Informing major changes to national cervical screening

Background

It is well known that the human papillomavirus (HPV) causes cervical cancer, along with a number of other cancers in both women and men. Since the national rollout of HPV vaccination in 2007, there has been a significant fall in HPV infections in young women. This has had a profound impact on the National Cervical Screening Program, which has traditionally relied on performing two-yearly Pap smears. This situation prompted a major national review, and Professor Canfell’s research team provided the evidence base that has informed changes to the national cervical screening program.

The research

• Professor Canfell’s team has shown that moving from two-yearly Pap smears to testing every five years for the presence of the HPV virus itself would reduce cervical cancer rates by up to 20% or more.
• This benefit will be achieved even though women will only need to be screened 10 times, compared to the current 26 times in a lifetime. The program will also
  be much more cost-effective.
• It is this ‘win-win’ situation that has driven a decision to overhaul the way screening is conducted. In 2014, the Australian Government announced that the national screening program will transition to HPV-based cervical screening by December 2017.

The impact

The new cervical screening program positions Australia as the first country to implement a truly integrated approach to screening in the context of HPV vaccination.

Professor Canfell’s team has recently performed a systematic review and further modelling to support the development of national clinical guidelines for this new screening program. Understanding of the new program is also being gained through the world’s first trial of cervical screening in an HPV-vaccinated population, which is known as Compass.

Cancer Council NSW researchers are collaborating with the Victorian Cytology Service to recruit over 120,000 women to Compass. Compass will provide critical information about cervical screening in our population, and also provide data to other countries grappling with the challenges of optimising cervical screening in the era of the HPV vaccine.