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Australia has passed a significant milestone in the quest to eliminate cervical cancer, recording zero new cases in people younger than 25 years in 2021, an achievement that has been attributed to the national HPV vaccination program.

The 2025 Cervical Cancer Elimination Progress Report found that the national incidence of cervical cancer in 2021 was 6.3 cases per 100,000 women, down from 6.6 cases per 100,000 in 2020, and a step closer to the World Health Organization’s 2030 target of fewer than four new cases per 100,000 per year.

However, the rates of cervical cancer were three times higher among Indigenous women and two times higher among women living in remote areas than among the general population of women.

Australia launched a national, free vaccination program against the human papillomavirus (HPV), estimated to cause around 99.7% of all cervical cancer worldwide, in 2007. It initially targeted girls aged 12-17 years but then expanded to women aged 27 years or younger. In 2013, boys also became eligible for the vaccine, which was administered through the school vaccination program.

" The fact that we’ve had now a year where no young woman and her family has had to go through that is quite remarkable. "
- Julia Brotherton, MD, PhD

While cervical cancer is relatively rare in women younger than 25 years, public health physician and epidemiologist Julia Brotherton, MD, PhD, from the University of Melbourne, Melbourne, said they were at risk for particularly aggressive types of HPV that could rapidly develop into cancer.

“The fact that we’ve had now a year where no young woman and her family has had to go through that is quite remarkable,” Brotherton, who was involved with the report, told Medscape News Australia. “We’ve really seen an absolute crashing of infection in young people with those very oncogenic, those very nasty HPV types, 16 and 18 in particular.”

Brotherton said that when the vaccination program was launched, around 20% of young people were experiencing infection with these highly cancer-causing types, whereas the incidence is now at around 1%.

“There’s no doubt in my mind that this is due to the remarkable impacts of the HPV vaccine, and it’s also consistent with what other countries have seen that have had high uptake programs,” she said.

Australia’s national vaccination program uses a vaccine that protects against nine types of HPV, including the oncogenic 16 and 18 types that are responsible for around 70% of all cervical cancers. The national prevalence of infection with HPV 16 and 18 in women and girls aged 25-74 years dropped to just 1.4% in 2024.

But it isn’t all good news. While vaccine uptake among girls younger than 15 is high at 81.1% in 2024, that figure is down 3.1% from the previous year and reflects an ongoing decline since 2020. Uptake is also lower among Indigenous girls and in remote areas.

“The bad news is our vaccine coverage is going down, which is incredibly disappointing, but it is probably very multifactorial,” Brotherton said, suggesting the drop results from a combination of lower school attendance, disruptions to programs during the pandemic, and other demands of life taking priority. “This is not all vaccine hesitancy,” she said.

Australia also has a national cervical cancer screening program, which began in 1991 with Pap smears and in 2017 moved to 5-yearly HPV testing, including the option for self-testing. Nearly three quarters of women were reported to be up-to-date with their screening in 2024, although that figure was much lower in those aged 25-29 years (50%), aged 30-34 years (68%), and those in disadvantaged areas.

" The bad news is our vaccine coverage is going down, which is incredibly disappointing. "
- Brotherton

Clinical microbiologist and sexual health physician Suzanne Garland, MD, director of the Women’s Centre for Infectious Diseases at The Royal Women’s Hospital in Melbourne, said she had been waiting with bated breath for these data to be released and that it marked a “wonderful” milestone.

“One of the things in this report that’s remarkable is that, if you reduce the pool of infectious virus circulating in the community, clearly you reduce the disease, even though the disease takes a long time to happen,” Garland, who is also involved with cervical cancer research, told Medscape News Australia.

Even though Australia has fairly comprehensive surveillance and data linkage for cervical cancer and HPV screening and vaccination, it did take a few years for the data on cervical cancer incidence to become available. “We’re a little bit slow in gathering all of the data,” Garland said. “It would be nice to see that to 2024/2025 at least because then we might see more of an effect.”

While the findings were welcomed, Garland said it is important to be vigilant and remind people that these are safe and effective vaccines. “We’re hoping we’re going to be the first country to see the elimination, meaning making it a rare disease with less than four per 100,000,” she said.

The study was funded by the Australian National Health and Medical Research Council. Garland reported receiving funding from the National Health and Medical Research Council.

Source:
Adapted from Medscape https://www.medscape.com/viewarticle/australian-hpv-vaccination-marks-cervical-cancer-milestone-2025a1000y4e

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