The development of efficacious human papillomavirus (HPV) vaccines that provide high levels of protection against infection with HPV – the cause of most cases of cervical cancer worldwide – is arguably one of the biggest population health innovations of the 21st century. Australia was the first country to introduce a publicly-funded national vaccination program in 2007, delivering three doses of the quadrivalent HPV vaccine to schoolgirls aged 12–13 years, with a ‘catch-up’ (2007–2009) for females up to 26 years. Schoolboys were added to the program in 2013.
Since implementation, Australian surveillance data has provided growing evidence for the population-level benefits of HPV vaccination, both direct, and through herd protection of those who remain unvaccinated. These benefits include rapid and substantial reductions in the prevalence of vaccine targeted HPV genotypes, diagnoses of genital warts and incidence of high-grade screen detected abnormalities, evident soon after program implementation. More recent surveillance data have found that vaccine-targeted HPV genotypes were nearing elimination among young women.
Prompted by the impact of vaccination and emerging evidence on cervical HPV testing, on December 1st, 2017, Australia transitioned to 5-yearly primary HPV screening, which is expected to further reduce cervical cancer incidence and mortality rates. Now is a time of great excitement in HPV control, with better vaccines (targeting more HPV types) and improved screening strategies (shifting from cytology to detection of HPV-DNA). Australia has been viewed as a global leader in both introducing new HPV prevention measures, and successfully demonstrating their impact. The research demonstrates that there is potential to eliminate one of the world’s most common viruses, and a major cause of cancer in women.