Australia is on track to eliminating cervical cancer, but future gains could be undermined by falling HPV vaccination and cervical screening rates, according to the latest annual report by the NHMRC Centre of Research Excellence in Cervical Cancer Control (C4), which tracks key cervical cancer metrics across Australia.
The 2025 Cervical Cancer Elimination Progress Report was authored by researchers at the University of Sydney, the University of Melbourne, the Kirby Institute at UNSW, The Australian National University and the Australian Centre for the Prevention of Cervical Cancer (ACPCC).
It found there was not a single documented case of cervical cancer among women under 25 across Australia in 2021 - the latest available data - demonstrating the efficacy of Australia's HPV (human papillomavirus) vaccination program which commenced in 2007.
"This reflects the effectiveness of human papillomavirus immunisation, which was introduced in 2007," said co-author Associate Professor Megan Smith from the University of Sydney's Cancer Elimination Collaboration . "While this is a great result, the key to reducing cervical cancer burden in unvaccinated populations is screening and improved targeting of services to disadvantaged groups, such as First Nations people, who experience far higher incidence and mortality rates than the general population."
85 percent of Australian women aged 35-39 years have had at least one HPV test in their lifetime, but the report also found that more than one in four women who are eligible for cervical screening are now overdue, marking a decline for the second year in a row. This is despite the broader availability of self-collection (a self-taken vaginal specimen) as part of the National Cervical Screening Program. Self-collection is now chosen by almost half of participants as their preferred screening method.
"We are seeing some improvements, including in the 35- to 39-year-old age group, even in very remote areas. But with 15 percent of that age group having never had a screening test in their lifetime, and only 50 percent of 25- to 29-year-olds being up to date with screening, we need to promote tailored strategies such as HPV self-collection," said Associate Professor Smith.
HPV vaccine coverage by the age of 15 has incrementally declined in recent years, falling more than 6 percentage points to just under 80 percent from a peak of almost 86 percent in 2020 among both girls and boys.
"The vast majority of all cervical cancers are caused by human papillomaviruses, particularly HPV types 16 and 18. HPV vaccines and HPV-based cervical screening are our future-proofing - they are our best insurance, and together vaccination and screening will lead to cervical cancer rates so low that the disease is expected to be eliminated as a public health problem by 2035," said Associate Professor Smith.
Co-author Julia Brotherton, Professor of Cancer Prevention Policy at the University of Melbourne, emphasised the importance of all young people being vaccinated against HPV.
"This highly effective and safe vaccine prevents cervical cancer and other HPV-related cancers such as anal and throat cancers, using just a single dose," Professor Brotherton said. "Parents should think of this as a gift they can give their child to protect them for their lifetime. And I urge all young people who missed out at school, for whatever reason, to talk to their GP, nurse or pharmacist about accessing their free catchup dose."
Co-author Dr Dorothy Machalek, epidemiologist, HPV vaccine and surveillance expert at the Kirby Institute, said that monitoring plays a vital role in tracking our progress towards elimination, particularly as it relates to equity.
"Our national elimination strategy is centred on achieving cervical cancer elimination for all. But our report continues to show that some groups are at high risk of being left behind unless we act now," Professor Machalek said. "We need to focus our efforts on collecting better and more timely data so we can better develop effective solutions."
The report recommends all stakeholders work together to:
- Address ongoing declines in HPV vaccination coverage
- Revitalise school-based immunisation approaches to better suit the current environment
- Prioritise vaccination equity for Aboriginal and Torres Strait Islander adolescents
- Address declining screening participation rates
- Resolve data gaps in screening data for Aboriginal and Torres Strait Islander women
- Enable better use of existing data so elimination indicators can be reported for more priority populations and by vaccination status
- Review suppression rules for small counts in reporting
- Enhance and accelerate national cancer data reporting and release
- Develop a cervical cancer treatment monitoring framework.
This is the fifth annual report by C4, whose work has underpinned major innovations in the successful delivery of HPV vaccination in girls and boys and the implementation of an HPV-based cervical screening program in Australia.
Declaration
The research was supported by the Department of Health, Disability and Aged Care, the Screening Analysis and Monitoring Unit of the Australian Institute of Health and Welfare, the National Cancer Screening Register, the National Centre for Immunisation Research and Surveillance. Data was provided by the Australian Cancer Database, the Australian Institute of Health and Welfare and the population-based cancer registries of New South Wales, Victoria, Queensland, Western Australia, South Australia, Tasmania, the Australian Capital Territory and the Northern Territory. The report was prepared with assistance from the Australian Centre for the Prevention of Cervical Cancer.
