1.1.1 Immunisation

The number of new cases of cervical cancer is likely to be dramatically reduced as the benefits of human papillomavirus (HPV) vaccination are realised (Hall et al. 2018). It is likely that in the future, cervical cancer will largely (but not exclusively) be confined to women who have not been immunised, or for whom immunisation comes well after exposure to HPV.

Three HPV vaccines are registered for use in Australia – Gardasil, Gardasil 9 and Cervarix. All three vaccines protect against the two high risk HPV types (16 and 18) which are associated with around 70 per cent of cervical cancers in Australian women. Gardasil and Gardasil 9 also protect against two low risk HPV types (6 and 11), which cause 90% of genital warts (Cancer Council Australia, 2017). Gardasil 9 replaced Gardasil on the National Immunisation Program in January 2018, Gardasil 9 commenced use in the NHVP program for 12 and 13-year-old girls and boys. This is protecting against an additional five strains of HPV (31, 33, 45, 52 and 58), and predicted to further reduce the incidence of cervical cancer (Simms K T el al 2016). HPV vaccination is delivered via a school-based program to adolescent females and males in years 7 or 8 (i.e. aged 12 to 13 years) as part of the National Immunisation Program, with a catch up program available to individuals (females and males) up to the age of 19 years.