Bryan Knight
Southern IML Pathology Laboratory, Australia
Title: The change to HPV DNA testing in the Australian National Cervical Cancer Screening Program
Biography
Biography: Bryan Knight
Abstract
The Australian National Cervical Cancer Screening Program commenced in 1982 and has reduced the incidence of cervical cancer from 20 per 100,000 women to 9 per 100,000 in 2010. The rate of reduction of cancers has leveled off and remained relatively unchanged since 2010. In 2007, a National HPV Vaccine program for girls and young women was commenced and in 2009 it became school based and expanded to include boys. Up-take of the quadrivalent vaccine is in the region of 85% and the incidence of HPV-related high-grade lesions has fallen in the vaccinated population. There has been a reduction in prevalence of high-grade lesions in older unvaccinated women, suggesting a herd-immunity effect. With the reduced incidence of cervical lesions, detection of abnormal smears on conventional Papanicolaou smears will become more difficult. In the HPV vaccine era, a more sensitive and specific test with a high negative predictive value is needed, predicating a change to HPV DNA testing. Numerous studies have shown that HPV DNA testing with partial genotyping confers the most cost-effective and effective means of population based cervical screening. The Renewed Cervical Screening Program commences in December 2017. Implementation of a new National Cancer Screening Register will change the way women are invited to screening or recalled for follow-up and will reduce under-screening. A new initiative to screen woman who for cultural or other reasons have not been screened, will enhance the efficacy of the program. A further reduction of the incidence of cervical cancer in Australia is anticipated.