Australia is on track to become the first country in the world to eliminate cervical cancer, but declining vaccination and screening rates are threatening to derail decades of progress, according to a new report released Saturday by the NHMRC Centre of Research Excellence in Cervical Cancer Control (C4).
The 2025 Cervical Cancer Elimination Progress Report, authored by researchers at the University of Sydney, the University of Melbourne, the Kirby Institute at UNSW, The Australian National University and the Australian Centre for the Prevention of Cervical Cancer (ACPCC), highlights the success of Australia’s multi-pronged approach to combating the disease, but warns that recent trends could reverse those gains.
Australia launched the National Cervical Cancer Screening Program in 1991, initially relying on Pap tests to detect precancerous cell changes. This program reduced cervical cancer cases and deaths by approximately 50%. In 2007, the country pioneered a national HPV vaccination program for young girls, leading to a significant drop in HPV infection rates and subsequent cervical pre-cancers. A further shift occurred in 2017 with the introduction of HPV-based cervical screening, directly testing for the presence of high-risk HPV types.
The introduction of a nine-valent HPV vaccine in 2018, protecting against nine cancer-causing HPV types (including the previously covered types 16 and 18), further bolstered prevention efforts. These advancements led to the launch of a national elimination strategy in 2023, setting ambitious five-year goals including 90% HPV vaccination coverage for both girls and boys, 70% screening participation for women aged 25-75, and 95% treatment of detected pre-cancers and cancers.
The report reveals encouraging data: cervical cancer rates have been slowly declining, falling from 6.6 cases per 100,000 women in 2020 to 6.3 cases per 100,000 in 2021. Remarkably, no cases of cervical cancer were diagnosed in women under 25 in 2021, a result researchers attribute to the widespread HPV vaccination program. HPV infection rates, particularly among younger women, are as well decreasing, with only 1% of women aged 25-29 testing positive for HPV types 16 or 18. Approximately 85% of women aged 35-39 have undergone at least one HPV test, significantly reducing their individual risk.
However, the report also reveals a concerning trend: vaccination and screening rates have been declining since the onset of the COVID-19 pandemic. HPV vaccination coverage among young people decreased from 85.7% in 2020 to 79.5% in 2024. More than one in four Australian women are now overdue for cervical cancer screening.
“Parents should think of this as a gift they can grant their child to protect them for their lifetime,” said Professor Julia Brotherton of the University of Melbourne, a co-author of the report. “And I urge all young people who missed out at school, for whatever reason, to talk to their GP, nurse or pharmacist about accessing their free catchup dose.”
Associate Professor Megan Smith from the University of Sydney’s Cancer Elimination Collaboration emphasized the need for tailored screening strategies. “We are seeing some improvements, including in the 35- to 39-year-old age group, even in incredibly remote areas. But with 15 percent of that age group having never had a screening test in their lifetime, and only 50 percent of 25- to 29-year-olds being up to date with screening, we need to promote tailored strategies such as HPV self-collection.”
The report also highlights disparities in access to prevention services. Indigenous Australians experience nearly double the national cervical cancer rate, with a significantly higher mortality rate. “Our national elimination strategy is centered on achieving cervical cancer elimination for all,” said Dorothy Machalek, an epidemiologist at the Kirby Institute and a co-author of the report. “But our report continues to reveal that some groups are at high risk of being left behind unless we act now. We need to focus our efforts on collecting better and more timely data so we can better develop effective solutions.”
The C4 report recommends revitalizing school vaccination programs, improving access for Aboriginal and Torres Strait Islander adolescents, piloting innovative screening methods, and strengthening national health data systems. The next report from C4 is expected in late 2026, and will provide further data on the effectiveness of current strategies and the impact of recent declines in vaccination and screening rates.
