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VCS FOUNDATION STRATEGIC PLAN 2020-2025
TWO SUPPORT AUSTRALIA’S EFFORTS TO ELIMINATE CERVICAL CANCER AS A PUBLIC HEALTH PROBLEM BY 2035
It is estimated that cervical cancer is likely to be eliminated as a public health problem (incidence <4 per 100,0000) in Australia by 2035, as the achievements of our previous cytology-based screening program, impacts of HPV vaccination and effect of the current HPV-based cervical screening program are realised. Challenges remain however, in ensuring elimination is achieved equitably and that its achievement and maintenance are not undermined by falls in participation in vaccination or screening. As described in the 2021 C4 CRE Monitoring Report (section 6), lower participation rates in cervical screening occur in rural and remote Australia, in areas of socio-economic disadvantage, amongst culturally and linguistically diverse groups of women, and also in Indigenous women. Aboriginal and Torres Strait Islander women continue to carry an inequitable burden of cervical cancer with incidence and mortality rates two and nearly four times higher than other Australians, respectively. HPV vaccination completion rates are also lower amongst Aboriginal and Torres Strait Islander students and those living in remote areas. Whether there is equity in access to and timeliness of treatment for cervical pre cancer and cancer is also currently unknown.
SUPPORTING EQUITY IN ELIMINATION VCS Foundation is committed to practically supporting equity across cervical cancer prevention initiatives and we do this is in the way we work, through our partnerships and advocacy, and providing policy relevant research and evaluation to support best practice. For example, we know that many people face challenges to screening because they may feel unsafe or unsupported to request a cervical screening test from their health care practitioner, may be people living with a disability who experience difficulty accessing suitable screening services, or have experienced trauma and are fearful of or distressed by cervical screening. VCS Foundation led program initiatives such as selfcollection and telehealth consultations will be an alternative pathway in Australia that can help to overcome such barriers to having a clinician-collected cervical screening test. These initiatives, as well as membership of government working parties and successful delivery of contracted tenders and research to support implementation, mean that VCS Foundation is providing our expertise and advocacy to support the likely policy transition to universally available self-collection. We also passionately believe that no person, and no groups of people, should be left behind as Australia pursues elimination. Our partnerships with leading Indigenous researchers and communities are about ensuring we play our part in closing the gap in cervical
cancer burden for Aboriginal and Torres Strait Islander people. Two examples of our work in this important area are:
Yarning about HPV Vaccination: a qualitative study of factors influencing HPV vaccination among Aboriginal and Torres Strait Islander adolescents in Australia This project is part of the TACTICS NHMRC Centre for Research Excellence, in which Professor Julia Brotherton co-leads the vaccination and screening stream with A/Prof Lisa Whop from the National Centre for Epidemiology and Population Health, Australian National University. The study is seeking to identify the factors influencing HPV vaccination among Aboriginal and Torres Strait Islander adolescents in Australia. The project is a critical step in addressing the burden of cervical cancer among Aboriginal and Torres Strait Islander women. Equitable access to primary prevention through HPV vaccination has the potential to reduce disparities in cervical cancer outcomes for Aboriginal and Torres Strait Islander women in Australia. Refer to the publication – Whop LJ, Butler TL, Brotherton JML, et al Study protocol: Yarning about HPV Vaccination: a qualitative study of factors influencing HPV vaccination among Aboriginal and Torres Strait Islander adolescents in AustraliaBMJ Open 2021;11:e047890. doi: 10.1136/ bmjopen-2020-047890
