Oral Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2023

Overview of the Australian and global strategies  (#46)

Karen Canfell 1
  1. Cancer Council NSW, Woolloomooloo, NSW, Australia

Cervical cancer is caused by the human papillomavirus (HPV). In more than half of countries worldwide, cervical cancer is among the three most frequent cancers in women of all ages. Cervical cancer was responsible for over 340,000 deaths globally in 2020, with the large majority of these in low and middle-income countries (LMIC).  However, cervical cancer is eminently preventable and treatable. The ‘three pillars’ of cervical cancer control are prophylactic vaccination of young adolescents against HPV, cervical screening with primary HPV testing followed by treatment of precancerous lesions in mid-adult and older women, and access to effective cervical cancer treatment services including surgery, radiotherapy, chemotherapy and supportive/palliative care.  Australia is an exemplar in this space – it was the first country in the world to introduce a national publicly- funded HPV vaccination program (in 2006-7) and it was one of the first countries to transition to HPV-based screening (in 2017). Australia is on track to achieve the goal of eliminating cervical cancer as a public health problem by 2035. However, to achieve this ambitious goal, all women and people with a cervix, particularly within disadvantaged communities including Indigenous and culturally diverse Australian communities, must be able to access community-led, co-designed solutions to culturally appropriate care. Building on the experience and evidence developed in Australia and other high-income counties, in 2018, the World Health Organisation called for action towards achieving the global elimination of cervical cancer. Subsequently a strategic plan encompassing elimination goals and 2030 ‘90-70-90’ coverage targets for vaccination, screening and treatment has been developed. The elimination initiative was launched in late 2020 and if scaleup to the intervention targets can be achieved, over 74M cases and 62M deaths could be averted in LMIC, with all countries achieving elimination at a threshold of 4 per 100,000 per annum over the next century. This talk will discuss the Australian experience and contributions to building the evidence supporting the efficacy of HPV vaccination and cervical screening, and the modelling that underpins the WHO strategic plan and the subsequent development of new WHO HPV screening and treatment guidelines. It will also touch upon the current challenges around implementation and some of the innovative technical and system-level solutions being used to overcome the challenges.