Experts urge urgent action as HPV vaccination drops and more than one in four eligible women miss timely screening.
Australia remains on course to eliminate cervical cancer as a public health problem, but progress is under rising threat from falling HPV vaccination and cervical screening rates.
That’s according to the 2025 Cervical Cancer Elimination Progress Report released by the NHMRC Centre of Research Excellence in Cervical Cancer Control (C4).
The report, produced by researchers from the University of Sydney, University of Melbourne, UNSW’s Kirby Institute, the Australian National University and the Australian Centre for the Prevention of Cervical Cancer, highlights both remarkable gains and growing vulnerabilities in Australia’s elimination efforts.
Among the most striking findings is that no cervical cancer cases were recorded in Australian women under 25 in 2021, the most recent year of national data.
Researchers attribute this milestone to the long-standing success of the HPV vaccination program, introduced in 2007.
Cancer survival improved in 2017-2021 compared to the previous period (five-year relative survival 76.8% in 2017-2021, compared to 73.9% in 2012-2016), however the data showed an ongoing disparity for Indigenous women in overall survival (64.3% at five years, compared to 74.6% in non-Indigenous women; relative survival not available by Indigenous status) that needed to be addressed.
Associate Professor Megan Smith from the University of Sydney said the results demonstrate the vaccine’s impact but warned that screening remains essential for those who are unvaccinated or under-vaccinated.
“While this is a great result, the key to reducing cervical cancer burden in unvaccinated populations is screening and improved targeting of services to disadvantaged groups, such as First Nations people, who experience far higher incidence and mortality rates than the general population,” she said.
The report showed 85% of Australian women aged 35-39 years have had at least one HPV test in their lifetime but also revealed that more than one in four women who are eligible for cervical screening are now overdue.
This marks a decline for the second year in a row and comes despite the broader availability of self-collection (a self-taken vaginal specimen) as part of the National Cervical Screening Program. Self-collection is now chosen by almost half of participants as their preferred screening method.
“We are seeing some improvements, including in the 35- to 39-year-old age group, even in very remote areas,” said Professor Smith.
“But with 15% of that age group having never had a screening test in their lifetime, and only 50% of 25- to 29-year-olds being up to date with screening, we need to promote tailored strategies such as HPV self-collection.”
Vaccination coverage is also slipping. HPV vaccine coverage by the age of 15 years fell to just under 80% from a peak of almost 86% in 2020 among both girls and boys, the report showed.
“The vast majority of all cervical cancers are caused by human papillomaviruses, particularly HPV types 16 and 18,” said Professor Smith.
“HPV vaccines and HPV-based cervical screening are our future-proofing – they are our best insurance, and together vaccination and screening will lead to cervical cancer rates so low that the disease is expected to be eliminated as a public health problem by 2035.”
Co-author Julia Brotherton, Professor of Cancer Prevention Policy at the University of Melbourne, emphasised the importance of all young people being vaccinated against HPV.
“This highly effective and safe vaccine prevents cervical cancer and other HPV-related cancers such as anal and throat cancers, using just a single dose,” Professor Brotherton said.
“Parents should think of this as a gift they can give their child to protect them for their lifetime. 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.”
Co-author Dr Dorothy Machalek, epidemiologist and HPV vaccine and surveillance expert at the Kirby Institute, said maintaining progress toward elimination requires investment in better, more timely data, particularly to monitor equity across populations.
“Our national elimination strategy is centred on achieving cervical cancer elimination for all. But our report continues to show that some groups are at high risk of being left behind unless we act now,” Professor Machalek said.
“We need to focus our efforts on collecting better and more timely data so we can better develop effective solutions.”
The authors called for coordinated national efforts from stakeholders to reverse declines in both vaccination and screening participation, and provided a number of recommendations to achieve this, including:
- Address ongoing declines in HPV vaccination coverage.
- Revitalise school-based immunisation approaches to better suit the current environment.
- Prioritise vaccination equity for Aboriginal and Torres Strait Islander adolescents.
- Address declining screening participation rates.
- Resolve data gaps in screening data for Aboriginal and Torres Strait Islander women.
- Enable better use of existing data so elimination indicators can be reported for more priority populations and by vaccination status.
- Review suppression rules for small counts in reporting.
- Enhance and accelerate national cancer data reporting and release.
- Develop a cervical cancer treatment monitoring framework.
This fifth annual report from C4 builds on more than a decade of research that has supported major innovations in HPV vaccination and HPV-based cervical screening – innovations that have put Australia at the forefront of global cervical cancer elimination efforts.
Read the full report here.
