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The renewal of the National Cervical Screening Program

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Australia has a good record in reducing cervical cancer rates — but strategies must change with new knowledge

It is an unfortunate fact that cervical cancer remains common and deadly throughout the world. It is estimated that each year 500 000 women develop cervical cancer, and that 250 000 women die of the disease.1 In Australia, cervical cancer also continues to be deadly, but the numbers of affected women are substantially lower than overseas, primarily as the result of an integrated and coordinated national screening strategy.2

Before 1991, Australian women underwent opportunistic screening for cervical cancer, usually annually. From 1991, a national, coordinated approach was implemented, the National Cervical Screening Program (NCSP), which included Pap tests (cervical smears) for women aged 18–70 years every 2 years. This approach has resulted in a significant reduction — nearly 50% — in the incidence of cervical cancer as a direct consequence of the diagnosis and treatment of pre-invasive cervical disease.3

Despite this success, the sensitivity and specificity of the Pap test are relatively low, each being estimated at 60–70%.4 Alternative strategies that either supplement or replace the Pap test have therefore been evaluated, including liquid-based…