Cervical screening in Australia has been successful in reducing the incidence and mortality of cervical cancer.
Declines in cervical cancer incidence and mortality following the introduction of universal healthcare in Australia in 1975 probably resulted from greater access to Pap testing, earlier access to diagnosis and treatment services, and improved effectiveness of treatment.
There was a sustained decline in the incidence of cervical cancer in New South Wales (NSW) after the introduction of the NSW Cervical Screening Programme in 1992, followed 3 years later by a sustained decrease in mortality from cervical cancer. The substantial reduction is largely the result of the implementation of a population-based organized cervical screening programme.
Hong Kong’s cervical cancer rates have declined since cervical screening first became available in the 1960s and routine cytology was systematically introduced as part of antenatal care in the 1980s. The overall age-adjusted incidence of cervical cancer in Hong Kong decreased from 24.9/100,000 in 1972–1974 to 9.5/100,000 in 1999-2001.
In another recent study, cervical cancer incidence and mortality statistics in Hong Kong were examined to estimate the potential number of cancer cases that could be averted and life-years saved after the launch of an organised, population-based cytologic screening recall programme in 2004. The estimated numbers of cases projected to be preventable from 2002 to 2016 with organised screening every 1, 3 and 5 years were 4226, 3778 and 2334, respectively.
Although screening has had a major effect on cervical cancer incidence, there is a need for improvement, as there is still a risk of cervical cancer in screened populations. In the UK, the predicted cumulative lifetime incidence of invasive cervical cancer is 1.70% in the absence of screening and 0.77% with pre-2003 screening practice.
A mathematical model of cervical HPV infection, CIN and invasive cervical cancer in the UK predicted a reduction in lifetime incidence to 0.46% if the sensitivity of the screening test regime was increased from its current average of 56% to 90%. This suggests that increasing the sensitivity of screening tests has the potential to further reduce the burden of cervical cancer.