Performance measures for Australian laboratories reporting cervical cytology 2009–2017: the impact of the national HPV vaccination program

Abstract

The significant decrease in the incidence of cervical cancer in Australian women since the implementation of an organised approach to cervical screening through the National Cervical Screening Program (NSCP) can be largely attributed to high-quality cervical cytology reporting by Australian laboratories. Performance measures for Australian laboratories reporting cervical cytology are a well-established and an integral part of monitoring and maintaining this high standard by facilitating interlaboratory comparison of performance. This study summarises the aggregate data collected annually by Royal College of Pathologists of Australasia Quality Assurance Programs (RCPAQAP) over the decade from 2009 until 30 November 2017, when the NCSP was revised and the cervical screening test replaced the Pap test as the primary mode of screening women for preinvasive disease. Overall, laboratories continued to perform to a high standard over this period. However, the introduction of a national school and GP based human papillomavirus (HPV) vaccination program in 2006 had a significant impact on the reporting of possible and definite high-grade abnormalities. In the renewed cervical screening program which commenced in December 2017 and which is based on HPV testing and reflex liquid-based cytology, new performance benchmarks will need to be developed when sufficient data have been collected.