Australia is racing to become the first country in the world to eliminate a form of cancer—cervical cancer—and new evidence suggests it may reach that goal within a decade.
The nation has adopted a two-pronged strategy: widespread vaccination against human papillomavirus (HPV) and a modern screening program. Since 2007, Australian schools have offered the HPV vaccine to 12- and 13-year-olds, and in 2013 the program was expanded to include boys. The vaccine, Gardasil, was developed by University of Queensland scientists and approved in 2006.
Alongside vaccination, Australia transitioned from Pap smears to a more sensitive HPV-based screening test in 2017, which is required only every five years. Women can also collect their own samples, a move the government calls a "game-changer" for those avoiding pelvic exams.
According to a recent assessment, Australia is on track to reduce cervical cancer to fewer than four cases per 100,000 people by 2035—the WHO definition of elimination. Incidence and mortality rates have already halved since 1982. Remarkably, for the first time in 2021, no cervical cancer cases were diagnosed in women under 25.
However, challenges remain. Vaccination rates have declined slightly, especially among Aboriginal and Torres Strait Islander communities, where cervical cancer rates are twice as high and death rates more than triple those of the broader population. Researchers point to vaccine hesitancy post-COVID, rising healthcare costs, and missed school vaccinations as barriers. Indigenous women may not benefit from elimination until 2047—12 years after the national target.
For patients like Chrissy Walters, a 39-year-old mother diagnosed with advanced cervical cancer after a major bleed, the progress is bittersweet. Her now-12-year-old daughter is part of the generation that may never face the disease. Walters, whose cancer has spread and is considered terminal, says, "I would never wish this on my worst enemy." But she takes comfort that her daughter will receive the HPV vaccine next year.
Professor Karen Canfell, a leading epidemiologist, hopes Australia's success will inspire global action. "Public health innovations in Australia gave a general exemplar for WHO to follow," she said. Yet replicating this success in low- and middle-income countries will require significant investment.
Australia's journey shows that eliminating a cancer is possible—but only with sustained effort and equity in healthcare access.