Cervical Cancer Awareness week, 13 – 19 November 2023

Cervical Cancer Awareness week each year, gives us an opportunity to focus on the incidence of cervical cancer, and its impact on women world-wide. The incidence of cervical cancer in developed countries is low because of the availability of regular screening. Never-the less, there are still about 800 women diagnosed with the disease each year in Australia, the majority (70%) of whom have never been screened or are overdue for screening.

Where screening is not available in developing countries, the incidence of cervical cancer is comparable to that of breast cancer, and it is the major cause of cancer death in women. The disease commonly affects premenopausal women, so a woman’s death usually leaves children without a mother.

In the past 30 years, it has become clear that virtually all cases of cervical cancer are caused by the Human Papilloma Virus (HPV). A vaccine against this virus was developed by Professors Ian Frazer and Jian Zhou at the University of Queensland in 2006.

Australia became the first country to introduce free HPV vaccination for schoolgirls 12 to 13 years of age under its National Immunisation Program in 2007. The program was extended to include schoolboys in 2013 and is now available for women up to 25 years. The Gardasil vaccine should eliminate 90% of cases of cervical cancer.

Screening for cervical cancer often allows diagnosis of precancer which is 100% curable. Even if cancer has developed, screening allows early diagnosis when the disease is usually eminently curable.

Screening has traditionally been done by taking a Pap smear, a scraping of cells from the cervix which are then examined under the microscope. The test is named after the Greek physician George Papanicolaou.

The Pap test has now been replaced by the HPV test. A swab is taken from the cervix and tested for the presence of the HPV virus. This test is more accurate than the Pap smear, and only needs to be done every 5 years instead of every 2-3 years. Another advantage of the HPV test is that it can be self-collected.

A recent report from the CEO of the Cancer Institute NSW, Professor Tracey O’Brien, indicated that there had been a recent upswing in the number of people choosing to use the self-collection option for cervical screening. This is particularly true of Indigenous women, who have traditionally had lower screening rates, particularly those living in remote areas. Lower screening rates in remote and rural Australia has led to Indigenous women being 2.5 times as likely to be diagnosed with cervical cancer and 3.8 times as likely to die from it. I am pleased that early indications are that the self-collection HPV test is increasing the number of women being screened for cervical cancer in Australia, because this will decrease the incidence and mortality of the disease.

Prof Neville F Hacker AM, MD. Founder & Director, AGCF