HPV testing picks up cancers missed by Pap tests

New research by the Daffodil Centre, at Cancer Council NSW and the University of Sydney, has found that in a national analysis of Australia’s renewed National Cervical Screening Program (NCSP), which came into place on 1 December 2017, that the new HPV testing approach has picked up extra cancers that would have been missed by Pap Smear tests.

The study, published in the British Medical Journal this week, analyses data from the first two years of the NCSP which saw two-yearly Pap tests replaced with five-yearly cervical screening tests starting at age 25 that detect the presence of human papillomavirus (HPV). The analysis, led by Associate Professor Megan Smith, found that within the first two years of using the new cervical screening test, 90 cancers were detected that would not have been detected by a Pap test. A total of 546 cervical cancers were detected during this period through routine screening.

Associate Professor Smith said “Previous Daffodil Centre research predicted that the introduction of the new screening test would initially detect more cervical cancer, due to the more sensitive screening test, then lower cervical cancer incidence and mortality by at least 20% over the longer term. This review of the data from the first two years of the program shows us that the new screening test is working as expected, and builds on findings from the first phase of the Compass trial, a major trial of primary HPV screening which demonstrated increased detection of high grade precancerous changes to the cervix with primary HPV screening.”

The new research also confirms previous findings that HPV vaccination (introduced in 2007) has had a positive impact on the incidence of HPV types 16 and 18, which cause the majority of cervical cancers.

“HPV 16 and 18 are now relatively rare in younger women – those from age 25 to around 40. These women are the first to participate in cervical screening who would have also been offered HPV vaccination when they were younger” added Associate Professor Smith.

“Our findings are a clear indication that the renewed cervical screening program and the HPV vaccination program are working. This data shows Australia is well on track to become the first country in the world to eliminate cervical cancer.”

The NCSP will be further enhanced this year with the introduction of screening by self-collection. From July 2022, people eligible for cervical screening will have the option to collect their own screening sample.

“Screening by self-collection is a game-changer for eliminating cervical cancer sooner and in a more equitable way. Self-collection gives people more choice and control in the screening process, and will help us reach more women who are not currently participating in screening.”

Currently, participation is significantly lower in some groups including Indigenous women, some culturally and linguistically diverse communities, and in individuals experiencing socioeconomic barriers to organised screening.

To learn more about Australia’s cervical screening program, visit Cancer Council’s website cervicalscreening.org.au. If you still have questions, you can call Cancer Council on 13 11 20 and speak to a specially trained health professional for free.