Notes on the data: Screening programs - Cervical screening

Cervical screening outcomes - High grade abnormality, females aged 20 to 69 years, 2013 and 2014 (NSW, Vic, WA, SA and ACT)

 

Policy context:  Cervical cancer is one of the most preventable and curable cancers. It is the nineteenth most frequent cause of cancer deaths in Australian women; and it is estimated that up to 90% of the commonest type of cervical cancer may be prevented, if cell changes are detected and treated early [1]. Cervical cancer is a rare outcome of persistent infection with human papillomavirus (HPV), and infection with a high-risk HPV type is necessary, although not sufficient, for the development of cervical cancer [2]. On screening, high-grade abnormalities can occur after persistent infection with HPV [1]. The probability of a high-grade abnormality progressing to cancer increases with age and extent of abnormality [3], but is still a very rare outcome, with regression rates for high-grade abnormalities estimated to be at least 80% [4].

Incidence and mortality of cervical cancer in Australia remain low, consistent with the National Screening Program's aim to reduce incidence and mortality. In Australia, there were 9.2 new cases per 100,000 women in 2005, and 1.9 deaths per 100,000 women in 2006 (aged 20-69 years) [1]. However, incidence for Aboriginal and Torres Strait Islander women has been estimated to be more than double, and mortality to be five times, that of other Australian women [5].

References

  1. Australian Institute of Health and Welfare (AIHW). Cervical screening in Australia 2010-2011. (AIHW Cat. no. CAN 72). Canberra: AIHW; 2013.
  2. Bosch FX, Lorincz A, Muñoz N, Meijer CJ, Shah KV. The causal relation between human papillomavirus and cervical cancer. J Clin Pathol. 2002;55(4):244-65.
  3. National Health and Medical Research Council (NHMRC). Screening to prevent cervical cancer: guidelines for the management of asymptomatic women with screen detected abnormalities. (Reference no. WH39). Canberra: NHMRC; 2005 [cited 2013 Oct 18]. Available from: http://www.nhmrc.gov.au/guidelines/publications/wh39
  4. Raffle AE, Alden B, Quinn M, Babb PJ, Brett MT. Outcomes of screening to prevent cancer: analysis of cumulative incidence of cervical abnormality and modelling of cases and deaths prevented. BMJ. 2003;326(7395):901.
  5. Australian Bureau of Statistics (ABS) & AIHW. The health and welfare of Australia's Aboriginal and Torres Strait Islander peoples 2008. (ABS Cat. no. 4704.0; AIHW Cat. no. IHW 21). Canberra: ABS & AIHW; 2008.
 

Notes:  Cervical screening outcomes for the 24 month period to the end of each calendar year are based on the number of women with an abnormal pap smear as an age-standardised rate of the number of women screened in the corresponding calendar years. If a woman has attended more than once in the 24 months with two high-grade abnormality results, she is counted once only, and her age is taken from the first visit.

High grade abnormalities are cytology test results S4, S5, S6, E3, E4 and E5 according to the national cytology coding schedule.

ACT totals include all of postcode 2618, although approximately 50% of the population in this postcode resides in NSW.

Rates of high grade abnormality within geographic areas along the Victorian and New South Wales borders, specifically the Murray PHN and the Albury Local Government Authority, may be under estimated because women tested in Victoria but who reside in New South Wales may not be fully allocated to the New South Wales geographic area.

Data are not available for Queensland, Tasmania and the Northern Territory.

 

Numerator:  Number of individual women aged 20 to 69 years with a high grade abnormality detected (cytology) over a 24 month period ending 31 December 2014

 

Denominator:  Number of women aged 20 to 69 years screened over a 24 month period ending 31 December 2014

 

Detail of analysis:  Indirectly age-standardised rate per 1,000 women screened; the standard population is the population of each respective jurisdiction

 

Source:  Compiled by PHIDU based on data from the NSW Department of Health and NSW Central Cancer Registry, 2013 and 2014; Victorian Cervical Cytology Register, 2013 and 2014; SA Cervix Screening Program, 2013 and 2014; Western Australia Cervical Cytology Register, 2013 and 2014; and ACT Cytology Register, 2013 and 2014.

 

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