New cervical screening framework needed when HPV vaccine takes effect

Government should set a timeline and framework for ensuring cervical cancer screening and human papillomavirus immunisation work together to further reduce cervical cancer burden in Australia, according to a report released by The Cancer Council Australia.

Releasing the recommendations of a "roundtable" meeting of Australian experts, the Cancer Council’s Chief Executive Officer, Professor Ian Olver, said the vaccine’s introduction would raise questions about cervical screening intervals and cost-effectiveness, and could lead to potential confusion about how the two programs work together.

"Australia’s cervical cancer screening program is the main reason incidence in women aged 20 to 69 halved between 1991 and 2005, while HPV immunisation has the potential to prevent up to 70 per cent of cervical cancers," Professor Olver said.

"As girls who have been vaccinated reach the screening age range of 18 to 20, we are likely to see fewer abnormalities and will need to look at screening intervals and pathology workforce.

"An evidence-based approach to policy and public information will help to ensure these two different approaches to cervical cancer prevention combine to further reduce incidence and mortality."

Cancer Council Australia President, Professor Ian Frazer, whose research team developed the HPV vaccine, said Australia was a world leader in reducing cervical cancer mortality using Pap testing.

"HPV immunisation has the potential to further reduce cervical cancer mortality, but it is vitally important that Australian women continue to be screened through Pap testing for pre-cancerous abnormalities and that they receive clear advice," Professor Frazer said.

The Cancer Council today also released the HPV immunisation chapter of its National Cancer Prevention Policy, which identifies opportunities for the vaccine to reduce cultural inequities in cervical cancer mortality.

Professor Frazer said Australia had a highly effective cervical cancer screening program but its success had not been shared equally, with Aboriginal and Torres Strait Islander women having "significantly higher cervical cancer mortality rates".

"As recommended in this new chapter of our National Cancer Prevention Policy, the government should continue to develop strategies to facilitate HPV immunisation among Aboriginal girls and women, who are at significantly higher risk of cervical cancer largely because of lower participation in screening."

Both reports can be found at: www.cancer.org.au/publications

(Source: The Cancer Council Australia: March 2008)