The projected timeframe until cervical cancer elimination in Australia: a modelling study

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.

They 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.