Cervical Cancer
The National Cervical Screening programme (NCSP) reduces illness and death from cervical cancer. Women and people with a cervix aged 25 to 74 years of age are invited to have a Cervical Screening Test every 5 years through their healthcare provider.
74.4% coverage rate over the 5-year reporting period
Cervical Screening Coverage Data
Definition
Coverage in cervical screening refers to the proportion of women aged 25–74 who had at least one HPV test or cytology test for any reason in Victoria in the five-year reporting period.
Coverage is measured over a 5-year reporting period and is based on calendar years, and is a key indicator for monitoring program participation timeliness.
Interpretation
As 2018-2022 was the first full 5-year reporting period for cervical screening coverage after the program renewal, a higher coverage rate was expected. The decline in coverage in 2019-2023 may be indicative of a delay in individuals returning for their next scheduled round of screening, particularly after the transition to HPV screening at the end of 2017. This is likely due to the rising cost of living and reduced access to bulk billing GPs. The overall reduction in cervical coverage was experienced across all areas and other monitoring suggests that this is an Australia wide issue¹.
Despite a decline in coverage overall, Victoria remains ahead of the national screening target to achieve cervical cancer elimination. The target is to screen 70% of eligible participants every five years. Victoria continues to achieve over 70% coverage for all age groups except those aged 70-74.
¹ Australian Institute of Health and Welfare (2024) National Cervical Screening Program monitoring report 2024, catalogue number CAN 163, AIHW, Australian Government:
435,119 cervical screening tests among eligible people aged 25-74
Cervical Screening Data
Definition
The number of cervical screening tests for any reasons, including self-collection tests, conducted in Victoria from Jan 2018 to Dec 2023 among women aged 25-74.
Interpretation
Cervical screening numbers measure the number of cervical screening tests in Victoria in 2023. This is a count of tests, not a count of women. Therefore, cervical screening numbers should not be directly compared with cervical coverage as coverage is calculated using the number of unique women who have completed a cervical screening test within a 5-year reporting period.
Looking at the various geographic stratifications for the total cervical screening volumes, both LPHUs and PHNs were closely aligned with population sizes, with larger populations corresponding to higher screening volumes whereas, smaller populations were associated with lower screening volumes.
The increased test volumes in 2023 correspond to women who screened in 2018 and 2019 becoming due for their next round of screening under the five-yearly screening interval introduced in 2017.
90,238 HPV self-collected tests were performed
Definition
The number of self-collected cervical screening tests performed by eligible people aged 25-74 over a 12-month period.
The uptake of self-collection tests is among all HPV tests performed by year.
“On-time” refers to eligible people who were less than two years overdue for screening (less than four years since last Pap screening test or less than 7 years since last HPV screening test).
“Under screened” refers to eligible people who were more than 2 years overdue for screening.
“Never screened” refers to eligible people who had no prior cervical screening tests.
Interpretation
From 1 July 2022, the eligibility criteria for accessing self-collection changed to enable all women and people with a cervix to access self-collection under the National Cervical Screening Program and availability was no longer restricted to under-screened or never-screened people.
The highest uptake of self-collection tests among all HPV tests was observed in the under-screened (32.4%) and never-screened people (26.7%) compared with people who screen on-time (19.3%).
This suggests that self-collection has been effective at reducing barriers to accessing cervical screening among under-screened and never-screened populations.
Regional LPHUs had a higher uptake of self-collected HPV testing compared to metropolitan LPHUs. In some regional LPHUs, nearly half of HPV tests were self-collected.
57.1% of participants proceeded to colposcopy
Time to Colposcopy
Definition
Time to colposcopy is defined as the number of days between the date of Cervical Screening Test (CST) and the date of the first subsequent colposcopy. Reported as a percentage, calculated as follows:
- Numerator: Number of women (with Victorian residential addresses at the time of the episode) who received a cervical screening test result in a calendar year which places them at higher risk of cervical abnormality within the next five years, and who completed a colposcopy.
- Denominator: Number of women (with Victorian addresses at the time of the episode) who received a cervical screening test result in a calendar year which places them at higher risk of cervical abnormality within the next five years.
Interpretation
In 2023, 57.1% of participants proceeded to colposcopy within 3 months following a screening test result with higher risk classification, which increased by 1.1% when compared to 2022.
77.4% of all those participants who were referred for colposcopy attended within 6 months in 2023.
Ongoing efforts are needed to ensure that services provide timely and appropriate colposcopy access to all participants and participants can prioritise attending appointments on-time.
Note:
These data only include women who had a higher-risk primary or follow-up test based on HPV and liquid-based cytology results. From 1 February 2021, women with an intermediate risk result on first follow-up test were managed as higher risk if they were aged 50+ years, were Indigenous, or were overdue for screening by at least 2 years. These women were directly referred to colposcopy but are not included in these data.
Further improvements to the calculation of this measure are ongoing, therefore caution in interpretation is advised.
Attendance data for “12 months” and “Ever attended” were excluded from this report as the comparison time periods for 2023 were incomplete at the time this report was produced.