Exit Testing Research Articles

Role of HPV in the Prediction of Persistence/Recurrence After Treatment for Cervical Precancer

Objectives(1) To determine the role of human papillomavirus (HPV) testing after excisional treatment of cervical precancer. (2) To determine clinical factors associated with persistence of cervical precancer post-treatment. MethodsA retrospective chart review was conducted including patients who had a loop electrosurgical excision procedure (LEEP) for cervical precancer (cervical intraepithelial neoplasia 3/adenocarcinoma in situ/high-grade squamous intraepithelial lesions [HSIL]). All patients treated between 2016 and 2018 at a tertiary centre colposcopy unit were included. Persistence/recurrence of disease was defined as high-grade cytology or histology identified during the time of follow-up. Univariate and multivariate regression models were performed to identify factors associated with persistence/recurrence and HPV positivity at exit testing. ResultsA total of 284 patients were included. The median follow-up time was 19 months. Of the LEEP specimens, 90.8% (n = 258) demonstrated HSIL and 3.9% (n = 11) had adenocarcinoma in situ. 28.5% (n = 81) of the LEEP specimens had positive margins. In follow-up, 72.9% had negative cytology, 17.6% had atypical squamous cells of undetermined significance/low-grade SIL, 1.8% had atypical squamous cells, HSIL cannot be excluded/low-grade SIL-H, and 6.7% had HSIL. At the final follow-up, 27.8% (n = 79) were HPV+. Overall rate of persistence/recurrence was 11.3% (n = 32); median time to persistence/recurrence was 6.5 months. Multivariate regression models demonstrated that follow-up HPV positivity (OR = 22.0) and positive margins (OR = 3.7) were significantly associated with persistence/recurrence. Similarly, in univariate regression models, positive margins were significant (OR = 2.2) for predicting HPV positivity in exit testing. ConclusionsPersistence/recurrence of precancer can occur due to incomplete treatment of lesions by local excision and by the persistence of HPV infection. Surveillance strategies for women treated for cervical precancer require a risk-based approach and should rely on HPV testing.

Comparison of Pure Tone Audiometry and Otoacoustic Emission based Hearing Assessment for Classical Music Students

Since the enforcement of the Control of Noise at Work Regulations research has been undertaken in collaboration with the Royal Academy of Music investigating the hearing acuity of more than 5000 students between 2007 and 2021. Standard pure tone audiometric screening methods were employed for both entry and exit testing of undergraduate and postgraduate students. The results of these investigations have informed a pilot study, ran in September 2021, comparing two hearing health surveillance methodologies: pure tone audiometry and otoacoustics emissions involving 256 classical music students. This comparison was necessary as music students had been found to be able to game the Bekesy test procedure as a result of their acute listening ability. The results showed that otoacoustic emissions were able to identify, at an early stage, hearing damage in an additional 3.8% of students. The test procedure itself was found to be quicker, more convenient and offered greater objectivity without learning bias. This provides reassurance that otoacoustic emissions can be an excellent tool for assessing the hearing health of classical music students and identifying hearing damage at an early stage.

Feasibility Study for Otoacoustic Emission Hearing Assessment of Classical Music Students

Since the introduction and enforcement of the Control of Noise at Work Regulations in 2008 continuing research has been undertaken on more than four thousand students at the Royal Academy of Music to understand their hearing acuity. Standard pure tone audiometric screening methods were employed for both entry and exit testing for the undergraduate students. Due to COVID standard audiometry was not possible, however it presented an opportunity to trial otoacoustic emission based hearing assessment. A feasibility study was undertaken in July 2021 involving 119 classical music students. The results showed very similar trends in hearing and thus provide reassurance that OAE can be used to assess the hearing of music students.

Технология чат-ботов как средства формирования иноязычной грамматической компетенции при самостоятельном обучении

Importance. The necessity for greater personalization of learning is a significant feature of foreign language teaching for an adult audience. This need is due to the individual experience of adult learners, narrower learning needs and limited time resources. One of the ways to build individual trajectories is the technology of an automated chatbot, which can be implemented on the basis of the Telegram messenger. The purpose of the study is to determine the effectiveness of this method for the development of the grammatical competence of adult learners. Materials and methods. Experimental methods were used with statistical processing of quantitative data, as well as questionnaires to collect qualitative data. The material of the study was the answers of the study participants, collected as part of the introductory and exit testing of grammatical skills in self-study. Results and Discussion. The bot was tested on a group of 29 A2-B1 students who scored an average of 61,11 % correct on the pretest. After three weeks of using the bot, the average percentage of correct answers on the post-test of the group reached 72,22 %. The results were statistically significant (p = 0,003) and confirmed the effectiveness of the bot as a tool for improving grammatical competence. Conclusion. The use of a chatbot has shown to be effective in developing the grammatical competence of adult learners. The data obtained can serve as a basis for the further development of similar tools aimed at developing a wider range of skills and abilities – lexical competence, listening or reading.

Daily Rapid Antigen Exit Testing to Tailor University COVID-19 Isolation Policy.

We evaluated daily rapid antigen test (RAT) data from 323 COVID-19-positive university students in Connecticut, USA, during an Omicron-dominant period. Day 5 positivity was 47% for twice-weekly screeners and 26%-28% for less-frequent screeners, approximately halving each subsequent day. Testing negative >10 days before diagnosis (event time ratio (ETR) 0.85 [95% CI 0.75-0.96]) and prior infection >90 days (ETR 0.50 [95% CI 0.33-0.76]) were significantly associated with shorter RAT positivity duration. Symptoms before or at diagnosis (ETR 1.13 [95% CI 1.02-1.25]) and receipt of 3 vaccine doses (ETR 1.20 [95% CI 1.04-1.39]) were significantly associated with prolonged positivity. Exit RATs enabled 53%-74% of students to leave isolation early when they began isolation at the time of the first positive test, but 15%-22% remained positive beyond the recommended isolation period. Factors associated with RAT positivity duration should be further explored to determine relationships with infection duration.

Monitoring European data with prospective space–time scan statistics: predicting and evaluating emerging clusters of COVID-19 in European countries

BackgroundCoronavirus disease 2019 (COVID-19) has become a pandemic infectious disease and become a serious public health crisis. As the COVID-19 pandemic continues to spread, it is of vital importance to detect COVID-19 clusters to better distribute resources and optimizing measures. This study helps the surveillance of the COVID-19 pandemic and discovers major space–time clusters of reported cases in European countries. Prospective space–time scan statistics are particularly valuable because it has detected active and emerging COVID-19 clusters. It can prompt public health decision makers when and where to improve targeted interventions, testing locations, and necessary isolation measures, and the allocation of medical resources to reduce further spread.MethodsUsing the daily case data of various countries provided by the European Centers for Disease Control and Prevention, we used SaTScan™ 9.6 to conduct a prospective space–time scan statistics analysis. We detected statistically significant space–time clusters of COVID-19 at the European country level between March 1st to October 2nd, 2020 and March 1st to October 2nd, 2021. Using ArcGIS to draw the spatial distribution map of COVID-19 in Europe, showing the emerging clusters that appeared at the end of our study period detected by Poisson prospective space–time scan statistics.ResultsThe results show that among the 49 countries studied, the regions with the largest number of reported cases of COVID-19 are Western Europe, Central Europe, and Eastern Europe. Among the 49 countries studied, the country with the largest cumulative number of reported cases is the United Kingdom, followed by Russia, Turkey, France, and Spain. The country (or region) with the lowest cumulative number of reported cases is the Faroe Islands. We discovered 9 emerging clusters, including 21 risky countries.ConclusionThis result can provide timely information to national public health decision makers. For example, a country needs to improve the allocation of medical resources and epidemic detection points, or a country needs to strengthen entry and exit testing, or a country needs to strengthen the implementation of protective isolation measures. As the data is updated daily, new data can be re-analyzed to achieve real-time monitoring of COVID-19 in Europe. This study uses Poisson prospective space–time scan statistics to monitor COVID-19 in Europe.

Flour exposure, sensitization and respiratory health among Alberta trainee bakers.

Sensitization to allergens encountered in baking, and allergic disease including asthma and rhinitis, is recognized. Attempts to reduce this risk have been instituted in some workplaces, but awareness remains low. This study aimed to quantify the current risk among Alberta bakers. To estimate the onset of sensitization to bakery allergens and allergic disease among trainee bakers at the outset of their career. Trainees attending one of the two bakery programmes were recruited between 2015 and 2018. At entry, an interview was held and spirometry and skin prick tests were performed. Participants were contacted every 6 months by telephone or online interview for 3 years to update work and health information. An exit interview was completed between 2018 and 2019 for all who could be contacted. Exposure was estimated using collected work history and a job exposure matrix was prepared for this study. A total of 220 individuals participated in the entry interview, 204 completed one or more periodic interviews and 113 completed the exit interview. Six who completed exit testing developed new sensitization to bakery antigens, an incidence of 2.49/100 person-years. Positive skin prick tests for bakery antigens were associated with bread making. Rhinitis symptoms were associated with total flour dust and new-onset rhinitis to months in trade. New-onset asthma was related to cumulative exposure to flour improvers. Trainee bakers in Alberta remain at risk of sensitization and occupational respiratory disease.

Changes in vestibular and cochlear function following platinum-based chemotherapy: A preliminary report.

This study investigated the changes in vestibular and cochlear function in patients receiving platinum-based chemotherapy. A longitudinal study of 32 participants (10-70years) receiving chemotherapy participated in the study. Baseline and exit vestibular and hearing assessments that included video head impulse (VHIT) testing, cervical and ocular vestibular evoked myogenic potentials (VEMP), dynamic visual acuity (DVA) and pure-tone audiometry were performed at the patient's treatment venue. Half (50%) of the participants showed cochleotoxicity from baseline to exit testing, with left ears significantly more affected than right ears. There was no consistent relationship between hearing loss and vestibular dysfunction. DVA yielded normal results at baseline and exit testing in all participants. VEMP responses were absent in 28.1% of participants at baseline, reflecting the challenges of using VEMP for monitoring. VEMP and VHIT results showed a statistically significant (p < 0.05) decline in results from baseline to exit testing; however, participants did not report symptoms related to vestibular dysfunction. VHIT also showed left ears significantly (p < 0.05) more affected than right ears. VHIT proved to be a valuable measure of changes in vestibular function secondary to ototoxicity. Future investigations should determine vestibulotoxicity criteria and optimal protocols for vestibulotoxicity monitoring at the patient's treatment venue.

Surveillance for ototoxicity in platinum-based chemotherapy using mobile health audiometry with extended high frequencies.

This study investigated mobile health enabled surveillance in ototoxicity. This was a longitudinal study of 32 participants receiving chemotherapy. Baseline and exit audiograms that included conventional and extended high frequency audiometry were recorded within the patient's treatment venue using a validated mobile health audiometer. Average hearing thresholds at baseline were within the normal range (81.2 per cent left; 93.8 per cent right), reducing at exit testing (71.9 per cent left; 78.1 per cent right). Half of participants presented with a threshold shift according to ototoxicity monitoring criteria. The frequencies affected the most were between 4000 and 16 000 Hz, with left ears significantly more affected than right ears. Noise levels exceeded the maximum permissible ambient noise levels in up to 43.8 per cent of low frequencies (250-1000 Hz). Mobile health supported audiometry proved to be an efficacious tool for ototoxicity monitoring at the treatment venue. Changes in hearing ability over time could be tracked, improving surveillance in patients with full treatment schedules.

Feasibility study for the hearing assessment of classical music student using Otoacoustic Emissions

Since the introduction and enforcement of the Control of Noise at Work Regulations in 2008 continuing research has been undertaken on five thousand students of the Royal Academy of Music to understand their hearing acuity. Standard audiometric screening methods were employed for both entry and exit testing. It was established that the music students obtained results that in over 50% of cases presented negative hearing losses as compared against the Health and Safety Executive categories. This presented an interesting problem which has now been addressed in an attempt to understand the hearing acuity of classical musicians using an otoacoustic emission based methodology. A feasibility study was undertaken in July 2021 of 120 musicians using Hearing Coach software for the analysis and Path Medical OAE instrument to undertake the measurements. The results presented show similar trends and thus provide reassurance that OAE can be used to assess the hearing of music students.

Effectiveness of a COVID-19 Preventive Sequestration Strategy: Deployment of the Aircraft Carrier USS Ronald Reagan (CVN-76).

Develop and evaluate a pre-deployment sequestration (PDS) protocol to prevent SARS-CoV-2 cases on board the USS RONALD REAGAN (CVN-76). The USS RONALD REAGAN includes a crew of approximately 3,000 Sailors and an embarked Air Wing of 2,000 personnel. The PDS was conducted in three waves of 14-day strict quarantines during the months of April and May 2020. Sailors were cleared to board the ship with two negative rtPCR tests at days 14 and 16. The ship was sanitized prior to Wave 1 boarding. From March 1, 2020 through May 31, 2020, a total of 51 SARS-CoV-2 positive cases were detected. During the three waves of PDS, 28 Sailors were found to be positive on exit testing (14, 11, and 3, respectively); no cases were found among the Air Wing. During the first 90 days at sea, no SARS-CoV-2 cases were detected among any of the embarked personnel. Although resource-intensive, the PDS protocol implemented for USS RONALD REAGAN resulted in a COVID-free ship during a global pandemic with unprecedented scope. Elements of this pandemic PDS protocol may be useful in other highly risk-averse environments with no tolerance for COVID-19 infections.

Modelling testing and response strategies for COVID-19 outbreaks in remote Australian Aboriginal communities

BackgroundRemote Australian Aboriginal and Torres Strait Islander communities have potential to be severely impacted by COVID-19, with multiple factors predisposing to increased transmission and disease severity. Our modelling aims to inform optimal public health responses.MethodsAn individual-based simulation model represented SARS-CoV2 transmission in communities ranging from 100 to 3500 people, comprised of large, interconnected households. A range of strategies for case finding, quarantining of contacts, testing, and lockdown were examined, following the silent introduction of a case.ResultsMultiple secondary infections are likely present by the time the first case is identified. Quarantine of close contacts, defined by extended household membership, can reduce peak infection prevalence from 60 to 70% to around 10%, but subsequent waves may occur when community mixing resumes. Exit testing significantly reduces ongoing transmission. Concurrent lockdown of non-quarantined households for 14 days is highly effective for epidemic control and reduces overall testing requirements; peak prevalence of the initial outbreak can be constrained to less than 5%, and the final community attack rate to less than 10% in modelled scenarios. Lockdown also mitigates the effect of a delay in the initial response. Compliance with lockdown must be at least 80–90%, however, or epidemic control will be lost.ConclusionsA SARS-CoV-2 outbreak will spread rapidly in remote communities. Prompt case detection with quarantining of extended-household contacts and a 14 day lockdown for all other residents, combined with exit testing for all, is the most effective strategy for rapid containment. Compliance is crucial, underscoring the need for community supported, culturally sensitive responses.

Determining quarantine length and testing frequency for international border opening during the COVID-19 pandemic.

BackgroundThe COVID-19 pandemic has resulted in the closure or partial closure of international borders in almost all countries. Here, we investigate the efficacy of imported case detection considering quarantine length and different testing measures for travellers on arrival.MethodsWe examine eight broad border control strategies from utilizing quarantine alone, pre-testing, entry and exit testing, and testing during quarantine. In comparing the efficacy of these strategies, we calculate the probability of detecting travellers who have been infected up to 2 weeks pre-departure according to their estimated incubation and infectious period. We estimate the number of undetected infected travellers permitted entry for these strategies across a prevalence range of 0.1–2% per million travellers.ResultsAt 14-day quarantine, on average 2.2% (range: 0.5–8.2%) of imported infections are missed across the strategies, leading to 22 (5–82) imported cases at 0.1% prevalence per million travellers, increasing up to 430 (106–1641) at 2%. The strategy utilizing exit testing results in 3.9% (3.1–4.9%) of imported cases being missed at 7-day quarantine, down to 0.4% (0.3–0.7%) at 21-day quarantine, and the introduction of daily testing, as the most risk averse strategy, reduces the proportion further to 2.5–4.2% at day 7 and 0.1–0.2% at day 21 dependent on the tests used. Rapid antigen testing every 3 days in quarantine leads to 3% being missed at 7 days and 0.7% at 14 days, which is comparable to PCR testing with a 24-hour turnaround.ConclusionsMandatory testing, at a minimal of pre-testing and on arrival, is strongly recommended where the length of quarantining should then be determined by the destination country’s level of risk averseness, pandemic preparedness and origin of travellers. Repeated testing during quarantining should also be utilized to mitigate case importation risk and reduce the quarantining duration required.

SARS-CoV-2 Infection Among Correctional Staff in the Federal Bureau of Prisons.

Objectives. To examine SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) epidemiology and risk factors among Federal Bureau of Prisons (BOP) staff in the United States.Methods. We calculated the SARS-CoV-2 case rate among 37 640 BOP staff from March 12 to June 17, 2020, using payroll and COVID-19-specific data. We compared occupational factors among staff with and without known SARS-CoV-2 using multiple logistic regression, controlling for demographic characteristics. We calculated relative risk among staff in stand-alone institutions versus complexes (> 1 institution).Results. SARS-CoV-2 was reported by 665 staff across 59.8% of institutions, a case rate of 1766.6 per 100 000. Working in dorm-style housing and in detention centers were strong risk factors, whereas cell-based housing was protective; these effects were erased in complexes. Occupational category was not associated with SARS-CoV-2.Conclusions. SARS-CoV-2 infection was more likely among staff working in institutions where physical distancing and limiting exposure to a consistent set of staff and inmates are challenging.Public Health Implications. Mitigation strategies-including augmented staff testing, entry and exit testing among inmates, limiting staff interactions across complexes, and increasing physical distancing by reducing occupancy in dorm-style housing-may prevent SARS-CoV-2 infections among correctional staff.

COVID-19 Response Strategies at Large Institutes of Higher Education in the United States: A Landscape Analysis, Fall 2020

PurposeTo examine the pandemic response plans of institutes of higher education (i.e., colleges and universities), including COVID-19 prevention, enforcement, and testing strategies. MethodData from the largest public (n = 50) and private (n = 50) US institutes of higher education were collected from October 30 to November 20, 2020. ResultsMost institutes of higher education (n = 93) offered some in-person teaching in the Fall 2020 semester; most adopted masking (100%) and physical distancing (99%) mandates. Other preventive strategies included on-campus housing de-densification (58%), classroom de-densification (61%), mandated COVID-19-related training (39%), and behavioral compacts (43%). Testing strategies included entry testing (65%), testing at regular intervals (32%), population sample testing (46%), and exit testing (15%). More private than public institutes implemented intercollegiate athletics bans, behavioral compacts, and suspension clauses for noncompliance. ConclusionsVariability in COVID-19 prevention and testing strategies highlights the need for national recommendations and the equitable distribution of sufficient pandemic response resources to institutes of higher education.

’Prepare yourself’: Testing the literacy skills of graduating teachers

The 2016 introduction of national literacy and numeracy exit testing for all Australian teacher graduates was a significant policy decision that adds further pressure on the tightly regulated area of Initial Teacher Education. There are implications to examine from this specific mandate about the nature of the testing, the capabilities of future teachers, and contemporary conceptions of literacy. Initial Teacher Educators of literacy also need to consider how they might address the preparation of their preservice students to satisfy the test requirements while extending them beyond meeting one achievement measure to fulfil their career ambitions. This paper explores the impact of the policy regulation on preservice teachers, specifically, in relation to their personal literacy skills and test preparedness. Against this background of legislative requirements, the project reported here adopted one approach to address students’ literacy needs by developing customised online literacy support. Research conducted with the first cohort of participants to evaluate this intervention had two purposes. First, to obtain students’ evaluation of the online resource and their assessment of its usefulness as a tool for their learning. Secondly, to gather students’ views about their confidence in their personal literacy skills, and their opinions about the introduction of the LANTITE literacy test (ACER, 2019). The self-reported data prompt further discussion about the preparation of Initial Teacher Education students and the nature of literacy development for beginning teachers. There are ongoing challenges for teacher educators as we prepare our future teachers for professional accreditation that requires the demonstration of a specific set of skills. Literacy competency and linguistic achievement cannot be assumed. It is essential to build rich contemporary conceptualisations of literacy, to develop tertiary students’ personal and professional confidence across a range of multiliteracy practices and multimodalities, and to extend these well beyond any single test measure.

Examining the information needed for acceptance of deintensified screening programmes: qualitative focus groups about cervical screening in Australia

ObjectivesGiven the changing understanding of overdiagnosis of screen detected cancers and advances in technology to detect and prevent cancer, updating and scaling back cancer screening programmes is becoming increasingly necessary....

The Influence of Specialized Physical Education Program for Students with Health Issues

This study, the aim is to improve the School's Physical education process through the application of the Physical education program to students with health problems for a year. Its Influence is followed through changes, arising in heart rate after performing a therapeutic complex with kinesi. It is applied at the beginning and end (Tests I and II) of the study is carried out and consists of 32 exercises, divided into three parts: Prepare with general exercises, Main sections with a combination of lessons from different physical education subjects, coordinating with key groups established with students and the final section.&#x0D; We examined the pulse rate as a reliable indicator for the level of motor suitability of a certain individual, as well as for the absence of training effect of the systematic activities with the program “Physical education for Students with Health Issues”.&#x0D; The kinesiotherapy complex is accurately dosage and conducted, which is indicative from the raising of the physiological curve; it can be performed by all students, regardless of their disease and it may be used for entry or exit testing (Bozhkova A, et al. 2017).&#x0D; The training of students in specialized programs has positively affected them in the following directions:&#x0D; - Achievements are changes in position function in the operation of the cardiovascular system of students, expressed by heart rate;&#x0D; - Increasing is the vitality that stimulates the recovery process, normalizes the reaction to increase the tolerance of the organism;&#x0D; - Improving circulation of separate agencies and systems;&#x0D; - Increase the physical ability of the whole organism;&#x0D; - Adjust the emotional state: provide energy, soothe, relax and relieve stress.

Advocacy of an Exit Test for History/Social Studies in New Jersey

As states like New Jersey navigate the issue of graduation requirements, most states have gone to what is called “high stakes” exit testing for the purpose of awarding high school diplomas. These tests typically emerge to be Mathematics and Language Arts/Reading based. In states like New Jersey, though, these exit tests have given way to subject based tests in things such as Biology and Algebra. Social Studies is not tested, but should be, if the state claims to care about producing well-rounded students prepared to fulfill their civic duties as voting adults. William Gorman, an educator with 30 years’ experience, lobbies for such testing in this editorial.

The projected timeframe until cervical cancer elimination in Australia: a modelling study

In 2007, Australia was one of the first countries to introduce a national human papillomavirus (HPV) vaccination programme, and it has since achieved high vaccination coverage across both sexes. In December, 2017, organised cervical screening in Australia transitioned from cytology-based screening every 2 years for women aged from 18-20 years to 69 years, to primary HPV testing every 5 years for women aged 25-69 years and exit testing for women aged 70-74 years. We aimed to identify the earliest years in which the annual age-standardised incidence of cervical cancer in Australia (which is currently seven cases per 100 000 women) could decrease below two annual thresholds that could be considered to be potential elimination thresholds: a rare cancer threshold (six new cases per 100 000 women) or a lower threshold (four new cases per 100 000 women), since Australia is likely to be one of the first countries to reach these benchmarks. In this modelling study, we used Policy1-Cervix-an extensively validated dynamic model of HPV vaccination, natural history, and cervical screening-to estimate the age-standardised incidence of cervical cancer in Australia from 2015 to 2100. We incorporated age-specific coverage of the Australian National HPV Vaccination Program in girls, including the catch-up programme, and the inclusion of boys into the vaccine programme from 2013, and a change from the quadrivalent to the nonavalent vaccine from 2018. We also modelled the effects of the transition to primary HPV screening. We considered two scenarios for future screening recommendations regarding the cohorts who will be and who have been offered the nonavalent vaccine: either that HPV screening every 5 years continues, or that no screening would be offered to these women. We estimate that, in Australia, the age-standardised annual incidence of cervical cancer will decrease to fewer than six new cases per 100 000 women by 2020 (range 2018-22), and to fewer than four new cases per 100 000 women by 2028 (2021-35). The precise year of attaining these rates is dependent on the population used for age-standardisation, HPV screening behaviour and test characteristics, the incremental effects of vaccination of men on herd immunity in women, and assumptions about the future frequency of benign hysterectomies. By 2066 (2054-77), the annual incidence of cervical cancer will decrease and remain at fewer than one case per 100 000 women if screening for HPV every 5 years continues for cohorts who have been offered the nonavalent vaccine, or fewer than three cases per 100 000 women if these cohorts are not screened. Cervical cancer mortality is estimated to decrease to less than an age-standardised annual rate of one death per 100 000 women by 2034 (2025-47), even if future screening is only offered to older cohorts that were not offered the nonavalent vaccine. If high-coverage vaccination and screening is maintained, at an elimination threshold of four new cases per 100 000 women annually, cervical cancer could be considered to be eliminated as a public health problem in Australia within the next 20 years. However, screening and vaccination initiatives would need to be maintained thereafter to maintain very low cervical cancer incidence and mortality rates. National Health and Medical Research Council (Australia).