Australia might achieve the elimination of cervical cancer as a public health problem (likely to be by 2035).³ Key challenges include:

• the need to improve cervical screening participation, especially amongst disadvantaged communities (noting that the move from a 2 yr to 5 yr screening interval complicates current estimates of participation);
• the need to overcome persistent inequities in incidence and mortality for Aboriginal and Torres Strait Islander women;
• the need to improve the timeliness of national cancer incidence data;
• the need to develop a method for routinely monitoring the uptake of treatment.⁴

In specifically considering the data available to inform Australia’s strategy for the elimination of cervical cancer, further important data limitations and gaps are apparent. In particular, there is a lack of information across the three elimination pillars of vaccination, screening and treatment relating to how well these programs and services are meeting the needs of priority population groups, such as Aboriginal and Torres Strait Islander women, people of a culturally and linguistically diverse background, people living with a disability, medically higher risk people, and lesbian, gay, bisexual, transgender, queer, and intersex people (LGBTQI+). Without these data, it is unlikely that Australia can achieve elimination equitably and likely that groups who bear a higher burden of disease may be left behind. Australia now needs to consider how best to develop further data and health service infrastructure that can document, understand and monitor the experiences and outcomes of the diverse spectrum of people accessing vaccination, screening and treatment services in Australia.

References

1. Australian Institute of Health and Welfare 2021. National Cervical Screening Program monitoring report 2021. Cancer series 134. Cat. no. CAN 141. Canberra: AIHW. Available from: https://www.aihw.gov.au/reports/cancer-screening/national-cervical-screening-program-monitoring-rep/summary (last accessed: Nov 27th, 2022)

2. Hull B, Hendry A, Dey A, Brotherton J et al. Annual immunisation coverage report 2020. National Centre for Immunisation Research and Surveillance. Published 29 November 2021. Available from: https://www.ncirs.org.au/sites/default/files/2021-11/NCIRS%20Annual%20Immunisation%20Coverage%20report%202020.pdf (last accessed: Nov 27th, 2022)

3. Hall MT, Simms KT, Lew JB, et al. The projected time frame until cervical cancer elimination in Australia: a modelling study. Lancet Public Health. 2019;4(1):e19-e27. Available from: https://doi.org/10.1016/s2468-2667(18)30183-x

4. NHMRC Centre of Research Excellence in Cervical Cancer Control. 2021 Cervical Cancer Elimination Progress Report: Australia’s progress towards the elimination of cervical cancer as a public health problem. Published online 26/3/2021, Melbourne, Australia. Available from: Reports - C4 – Cervical Cancer Control (last accessed: Nov 27th, 2022)

HPW EDITOR'S NOTE

From Feb 6th 2023, Australia has moved from two doses to a single dose of the Gardasil®9 HPV vaccine for routine immunisation of young people under the National Immunisation Program.
The free catch-up program for young people who have missed vaccination has also been extended from the current 19 years of age to people under 26 years of age.
Young people (except those who are immunocompromised) who receive a single dose before 26 years of age are now considered fully vaccinated and don’t need further doses.

Find more information here:
https://www.health.gov.au/resources/publications/hpv-vaccine-factsheet-outlining-changes-under-the-national-immunisation-program-in-2023?language=en

The Catalan Institute of Oncology (ICO) in Barcelona, Spain and the International Agency for Research on Cancer (IARC) in Lyon, France jointly lead the HPV Information Centre, a web-based resource that compiles, processes and disseminates published information on HPV infection and HPV-related diseases for all countries of the world.

Country-specific Fact Sheets are standardized summaries of HPV-related disease burden and associated risk factors, prevention strategies, screening activities, and immunization programs for each of the 194 WHO member states. Fact Sheets include concise, self-explanatory graphs and tables to offer a quick overview of the situation in the designated population. The system allows queries to generate statistics for individual countries, groups of countries, geographical regions or worldwide summaries.

More elaborated supplementary tables and comments can also be found in country-specific, regional and worldwide Full Reports from the original database (www.hpvcentre.net). The HPV Information Centre publishes internationally recognized review monographs and targeted scientific publications to address relevant questions in the path to the cervical cancer elimination campaign. The HPV Information Centre is an open access, publicly funded resource to support the work of the scientific HPV community worldwide.

AUSTRALIA:
I. KEY DATA ON HPV AND HPV-RELATED CANCERS¹

Australia has a population of 10.8 million women aged 15 years and older who are at risk of developing cervical cancer. Current estimates indicate that every year 920 women are diagnosed with cervical cancer and 328 die from the disease.

Cervical cancer ranks as the 14th most frequent cancer among women in Australia and the 5th most frequent cancer among women between 15 and 44 years of age. About 2.3% of women in the general population are estimated to harbour cervical HPV-16/18 infection at a given time,² and 77.1% of invasive cervical cancers are attributed to HPVs 16 or 18.³

II. COMPLEMENTARY DATA ON CERVICAL CANCER PREVENTION¹



References

1. Bruni L, Albero G, Serrano B, et al. ICO/IARC Information Centre on HPV and Cancer (HPV Information Centre). Human Papillomavirus and Related Diseases in Australia. Summary Report 22 October 2021. Available from: https://hpvcentre.net/statistics/reports/AUS.pdf?t=1669574193383 (last accessed: Nov 27th, 2022)

2. Australian Institute of Health and Welfare 2021. National Cervical Screening Program monitoring report 2021. Cancer series 134. Cat. no. CAN 141. Canberra: AIHW. Available from: https://www.aihw.gov.au/reports/cancer-screening/national-cervical-screening-program-monitoring-rep/summary (last accessed: Nov 27th, 2022)

3. Brotherton JML, Tabrizi SN, Phillips S, et al. Looking beyond human papillomavirus (HPV) genotype 16 and 18: defining HPV genotype distribution in cervical cancers in Australia prior to vaccination. Int J Cancer. 2017 Oct 15;141(8):1576-1584. Available from: https://doi.org/10.1002/ijc.30871

4. Bruni L, Serrano B, Roura E et al. Cervical cancer screening programmes and age-specific coverage estimates for 202 countries and territories worldwide: a review and synthetic analysis. Lancet Glob Health. 2022;10(8):e1115. Available from: https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(22)00241-8/fulltext

5. WHO-Cervical Cancer Profile: Available from: https://www.who.int/publications/m/item/cervical-cancer-country-profiles (last accessed: Feb 12th, 2023)

OTHER HPV INFORMATION CENTRE FACT SHEETS PUBLISHED IN HPW

Fact Sheet: Argentina

Fact Sheet: Italy

Fact Sheet: Japan

Fact Sheet: Mexico

Fact Sheet: Portugal

Fact Sheet: Republic of Korea

Fact Sheet: Spain

Fact Sheet: Brazil

Fact Sheet: Colombia

Fact Sheet: USA

Fact Sheet: Russia

Fact Sheet: Western Africa

Fact Sheet: France

Fact Sheet: United Kingdom

Fact Sheet: South Africa