Australia On Track To Be The First Country To Eliminate Cervical Cancer

9 February 2022
by: Juicing For Health
in Health, News

Last updated on

Cervical cancer is one of the few cancers the world has agreed could almost disappear within a generation, and Australia is closer than any other country to making that real. The nation is on track to become the first to effectively eliminate cervical cancer by around 2035, thanks to HPV vaccination and modern screening, yet behind this hopeful headline sit quieter stories of slipping vaccination rates, delayed tests, and communities who still face far higher risks than others.

Where Australia Stands On Cervical Cancer Elimination In 2025

Australia is closer than any other country to eliminating cervical cancer as a public health problem, but it has not crossed the line yet. The World Health Organization defines elimination as fewer than 4 new cases per 100,000 women each year. In 2021, Australia recorded 6.3 cases per 100,000 women, already among the lowest rates worldwide but still above that benchmark. One milestone is historic: in 2021, there were no documented cases of cervical cancer in women under 25, for the first time in records going back to 1982. Researchers attribute this to the national HPV vaccination program, introduced in 2007, which has dramatically reduced infections with high risk HPV types, particularly 16 and 18. Screening reforms are also reshaping the landscape. Australia moved from cytology based Pap smears to HPV testing, a more sensitive method that initially caused a temporary increase in detected cancers as previously unseen disease was found earlier. Recent data hint that incidence is now beginning to decline again, in line with modelling.
Yet this progress is not shared equally. Between 2017 and 2021, cervical cancer incidence was 11.7 per 100,000 among Aboriginal and Torres Strait Islander women, compared with 5.8 per 100,000 in non Indigenous women. Mortality in 2019 to 2023 was 4.3 deaths per 100,000 for Aboriginal and Torres Strait Islander women, versus 1.3 for non Indigenous women, and increased with socioeconomic disadvantage and remoteness. In simple terms, Australia is poised to become the first country to eliminate cervical cancer as a public health problem by around 2035. Whether that achievement is truly national, and not just statistical, depends on what happens next with vaccination, screening, and equity focused care.

Australia’s HPV Success Story, Now At Risk

If Australia does eliminate cervical cancer, HPV vaccination will be the cornerstone of that success. The impact is already visible in the data: in 2021, there were no recorded cases of cervical cancer in women under 25, a result researchers link directly to the National HPV Vaccination Program, introduced in 2007. Prevalence of the most dangerous HPV types, 16 and 18, is now very low among screened women, at 1.4 percent in 2024. Yet the very tool that delivered these gains is losing ground. HPV vaccine coverage by age 15 has slipped from a peak of 85.7 percent in 2020 to 79.5 percent in 2024 across girls and boys, with coverage at 81.1 percent for females and 77.9 percent for males. The World Health Organization’s 2030 target is 90 percent of girls fully vaccinated by 15, so Australia is moving away from, not towards, that benchmark. The decline is uneven, too. Coverage is consistently lower for Aboriginal and Torres Strait Islander adolescents, for young people in disadvantaged areas and those living in remote and very remote regions. These gaps are widening, not narrowing.
Experts are clear about what is at stake. Associate Professor Megan Smith notes that “the vast majority of all cervical cancers are caused by human papillomaviruses, particularly HPV types 16 and 18,” and describes HPV vaccines and HPV-based screening as “our future-proofing… our best insurance.” Professor Julia Brotherton calls the HPV vaccine “a gift… to protect [children] for their lifetime” and urges young people who missed school vaccination to seek a free catch-up dose. In other words, Australia’s elimination timeline depends heavily on whether it can halt and reverse this slide in HPV vaccination, especially among those currently being left behind.

Missed Tests In A World Leading Screening Program

If HPV vaccination is Australia’s first line of defence, cervical screening is the safety net that catches what the vaccine does not. Here, the story is one of high overall coverage but worrying slippage. By the end of 2024, 85.0 percent of women aged 35 to 39 had undergone at least one HPV test, already exceeding the World Health Organization target of 70 percent screened by age 35. Screening is reaching women in remote, very remote, and more disadvantaged areas more effectively than in the past, helped by the rollout of self-collection, where people take their own vaginal sample. Almost half of participants now choose this option, and modelling shows that even a single lifetime screen can substantially reduce cervical cancer risk. Yet, at the same time, fewer people are keeping up to date. The proportion of screen-eligible women who are up to date with screening has fallen for the second consecutive year, from 76.5 percent at the end of 2022 to 74.2 percent at the end of 2024. More than one in four eligible women are now overdue for a test. Participation over a 5.5 year period has also declined, from 81.1 percent (2018 to mid 2023) to 78.1 percent (2020 to mid 2025).
The drop is most pronounced among younger women aged 25 to 29, where only half are up to date, and among those in the most disadvantaged areas. Out of pocket costs for primary care, limited appointment availability, and logistical barriers are all likely contributors. Researchers argue that turning this around will require innovative and flexible screening models that meet people where they are, rather than relying solely on traditional clinic based care, so that convenience does not become a quiet risk factor.

Aboriginal And Torres Strait Islander Women Face Higher Risks

Behind Australia’s world leading averages sit stark divides in who develops, survives, and is treated for cervical cancer. For Aboriginal and Torres Strait Islander women, incidence between 2017 and 2021 was 11.7 per 100,000, around three times the national elimination threshold and roughly double the rate in non Indigenous women. Mortality between 2019 and 2023 was 4.3 deaths per 100,000, more than three times that of non Indigenous women. Treatment and follow up patterns echo this imbalance. Nationally, 82.7 percent of people with high grade precancer detected in 2023 were treated within 6 months, and 86.5 percent within 12 months, short of the World Health Organization goal of 90 percent. Colposcopy attendance after abnormal results is lower for Aboriginal and Torres Strait Islander people at 3, 6, and 12 month time points, pointing to structural barriers rather than individual choice. Survival data tell a similar story. Overall 5 year relative survival from 2017 to 2021 was 76.8 percent, but only 64.3 percent for Indigenous women, compared with 74.6 percent for non Indigenous women. Outcomes also worsen with socioeconomic disadvantage and remoteness.
Data gaps make some inequities harder to see. For Aboriginal and Torres Strait Islander women, for culturally and linguistically diverse communities, and for LGBTQ+ and intersex people, information is incomplete or inconsistently recorded. As epidemiologist Dr Dorothy Machalek puts it, “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.” Australia’s challenge is not only to reach elimination, but to ensure the path there does not entrench existing health divides.

What It Will Take To Truly Eliminate Cervical Cancer

Australia is closer than any other country to meeting the World Health Organization’s 90-70-90 targets for cervical cancer elimination, but progress is fragile. Screening by age 35 already exceeds the 70 percent target, yet HPV vaccination coverage has slipped from its 2020 peak and treatment of precancer is still below the 90 percent benchmark. The science is in place. What is missing is consistent delivery at scale, especially for communities that shoulder the greatest burden. The 2025 progress report calls for a reset. Rebuilding HPV vaccination means revitalising school programs, systematically inviting all under 25s who missed out to catch up, and making vaccination easy through free clinics, pharmacies, and opportunistic offers in primary care. On screening and treatment, the priorities are expanding flexible models such as self-collection outside traditional clinics, reducing out-of-pocket costs and access barriers, and improving timely follow up for abnormal results. Underpinning all of this is data: Australia needs faster, more complete linkage between immunisation, screening, cancer registries, and death records so that inequities can be seen and acted on, not hidden in statistical gaps. For readers, elimination is not an abstract policy goal but a series of small decisions. Check when you or the people you care for last had a cervical screening test. Ask your clinician about HPV self-collection if that feels more acceptable. If you are a parent or caregiver, confirm your child’s HPV vaccination status and arrange any catch up doses. Support services that prioritise Aboriginal and Torres Strait Islander communities and people in remote and disadvantaged areas. Australia has a genuine chance to make cervical cancer a rarity by 2035, but whether it happens for everyone depends on choices made now.

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