Australia has committed to a landmark target to eliminate cervical cancer (incidence <4 per 100,000) by 2035, supported by a comprehensive national strategy launched in 2023, across the three pillars of vaccination, screening and treatment. Key initiatives already undertaken include developing national cervical cancer treatment guidelines and major screening promotional campaigns.
Screening directly drives the timing of cervical cancer elimination, but screening uptake and coverage have declined, threatening to push back the elimination timeline. Recent modeling focused specifically on Aboriginal and Torres Strait Islander women shows that without intensive outreach to ensure no one is left unscreened, elimination among this community will be 12 years later than the 2035 target. In many other priority groups, screening participation is unknown due to data gaps.
To bridge the gap between hope and reality, the 2023 national elimination strategy places equity and structural access at its core. In screening, the transition to primary HPV testing provides not only a more effective clinical tool, but the option of self-collection. Self-collection improves the acceptability of screening and, importantly, opens up flexibility in where and how screening can be offered, making it a key approach for reaching underserved groups. There is significant activity exploring the flexibility of self-collection and developing locally-relevant models with communities. Some systems-level barriers remain, and identifying and scaling up successful models, as well as connection to follow-up care, remains a challenge.
To ensure reality matches our national ambition, public health efforts must focus on: proactively identifying and reaching the never-screened, reversing the downward trend in screening coverage, and ensuring that every individual who requires follow-up receives it in a timely, equitable manner. Success requires designing models in partnership with communities.