In 2017, Australia is moving to a new state-of-the-art, evidence-based cervical screening program using primary human papillomavirus (HPV) DNA testing for all women, whether they have received HPV vaccination or not. Commencing HPV screening at 25 years of age is only possible in the context of a decrease in high-risk HPV prevalence in young women. This is because in an unvaccinated population of young women, infection with HPV (particularly the most oncogenic types, HPV 16 and 18) is common and would result in over-referral of women who test positive for HPV 16 or 18 to colposcopy for infections never destined to persist or cause disease. Since the implementation of the quadrivalent HPV vaccination program in Australia between 2007 and 2009, when over half of all women aged 12–26 years were fully vaccinated, the prevalence of HPV 16 and 18 in young women has declined dramatically.1,2
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- 2. Tabrizi SN, Brotherton JM, Kaldor JM, et al. Assessment of herd immunity and cross-protection following a human papillomavirus vaccination programme: a repeat cross-sectional study. Lancet Infect Dis 2014; 14: 958-966.
- 3. Brotherton JML, Malloy M, Budd AC, et al. Effectiveness of less than three doses of quadrivalent human papillomavirus vaccine against cervical intraepithelial neoplasia when administered using a standard dose spacing schedule: observational cohort of young women in Australia. Papillomavirus Res 2015; 1: 59-73.
- 4. Mullins R, Coomber K, Broun K, Wakefield M. Promoting cervical screening after introduction of the human papillomavirus vaccine: the effect of repeated mass media campaigns. J Med Screen 2013; 20: 27-32.
- 5. Casey GM, Morris B, Burnell M, et al. Celebrities and screening: a measurable impact on high-grade cervical neoplasia diagnosis from the “Jade Goody effect” in the UK. Br J Cancer 2013; 109: 1192-1197.
- 6. Medical Services Advisory Committee. National Cervical Screening Program renewal: effectiveness modelling and economic evaluation in the Australian setting (MSAC application no. 1276.) Canberra: Commonwealth of Australia, 2013. http://www.cancerscreening.gov.au/internet/screening/publishing.nsf/Content/E6A211A6FFC29E2CCA257CED007FB678/$File/Renewal%20Economic%20Evaluation.pdf (accessed Dec 2015).
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