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This mimics the similar tables
for incidence of cervical cancer and
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rates of vaccination across Australia , which are excellent . The rate |
This vaccine is also effective against other HPV-associated dis- |
Box 1 . The 2017 NCSP screening guidelines for asymptomatic women |
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reflects the variation across Australia .
HPV VACCINATION PROGRAM
THE national HPV vaccination program
was introduced in 2007 . The vaccines , largely developed in Australia , represented a significant medical breakthrough and followed seminal work by Professor Ian Frazer and Dr Jian Zhou at the University of Queensland .
Two vaccines were available under
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is slightly higher for girls than boys but there is a relatively equal uptake across socio-economic groupings , a benefit of having a national schoolsbased program . Of note is the lower rate in the Indigenous population . 6
Since the introduction of the vaccine , there have been two significant advances .
The first advance was the development of a nonavalent vaccine that covers more than 90 % of the oncogenic HPV subtypes
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eases such as oropharyngeal and anal carcinomas .
THE DECEMBER 2017 SCREENING GUIDELINES
SCREENING guidelines for asymptomatic
women appear in box 1 .
A non-screening pathway is also available to meet certain clinical situations . The test of choice in these circumstances is co-testing , where both an HPV test and a cytology test are
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• Screening starts at age 25 , with screening at an interval of five years , up until the age of 74 .
• The screening test is for HPV with subtyping for HPV subtypes 16 and / or 18 or a combined group of the other 13 oncogenic variants .
• If the test is positive for HPV , a reflex cytology sample is then prepared and examined , with management determined based on the combined result .
• An HPV screening test is available for women under the age of 25 who have had early onset of sexual activity or unwanted sexual activity . 4
• A follow-up test for HPV is to be performed if the initial test was positive for non16 / 18 with low-grade or negative cytology .
• Colposcopy is recommended if the patient tests positive HPV 16 and / or 18 .
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the national program , Cervarix ( biva- |
( 6,11,16,18,31,33,45,52,58 ). This was |
undertaken at the same time . |
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lent ) and Gardasil ( quadrivalent ). |
introduced into the Australian pro- |
Non-screening co-testing is done |
is important to follow the guidelines , |
has been the development of a |
|
The bivalent vaccine has been |
gram in 2018 . |
if the patient ( of any age ) has signs or |
otherwise the patient may receive a |
National Cancer Screening Register |
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designed to prevent HPV subtypes |
The second advance was the |
symptoms suggestive of cervical can- |
private bill from the pathology labora- |
( NCSR ). 7 |
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16 and 18 whereas the quadrivalent |
development of a highly effective sin- |
cer or its precursors , such as abnor- |
tory . Figure 5 lists the Medicare items |
This replaces six previous , sep- |
|
vaccine contained antigens for HPV |
gle-dose vaccine . |
mal vaginal bleeding , or where there |
when ordering a CST . |
arate state-based Pap test registers . |
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16 , 18 , 11 and 6 . HPV types 11 and 6 |
Starting in February 2023 , the sin- |
is an abnormal-looking cervix on |
The procedures for self-collection |
The new register collects information |
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are associated with the development |
gle-dose vaccine has been delivered |
examination . |
of HPV DNA ( see later ) became avail- |
not just from the NCSP but also from |
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of genital warts . The initial recom- |
to children in their first year of high |
Non-screening co-testing is also |
able for women for routine cervical |
the National Bowel Cancer Screening |
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mendation was for three doses to be |
school . A catch-up program offering |
used for the test-of-cure pathway |
screening and 12-month follow-up |
Program . |
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administered two months apart over |
a federally-funded , free , single-dose |
undertaken after histologically proven |
sampling in July 2022 . |
The information collected from the |
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a 12-month period .
The vaccination program was first introduced for female high school students but was extended to include males in 2013 .
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vaccination for young people aged up to age 25 was introduced at the same time . For people older than 26 and immune-compromised , a three-dose schedule is still needed at zero , two |
high-grade disease has been treated .
These specific clinical situations have stringent Medicare restrictions . The restrictions have caused confusion because similar restrictions did
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NATIONAL CANCER SCREENING REGISTER
ONE of the cornerstones of the
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NCSP includes results of HPV testing , cytology , histology , colposcopy and treatment .
Transferring all the patient information from the original state-based
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Figure 4 demonstrates the current |
and four months . |
not apply in the previous program . It |
renewed cervical screening program |
registers was complicated |
PAGE 22 |