{"entity":{"id":"paper-hall-cervical-elimination-australia-lancet-public-health-2019","kind":"paper","name":"The projected timeframe until cervical cancer elimination in Australia: a modelling study","aka":[],"tldr":"A model of Australia's vaccination and screening programmes that projected cervical cancer falling below 4 cases per 100,000 women by about 2028, the threshold the national elimination strategy later adopted.","summary":"Australia introduced a national HPV vaccination programme in 2007, extended it to boys from 2013 and changed from the quadrivalent to the nonavalent vaccine from 2018; in December 2017 organised screening moved from two-yearly cytology to primary HPV testing every five years from 25 to 69, with exit testing at 70 to 74. The authors used Policy1-Cervix, a validated dynamic model of HPV vaccination, natural history and screening, to project age-standardised cervical cancer incidence, then about seven cases per 100,000 women, from 2015 to 2100.\n\nThey estimated incidence falling below six per 100,000 by 2020 (range 2018-22) and below four per 100,000 by 2028 (2021-35), and mortality below one death per 100,000 by 2034 (2025-47). Incidence would stay below one per 100,000 from 2066 if five-yearly screening continues in vaccinated cohorts, or below three if it does not. The exact year depends on the standard population, screening behaviour, test characteristics, herd effects from vaccinating boys and assumptions about hysterectomy.","asOf":"2026-11-03","links":[{"label":"The Lancet Public Health 2019","url":"https://doi.org/10.1016/S2468-2667(18)30183-X"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/30291040/"}],"tags":[],"related":[],"cancers":["cervical"],"sections":["prevention"],"technologies":["hpv-vaccine"],"targets":[],"drugs":[],"companies":[],"institutions":["acpcc"],"pathways":[],"terms":[],"trials":[],"people":["karen-canfell","ian-frazer"],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"journal":"The Lancet Public Health","year":2019,"doi":"10.1016/S2468-2667(18)30183-X","pmid":"30291040","authors":"Hall MT, Simms KT, Lew JB, Smith MA, Brotherton JM, Saville M, Frazer IH, Canfell K","paperType":"methods","findings":["Projected incidence below 6 per 100,000 women by 2020 (2018-22) and below 4 per 100,000 by 2028 (2021-35).","Projected mortality below 1 per 100,000 by 2034 (2025-47).","From 2066 (2054-77) incidence below 1 per 100,000 if HPV screening continues in nonavalent-vaccinated cohorts, below 3 if those cohorts are not screened."],"whatItMeans":"It put a date on elimination for the first time in any country, and the threshold it used, four cases per 100,000 women, is the one in the national strategy that aims for elimination by 2035.","caveats":["A model, not an observation: the year depends on the population used for age-standardisation, screening behaviour, test performance, herd immunity from vaccinating men and the future frequency of benign hysterectomy.","The authors stress that vaccination and screening must be maintained after the threshold is reached."]},"route":"/key-papers/paper-hall-cervical-elimination-australia-lancet-public-health-2019/","neighbours":{"cancer":[{"id":"cervical","kind":"cancer","name":"Cervical cancer","route":"/cancers/cervical/"}],"section":[{"id":"prevention","kind":"section","name":"Prevention & Risk","route":"/fronts/prevention/"}],"technology":[{"id":"hpv-vaccine","kind":"technology","name":"HPV & HBV vaccination","route":"/technologies/hpv-vaccine/"}],"institution":[{"id":"acpcc","kind":"institution","name":"Australian Centre for the Prevention of Cervical Cancer","route":"/institutions/acpcc/"}],"person":[{"id":"ian-frazer","kind":"person","name":"Ian Frazer","route":"/people/ian-frazer/"},{"id":"karen-canfell","kind":"person","name":"Karen Canfell","route":"/people/karen-canfell/"}]}}