Treatment Uptake Indicators

Cervical screening is important to expedite elimination of cervical cancer, as it will take decades for the impact of HPV vaccination to be reflected in overall cervical cancer incidence (1,2). For screening to prevent cervical cancer, treatment of screen-detected high-grade abnormalities is essential.

A target has been set in the WHO strategy to accelerate elimination of cervical cancer for treatment of women with identified disease (1). Australia has raised the target to 95% as a commitment to achieving equity in elimination (2). 

In 2023, there were 12,785 women diagnosed with histologically-confirmed high-grade cervical disease (12,258 aged 25-74 years) in Australia. Overall, 54.6%, 82.7%, and 86.5% were treated within 8 weeks, 6 months, and 12 months, respectively (Figure 9.1). Nationally, there was a small decrease in the proportion treated within in each timeframe in 2023 compared to those with high-grade cervical disease detected in 2022.

The WHO target of 90% treated was not met within 8 weeks in any group but was met by 6 months among women diagnosed with AIS and those aged 60-64 years (Figure 9.2). By 12 months, the 90% target was additionally met in Western Australia, among those with CIN3, and in all age groups between 40-54 years. While the proportion treated did not reach 90% within 12 months in any geographic category (state/territory, remoteness, area-level SES) apart from WA, it exceeded 85% everywhere except Victoria (84.7%). The Australian target of 95% treated was not met in any timeframe for any category considered in this report. 

The proportion treated was higher at 8 weeks and 6 months for non-Indigenous women than it was for Aboriginal and Torres Strait Islander women. The difference was much more pronounced at 8 weeks (55.0% vs 49.8%) but had narrowed at 6 months (83.7% vs 82.0%) and by 12 months the proportion treated was slightly higher for Aboriginal and Torres Strait Islander women (88.0% vs 87.6%). 

The proportion treated within 8 weeks and 6 months was lowest in very remote areas, but at 12 months the proportion treated was higher in very remote areas than it was in major cities. Since 2020 the proportion treated within 12 months has progressively increased in very remote areas, while it has progressively decreased in major cities. In fact, the proportion treated decreased in major cities between 2020 and 2023 within every timeframe considered, and this pattern was generally true in inner and outer regional areas too.  While there is some degree of correlation between remoteness and area-level SES, it is notable that the fairly consistent decline since 2020 in major cities and inner/outer regional areas was not directly mirrored in any SES group other than the middle quintile, and to some extent in the second highest SES quintile. The proportion treated within 12 months was below 80% among those outside the screening age range (aged <25 or 75+); and in those whose high-grade lesion was 'HSIL not otherwise specified'. 

There was some variation in the proportion treated within 8 weeks by remoteness area and state/ territory (range: 44.2%-55.5% for remoteness area; 47.5%-59.0% for state/ territories). The variation had become relatively smaller by 6 months for remoteness area (range: 80.4-84.4%) and by 12 months for state/ territory (range: 84.7-90.2%).

Source: Analysis of NCSR data (NCSR RDE 11/07/2025, data extracted on 11 July 2025); data prepared by the Screening Analysis and Monitoring Unit of the Australian Institute of Health and Welfare.

High-grade abnormality is defined as HSIL NOS (S3.1), HSIL-CIN2 (S3.2), HSIL-CIN3 (S3.3), or AIS (E3.2, E3.3). A record of ablative or excisional treatment is identified through any of colposcopy records, histology records, or MBS claims for ablative or excisional treatment or a hysterectomy. Date of diagnosis is defined as the biopsy sample collection date and allows for treatment on the same date as biopsy. The proportion of people treated is reported as a crude rate across all ages, as for most demographic groups, age-specific data were not available in sufficient detail to allow for age-standardisation or restriction to ages 25-74.

Aboriginal or Torres Strait Islander identification was based on whether a person had ever self-reported their status, as recorded in the National Cancer Screening Register (3). People with no recorded Indigenous status are excluded from the results stratified by Indigenous status.

In previous reports, aggregated results for this indicator have been provided directly by the National Cancer Screening Register (NCSR), whereas this year they have been provided by AIHW, based on a raw data extract data from the NCSR.  Provision by AIHW has been made possible as MBS claims are now included in the data supplied to AIHW. The values for this indicator are about 1-2 percentage points lower than those previously calculated for the corresponding time periods by the NCSR. This may be due to slight differences in the timing or completeness of the data.

Currently, this series of elimination progress reports is the only source of published data on this indicator in Australia. A combination of colposcopy and histology records, and MBS claims for treatment (including hysterectomy) were used to identify if treatment had occurred. While this was as complete as could be identified using NCSR data, it is possible that some ablative treatments were missed if they were not recorded on colposcopy forms and also not associated with an MBS claim.

Neither the WHO nor Australian target for 2030 stipulate a timeframe over which to measure whether treatment has occurred. We have presented results at multiple timepoints to enable better visibility of whether treatment does eventually occur (by 12 months) as well as whether it occurs in a shorter timeframe, more consistent with best practice (8 weeks; 6 months), but it is not clear to which of the reported timeframes the 90% WHO target and 95% Australian target should apply. Overall, most of those with high-grade cervical disease detected were treated within 8 weeks (and a very large proportion of the remainder had been treated by 6 months), but there were several groups where only a minority were treated within 8 weeks (Aboriginal and Torres Strait Islander women, those aged less than 30, those with CIN2 or HSIL not otherwise specified, and those living in outer regional, very remote areas or in the NT).  There was relatively little increase in the proportion of people treated between 6 and 12 months. Even over the relatively long timeframe of 12 months, however, the 90% target was not met in most cases, and Australia did not meet the target nationally. In some cases, there may have been an explicit choice to undergo a period of observation prior to treatment, which the NCSP Guidelines allow for - for example young women or those who had not completed childbearing with CIN2 - which may explain the lower treatment rates in these groups (4).

Data by country of birth are still very incomplete on the NCSR and therefore this measure has not yet been reported by country of birth.

1 World Health Organization. Global strategy to accelerate the elimination of cervical cancer as a public health problem. 2020. Available at: https://www.who.int/ publications/i/item/9789240014107.

2 Australian Centre for the Prevention of Cervical Cancer. National strategy for the elimination of cervical cancer in Australia5: A pathway to achieve equitable elimination of cervical cancer as a public health problem by 2035. November 2023. Available at : https://www.health.gov.au/resources/publications/national-strategy-for-the-elimination-of-cervical-cancer-in-australia?language=en  

3 Australian Institute of Health and Welfare. National Cervical Screening Program monitoring report 2023, Canberra: AIHW; 2025. Available at: https://www.aihw.gov.au/reports/cancer-screening/ncsp-monitoring-report-2025 

4 Cancer Council Australia Cervical Screening Guidelines Working Party. Treatment of high-grade squamous abnormalities. In: National Cervical Screening Program Guidelines 2025. Available at: https://www.cancer.org.au/clinical-guidelines/cervical-cancer-screening/ 

Information on cervical cancer survival provides an indication of cancer prognosis at the individual level and the effectiveness of treatment. Relative survival indicates the percentage of people who are still alive for a specific amount of time (typically 5 years) following a cervical cancer diagnosis, relative to the expected rate in women their age in the general population and is expressed as a percentage.

A range of factors influence survival, including characteristics of the patient (such as age, comorbidities, and functional status), the nature of the tumour (such as stage at diagnosis and histology type) and the health system (access to services, whether the cancer was screen-detected, diagnostic and treatment facilities, follow-up services) (1,2).

Overall, 5-year relative cervical cancer survival for Australia was 76.8% in 2017-2021, showing minor improvements over time, rising from 73.0% in the period 1997–2001. In the most recent period, 5-year survival was highest in the Qld (78.0%) and lowest in SA (69.9%). The NT showed the greatest improvements with 5-year survival increasing to 74.8% from 62.4% in 2012-2016 (Figure 11.1).

Overall, 5-year relative survival decreased with increasing age from 97.7% among women diagnosed when aged 20–24 years to 43.5% at 80-84 years (Figure 11.2).

Relative survival could not be calculated by Indigenous status, socioeconomic status, remoteness area, or country of birth, but observed 5-year survival rates were lowest for Indigenous women (64.3%), women living in the lowest socioeconomic quintile (66.6%) and very remote areas (60.3%). Rates were similar for Australian-born and overseas-born women, noting that these high-level groupings may obscure diversity in survival for different culturally and linguistically diverse groups (Figure 11.3).

Source: 2021 Australian Cancer Database, with additional analyses of Cancer data provided by AIHW.

Relative survival rates provide an objective measure of survival probability from cancer, controlling for differences in mortality from other causes. It is the ratio of the observed survival rate in a group of patients during a specified follow-up period to the expected survival rate in a comparable population. Calculations of expected survival rates require information on the probability of a comparable population living to or dying at a particular age (i.e., life tables). Relative survival for Australia overall and by age group was calculated using national life tables, whereas relative survival by jurisdiction was calculated using jurisdiction-specific life tables. Life tables were not available by Indigenous status, socioeconomic status, remoteness area, or country of birth and observed (crude) survival rates are presented. Relative survival rates for women under the age of 20 years were not published due to an insufficient number of cases to calculate a stable estimate of survival.

Aboriginal or Torres Strait Islander identification was based on whether a person had ever self-reported their status, as recorded by six state and territory cancer registries (NSW, Vic, Qld, WA, ACT and NT) (3).

Cervical cancer survival rates in Australia are above the international benchmarks, which generally show a range in 5-year survival between 50–70% (4). Survival gains over time have been modest, likely due partly to the limited progress in treatment advancements. Recent trial findings suggest a new treatment option that could significantly improve survival and outcomes for patients with locally advanced cervical cancer (5).

Crude survival data show disparities by Indigenous status, socioeconomic status and remoteness, which may be partially explained by diagnosis at a later stage (6,7,8). Nevertheless, comparisons of crude survival rates across the different sub-population groups should be interpreted with caution as they do not control for underlying chances of survival without cervical cancer.

Cancer stage is a strong predictor of survival, but the stage at diagnosis is only routinely collected by the NSW Cancer Registry, and so cannot be accounted for here. 

Data from the previous Pap-based screening program shows that overall cervical cancer survival is notably higher for women with an adequate screening history compared with lapsed or never screened women, and among women who have been screened, for screen-detected cancers (9). This demonstrates the greater survival benefits for women regularly participating in screening (especially when the cancer was screen-detected), which is likely due to cervical cancers detected through screening being diagnosed at an earlier stage and being slower developing cancers than cancers diagnosed in women who were under or never screened.

The Indigenous status variable is not of sufficient quality for analysis of records from SA, Tasmania or the ACT. Therefore, the survival statistics presented by Indigenous status are for NSW, Vic, Qld, WA and NT combined.

The survival figures are not age-adjusted. This could affect the comparison of results between jurisdictions and/or within a jurisdiction over time if the age characteristics of people diagnosed with cervical cancer varies between jurisdiction or changes over time.

1 Diaz A, Baade PD, Valery PC, et al. Comorbidity and cervical cancer survival of Indigenous and non-Indigenous Australian women: A semi-national registry-based cohort study (2003-2012). PLoS One 2018; 13(5): e0196764.

2 Australian Institute of Health and Welfare 2021. Cancer in Australia 2021. Cancer series no. 133. Cat. no. CAN 144. Canberra: AIHW.

3 Australian Institute of Health and Welfare 2021. Cancer in Australia 2021. Supplementary tables for Chapter 10. Available at: https://www.aihw.gov.au/getmedia/501b86ea-2d72-406e-b609-0d597cd1350b/aihw-can-144-data-tables-Ch-10-Key-Population-Groups.xlsx.aspx. 

4 Allemani C, Matsuda T, Di Carlo V, et al. Global surveillance of trends in cancer survival 2000-14 (CONCORD-3): analysis of individual records for 37 513 025 patients diagnosed with one of 18 cancers from 322 population-based registries in 71 countries. Lancet. 2018; 391(10125): 1023-75.

5 Mirza, MR, Chase, DM, Slomovitz BM, et al. Pembrolizumab or placebo with chemoradiotherapy followed by pembrolizumab or placebo for newly diagnosed, high-risk, locally advanced cervical cancer (ENGOT-cx11/GOG-3047/KEYNOTE-A18): A randomized, double-blind, phase 3 clinical trial. The Lancet, 403 (10388), 1305-1314.

6 Australian Institute of Health and Welfare 2019. Cervical screening in Australia 2019. Cancer series no. 123. Cat. no. CAN 124. Canberra: AIHW. 

7 Diaz A, Moore SP, Martin JH, et al. Factors associated with cancer-specific and overall survival among Indigenous and non-Indigenous gynecologic cancer patients in Queensland, Australia: a matched cohort study. International Journal of Gynecological Cancer 2015; 25(3): 542-7.

8 Australian Institute of Health and Welfare 2018. Analysis of cancer outcomes and screening behaviour for national cancer screening programs in Australia. Cancer series no. 111. Cat. no. CAN 115. Canberra: AIHW.

9 Australian Institute of Health and Welfare 2019. Analysis of cervical cancer and abnormality outcomes in an era of cervical screening and HPV vaccination in Australia. Cancer series no. 126. Cat. no. CAN 129. Canberra: AIHW.