Stephanie Steer always had regular cervical screenings.
But just four months after the healthy and active young woman had her last screen, she noticed some changes in her body that she couldn’t explain.
So, she asked a specialist to investigate.
“Lucky I did that because they came back with some things and I was in emergency surgery a week later,” Ms Steer said.
They found an extensive amount of abnormal, or precancerous, cells across her cervix.
Stephanie is now fine, but said early detection was key.
“If I went without detecting this and going untreated, it could have been a matter of years where … I could have been dead without even knowing why.”
Almost all cervical cancer is caused by Human Papillomavirus (HPV). So, if doctors can identify the virus in a patient early, they can typically prevent it from developing into cervical cancer.
Now, the federal government has set aside $5.8 million to help reach its goal of eliminating cervical cancer in Australia by 2035.
It’s a goal likely to be achieved thanks to Australia’s good cervical screening program, a high uptake of the HPV vaccine by school aged boys and girls, and good treatment options for women who do develop HPV.
Health Minister Greg Hunt said the funding would support the Australian Centre for the Prevention of Cervical Cancer (ACPCC) to help develop a National Cervical Cancer Elimination Strategy by the end of 2022.
ACPCC’s chief executive, Marion Saville, said the strategy would involve looking at ways to break down cultural and social barriers that prevent women from accessing traditional cervical cancer prevention programs.
Because, while Australia’s cervical cancer progress is one of the best in the world, there is still inequality.
Aboriginal and Torres Strait Islander women are four times more likely to die from cervical cancer than non-Indigenous Australian women. Changing that will be key to Australia’s success.
“Historically, access to screening has not been great for a number of communities,” Professor Saville said.
“That’s partly because of where they live, partly because of involvement with primary health services, but I think, principally because the pelvic exam with the speculum and collection of those cells from the cervix is just something that a range of groups find just too much vulnerability.
“The opportunity to have self-collection … I think, is going to be a game-changer.”
Cervical screenings test for HPV, which is the cause of about 90 per cent of all cervical cancers. Routine screening is available through Medicare every five years for anyone with a cervix aged between 25 and 74 years.
But, from July 1 next year, anyone with a cervix will be offered a self-collection kit. The kits have been available since 2017, but only for certain women over the age of 30.
The kits contain a vaginal swab which does not have to be inserted as far as the swab used in a regular pelvic exam and there is no speculum, which is a device used to help a medical practitioner reach the cervix.
In most cases, the exam will still need to be conducted in a healthcare setting, but the patient can take their own swab and can do so from behind a curtain or from the privacy of a bathroom.
Lisa Whop is an epidemiologist and chief investigator on the Centre for Research Excellence on Targeted Approaches To Improve Cancer Services for Aboriginal and Torres Strait Islander Australians. She thinks progress to close the gap can be made.
“The way the current program is set up, it’s not culturally accessible to a lot of Aboriginal and Torres Strait Islander people,” Dr Whop said.
She thinks self-collection kits will lead to significant change.
“The evidence indicates that self collection is highly acceptable for Aboriginal and Torres Strait Islander populations,” she said.
“People want agency control over the type of screening they get, whether that be by their clinician or by a self collection.”
She attributes a slow take up of the self-collection service to the fact it has been heavily restricted to certain women, and said it would be important all women and people with a cervix are given the option of a traditional exam, or self-collection.
Part of that will mean getting GPs and nurses on board.
“Policy change is not enough,” Dr Whop said.
“We have to ensure that it’s embedded into usual practice, so that any time someone is due for their cervical screen that the option of self collection is offered.”
Professor Ian Frazer was one of the architects of Gardasil, the first vaccine used to protect against strains of HPV.
“We’ve got a chance to get rid of a cancer completely; first time ever,” Professor Frazer said.
“And here we have a vaccine and a means of doing it. It’s really important that we do this.”
The government will also use the money to support Australia’s largest clinical trial, known as Compass, which examines the interactions between the HPV vaccine and HPV screening.
The trial has over 76,000 participants and information from the trial is used to improve the National Cervical Screening Program.
For Stephanie Steer, life is back on track. But she said she thinks better education about sexual and women’s health would make a big difference.
She also thinks steps need to be taken to reduce the financial burden on women who need to seek help.
“When I went through what I went through, it ended up costing thousands of dollars,” she said.
“As a woman in her early 20s, this was a lot of a financial burden to bear. So, anything that the government can do to reduce this, I think, will be a huge help.”
This article is written by the Specialist Reporting Team’s Penny Timms and Mary Lloyd, ABC News, and originally posted on ABC’s website.
ACRF provided the seed-funding of $1M to the Diamantina Institute to fund the worlds first cervical cancer vaccine.