The World Health Organization has a global goal to eliminate cervical cancer, requiring all countries to reach fewer than 4 cases per 100,000 women.
While Australia is on track to meet its 2035 target, a study has found that cervical cancer elimination for Aboriginal and Torres Strait Islander women will take 12 years longer to be achieved.
Incidence rates in Aboriginal and Torres Strait Islander women are approximately twice as high as the national rate, currently at 11.7 cases per 100,000 women compared to 6.3 cases per 100,000 women.
Vaccination has brought overall cervical cancer rates down, but starting from such high numbers simply means cases in Indigenous women will take longer to fall.
“Vaccination absolutely works but it just doesn’t change things quickly,” Associate Professor Megan Smith from the University of Sydney’s Cancer Elimination Collaboration told the SSH.
The solution is cervical screening, the most effective short-term prevention.
Cervical screening detects abnormalities in the cervix. It has been a national program for 35 years, freely available for women aged 25 to 75. However, Professor Smith said the disparity stems from decades of Aboriginal women – especially those in remote areas – not having the same access.
“What we really need to do is ensure that everybody gets the benefits of vaccination and screening treatment that Australia in theory offers,” she said.
“If you could make sure every Aboriginal and Torres Strait Islander woman was screened at least once, that would be the single most powerful thing you could do to bring forward the timing of cervical cancer elimination.”
Cervical cancer is the fourth most common cancer among women worldwide. It is caused by the human papillomavirus (HPV), a sexually transmitted disease which can cause infected cervical cells to replicate uncontrollably.
Cervical cancer has a 76.8% survival rate. However, Professor Smith emphasised that the disease must be detected early.
“You don’t get screened because you’ve got cancer, you pick up something before it’s cancer.”
Traditionally, doctors use a speculum and swab to examine the cervix, but now women have the option to do a self-collection test.
Participation is encouraged by the greater sense of privacy, fast test results, ease of use and lack of shame when taking the sample themselves.
“It just gives people more choice and it gives services options to take screening into the community rather than having it in a clinic setting,” said Professor Smith.
“There are real shortages of GPs in some parts of Australia, so having a convenient way of accessing something like self-collection could help that.”
In Western Australia’s remote Kimberley region, women have access to self-collection, immediate HPV testing and same-day specialist follow-up through culturally respectful community programs, guided by Aboriginal leadership.
The creation of these safe, welcoming health spaces has been well received by the community, with many women recommending the services to others.
“This isn’t about inventing new solutions but backing what communities already know works,” said Professor Lisa Whop from the National Centre for Aboriginal and Torres Strait Islander Wellbeing Research at the Australian National University.
“A concerted effort, funded by government and led by Aboriginal and Torres Strait Islander communities, will help to overcome longstanding inequities in cervical cancer screening.”
