Women’s cancers and
cancer screening
in the Northern Territory

Xiaohua Zhang
John Condon
Fiona Douglas
Di Bates
Steve Guthridge
Lindy Garling
Guillermo Enciso
Ramakrishna Chondur

Acknowledgements
Data used in the production of this report was provided by the NT Cancer Register, the NT Pap Smear Register and breastScreenNT. The authors are grateful to the many people who have assisted in the production of this report, particularly staff of the Well Women’s Cancer Screening service, NT Department of Health.

© Department of Health, Northern Territory 2012
This publication is copyright. The information in this report may be freely copied and distributed for non-profit purposes such as study, research, health service management and public information subject to the inclusion of an acknowledgement of the source. Reproduction for other purposes requires the written permission of the Chief Executive of the Department of Health, Northern Territory.

Suggested citation
Zhang X, Condon J, Douglas F, Bates D, Guthridge S, Garling L, Enciso G and Chondur R. Women’s cancers and cancer screening in the Northern Territory. Department of Health, Darwin, 2012.

ISBN  978 0 9804235 4 9 

Printed by the Government Printer of the Northern Territory, 2012.

An electronic version is available at: http://www.health.nt.gov.au/Publications/Health_Gains_Planning_Publications/index.aspx 

General enquiries about this publication should be directed to: 
Director, Health Gains Planning
Department of Health
PO Box 40596, Casuarina, NT 0811

Phone: (08) 8985 8074
Facsimile: (08) 8985 8075
Email: ntghealth.gains@nt.gov.au

Table of contents
1. Summary
Key findings
2. Background, data sources and methods
2.1 Background
2.2 Data sources
NT Cancer Register
Pap Smear Register
Breast Screen data
Population data
2.3 Statistical analysis
Cancer incidence, mortality and survival
Cancer incidence rate
Cancer death rate
Cancer survival rate
Breast and cervical screening
Screening participation rate
Early rescreening rate
High-grade abnormality detection rate
Cytology-histology correlation
Age-specific and age-adjusted rates
Cervical screening for Indigenous women
Analysis at regional levels
Limitations
HREC approval
3. Cancers
3.1 Most common cancers in NT women
3.2 Cancer of the breast
3.3 Cancer of the cervix
3.4 Cancer of the uterus
3.5 Cancer of the ovary
3.6 Cancers of the vulva and vagina
4. Breast screening
4.1 Participation
Two-year participation
Regions and remoteness
Three-year participation
4.2 Detection of breast cancer

5. Cervical screening
5.1 Participation
Two-year participation
Regions and remoteness
Estimated Indigenous participation
Three-year and five-year participation
5.2 Early rescreening
5.3 Cytology
5.4 Histology
5.5 High-grade abnormality detection
5.6 Cytology-histology correlation
References
Appendix
List of tables
List of figures

1. Summary
Key findings
•	Breast cancer is the most common cancer occurring in NT Indigenous and non-Indigenous women, although the incidence rate is almost twice as high in non-Indigenous as Indigenous women. 
•	Although not as common as breast cancer, lung cancer is the most common cause of cancer death for both Indigenous and non-Indigenous women because lung cancer has a much lower survival rate than breast cancer. 
•	Cancers of the cervix, uterus, ovary, vagina and vulva occur only in women and breast cancer, which is very rare in men, occurs predominantly in women. Several of these cancers (breast, cervix, uterus, ovary) are among the most common cancers in NT women. Cancer of the vagina and vulva are very rare in all women, including NT women, with the exception of a cluster of cases of vulvar cancer in younger women in Arnhem Land.
•	Cervical cancer incidence decreased by more than 50% for Indigenous women and 40% for non-Indigenous women between 1991-1995 and 2001-2008, while mortality decreased by about 75% for both groups, indicating the effectiveness of the cervical screening program to prevent cervical cancer or detect it early. 
•	Regular cervical screening (by Pap test) can identify early neoplastic changes in the cervix and enable treatment to prevent cervical cancer developing or, if cancer has developed, enable early treatment with a high chance of success. Similarly regular breast screening (by mammogram) can identify breast cancer before it causes symptoms and enable early treatment. 
•	Cervical screening participation is lower for NT women than for Australian women generally, 55% in the NT compared with 61.2% nationally in 2007-2008 (for the target age-group of 20-69 years). The NT participation rate decreased from a peak of 60% in 1999-2000 to 55% in 2007-2008. 
•	Cervical cancer incidence and mortality rates remain much higher for Indigenous than non-Indigenous women; screening participation needs to increase for Indigenous women to further reduce incidence and mortality. 
•	Cervical screening participation rates for Indigenous women can only be estimated for areas with a high Indigenous population, all of which are remote. Indigenous participation rates for these areas were estimated as 46% in 2009-2010; however, some areas had high participation rates, such as the Katherine East and Borroloola Health Service Delivery Areas where Indigenous participation rates were over 70%.
•	Breast screening participation is also lower for NT women than for Australian women generally. The participation rate for NT non-Indigenous women was 45% in 2009-2010, compared to the national rate of 55.2% in 2008-2009 (for the target age-group of 50-69 years). The NT non-Indigenous rate has decreased considerably since 1997-1998, when it was 58%. For Indigenous women, the participation rate increased from 18% to 24% over the same period but is still less than half the national rate.

2. Background, data sources and methods
2.1 Background
Cancer is one of the most serious health problems affecting NT and other Australian women. It is one of the most common causes of death, and has a major physical, emotional, financial and social impact on affected women and their families. Breast cancer is the most common cancer in Australian women, followed by bowel, melanoma of skin, lung and lymphoid cancers.1 However, lung cancer causes more deaths than breast cancer because the survival rate is much lower for lung cancer than breast cancer. 
Cancer occurs most commonly among older people. The population of the Northern Territory has the youngest age distribution of any Australian state or territory, with only 5.4% of women aged over 65 in 2011.2 However the NT population, like the total Australian population, is gradually ‘ageing’; older people comprise a higher proportion of the population now than they did twenty years ago (2.4% aged over 65 years in 1991), and there are three times as many older females living in the NT now (5,591 aged over 65 years in 2011) than twenty years ago (1,927 in 1991). 
Cancer is consequently becoming an increasingly important health issue for women in the Northern Territory. The number of NT resident women diagnosed with cancer has increased from 128 in 1991 to 261 in 2008, an increase of 104% compared with the 33% increase in the NT female population over the same period.2
This report focuses on cancers of the female genital tract (cancers of the cervix, uterus, ovary, vagina and vulva), which occur only in women, and cancer of the breast, which is very rare in men. However, many other cancers are also common among women and the report presents statistics on the ten most common cancers affecting women. 
Two of these cancers can be prevented or detected early by regular screening tests. Cancer of the cervix is caused by persistent infection with oncogenic (i.e. cancer-causing) types of Human Papillomavirus (HPV). The damage to the cervix caused by HPV can be detected by the Pap test before cancer develops, and treatment of the cervix to remove the affected tissue can prevent cancer of the cervix developing. Pap testing has been available to Australian women for several decades and a national coordinated cervical screening program commenced operating in Australia in 1991. The program promotes routine screening with Pap tests every two years for women aged 20-69 years. Not all states and territories were able to commence immediately, the NT Cervical Screening Program commenced operating in 1996. The Cervical Screening Program includes a register of women’s Pap tests and sends reminders to women whose next Pap test is overdue. This report includes statistics on participation in the Pap test screening program by NT women, and on the outcome of that screening. As is apparent in the report, Pap test screening has been very successful at reducing the occurrence of cancer of the cervix in NT women.  Future further reduction in incidence of cervical cancer can confidently be expected as girls aged 12-13 years participating in the national HPV Vaccination Program become protected against the two most common oncogenic types of HPV.
The cause of cancer of the breast is not known, but mammography screening of the breast can detect cancer in the breast before it causes any symptoms that are noticed by the woman. The earlier that it is detected and treated, the more likely the cancer can be completely removed and the woman cured. Breast screening therefore does not prevent breast cancer but rather detects the cancer early and improves the chance that treatment will successfully cure the disease. Australia has had a national coordinated breast cancer screening program (called ‘BreastScreen’) since 1991. BreastScreen commenced in the NT in 1994 (the NT program is currently called breastScreenNT). BreastScreen Australia is targeted specifically at well women without symptoms aged 50-69, although women aged 40-49 and 70 years and older are able to attend for screening. This report includes statistics on participation in the BreastScreen program by NT women, and on the outcome of that screening. 
Cancer has a different impact on Indigenous than other Australian women. Some cancers are much less common among Indigenous women including melanoma, lymphoma, and cancer of the bowel and breast.3 Other cancers are much more common among Indigenous women, including lung and other smoking-related cancers, and cancer of the liver and cervix. Survival rates for most cancers are lower for Indigenous than other Australian women. This report includes separate statistics for Indigenous and non-Indigenous women.
Cancer incidence, mortality and survival rates have previously been reported for NT women, but there have been no detailed reports about cancer screening programs for NT women. This report presents data on the most common cancers affecting NT women, more detailed information on cancers that affect predominantly or exclusively women (cancers of the breast, cervix, uterus, ovary, vagina and vulva); and information on the cervical and breast cancer screening programs including participation rates and abnormal test results.
This report presents information on cancer occurrence in NT women and on cervical and breast screening programs. It includes information on cancer incidence, mortality and survival rates and screening participation rates. The report presents separate information for Indigenous and non-Indigenous women, and compares cancer and screening statistics for the NT with those for Australia as a whole. It also presents information for specific age-groups, regional areas and time periods. 
Chapter three presents information on cancer incidence, mortality and survival for NT women. Chapter four presents information about the breast screening programs in the NT, focusing on screening participation rates. Chapter five presents information about the cervical screening program, including participation rates and screening results.
2.2 Data sources
Statistics presented in this report were calculated using data from the NT Cancer Register (cancer incidence and survival rates), the national deaths dataset (cancer death rates), the NT Pap Smear Register (cervical screening participation rates and related statistics), the breastScreenNT (breast screening participation rates) and the National BreastScreen Program performance reports. 
NT Cancer Register
The NT Cancer Registry is part of the Health Gains Planning Branch of the NT Department of Health. The Cancer Register includes information about all NT residents who are diagnosed with an invasive cancer (except non-melanotic skin cancers). Information recorded in the Register includes demographic details about the person (name, date of birth, sex, Indigenous status, address), clinical information about their cancer diagnosis (date of diagnosis, the site within the body at which the cancer originated, date and cause of death for those who have died), and pathological features of the cancer (the histological characteristics). The Register operates according to the NT Cancer (Registration) Act. Information on the Register is strictly confidential and it used only for statistical reporting and research purposes.
Further information about the operation of the NTCR can be found in the publication, Northern Territory Cancer Registry: Data Collection, Analysis and Reporting Procedures. That publication details the statistical methods used in preparing this report; additional or corrected methods used in this report are presented in Appendix 1.
Pap Smear Register
The Pap Smear Register (PSR) is maintained by the Well Women’s Cancer Screening service of the NT Department of Health. The PSR is the central component of the national co-ordinated cervical screening program. The PSR does not perform Pap tests; these are done by each woman’s usual healthcare provider. The PSR operates as a central data recording and overdue test reminder system; it also provides data for national reporting and monitoring programs and undertakes promotional activities to increase the awareness of women about cervical cancer and the importance of regular Pap tests to prevent it.
The PSR records all Pap tests performed in the NT (except for women who choose not to have their Pap tests recorded) and sends reminder notices to women when their next Pap test is due. Data from the PSR can be used to calculate cervical screening program participation rates, the proportion of Pap tests that detect an abnormality, and other related statistics. Only a small proportion of women choose to ‘opt off’ the PSR, so statistics from PSR data include almost all Pap tests performed. 
Breast Screen data
The breastScreenNT performs screening mammograms and follow-up investigations for women with an abnormal mammogram result. Data extracted from the breastScreenNT clinical information system was analysed to calculate breast screening participation rates. 
Unlike the PSR, which is only a central register of Pap tests and follow-up investigations performed by others, breastScreenNT actually performs the screening because mammography is a highly complex test requiring specialised X-ray equipment and dedicated qualified radiologist readers. All screening mammograms in the NT are performed by breastScreenNT.
Population data
Data on the NT female population was used as the denominator to calculate cancer incidence and death rates, and screening participation rates. The Estimated Resident Population for the NT, by Indigenous status, age-group, sex and year, published by the Australian Bureau of Statistics4, was used for calculation of rates at the total NT level. When calculating rates for regions within the NT, population estimates produced by the Health Gains Planning Branch, based on data obtained from the Australia Bureau of Statistics, were used5.

2.3 Statistical analysis
Most cancer and screening statistics are reported separately for Indigenous and non-Indigenous women and for several time periods. Screening statistics are also reported for specific age-groups as well as all age-groups combined (within the target age-range). The following statistical measures are used to report cancer occurrence, deaths and survival, and screening participation levels and results. 
Cancer incidence, mortality and survival
Age-adjusted incidence rates and mortality rates for all cancers combined and for specific cancer sites are reported by time-period. Three periods are reported for cancer of the breast and cervix but only one or two periods for other cancers because there were too few cases each year for the less common cancers to analyse time trends. Trends in cancer incidence were also examined for cancer of the breast and cervix using Poisson regression analysis. 
Cancer survival rates were analysed at one year and five years after diagnosis. Relative survival, using the cohort analysis method, was used to calculate survival rates. The relative survival rate indicates the proportion of cancer patients still alive one or five years after their cancer diagnosis, relative to the general population of the same age, sex and Indigenous status; for example, a five-year relative survival rate of 73% for non-Indigenous women in 1991-2000 means that a non-Indigenous woman diagnosed with cervical cancer in 1991-2000 had a 73% chance of surviving five years after diagnosis of her cancer, relative to other non-Indigenous women of similar age in the same time period. Background population mortality rates are required to calculate relative survival; these were calculated using age-specific mortality rates for the NT Indigenous women and total Australian women, the latter was used for the NT non-Indigenous women. Analyses were performed using the strs commands in Stata version 11.
For further information about relative survival, see the national cancer survival reports published by the Australian Institute of Health and Welfare (AIHW) and the Australasian Association of Cancer Registries.6
Cancer incidence rate
The incidence rate measures the occurrence of cancer in the population. It is calculated as the number of women diagnosed with cancer within a year divided by the number of women in the population, expressed as ‘cases per 100,000 population’. 
Cancer death rate
The death rate measures deaths from cancer in the population. It is calculated as the number of women who died from cancer within a year divided by the number of women in the population, expressed as ‘deaths per 100,000 population’. 
Cancer survival rate
The survival rate measures the proportion of women who have not died from their cancer one year and five years after being diagnosed with cancer. The survival rate is expressed as a percentage. 

Breast and cervical screening
Statistical measures used in this report were calculated according to the classification calculation guidelines for national reporting of cervical and breast screening performance indicators; further information about these guidelines is available in the relevant guidelines documents7-8. The rescreening rate, cytology and histology abnormality detection rates, and cytology-histology correlation relate to cervical screening only. 
Screening participation rate
The proportion of women eligible for screening who were screened in a specified period, expressed as a percentage. 
Cervical screening participation rate
The participation rate in cervical screening was calculated for age-group 20-69 years, the target population of the National Cervical Screening Program. The rate is expressed as number of women screened within a specified time interval (two, three or five years) as a percentage of the eligible female population. The denominator is the female population adjusted to remove women who had a total hysterectomy. Age-specific hysterectomy fractions for such adjustment are derived from self-reported information on hysterectomies in the 2001 National Health Survey (NHS). The same hysterectomy fractions were used in several national reports (e.g. AIHW 2007-08 report9) until recently. The AIHW national report of 2008-0910 used a different hysterectomy fraction dataset, in order to reflect the changed frequency of hysterectomy in the current female population.  This resulted in lower participation rates being calculated in recent AIHW reports. Due to the wide range of time period covered in this report, hysterectomy fraction data based on the 2001 NHS is more appropriate for our analyses. Therefore, the results presented in this report should not be compared directly with those in the AIHW report of 2008-09 or subsequent years.
Breast screening participation rate
The participation rate in breast screening was calculated for age-group 50-69, the target population of the National BreastScreen Program. The rate is expressed as number of women screened within a specific time interval (two or three years) as a percentage of female population. The National BreastScreen Program reports only screening participation for two-year periods only; in this report three-year participation rates are also reported.
Early rescreening rate
The early rescreening rate is the proportion of screened women with a normal Pap test result and without an abnormal test in the preceding three years, who had another (one or more) Pap test earlier than recommended (measured as having one or more Pap tests within 21 months of the previous test), expressed as a percentage of women screened. 
High-grade abnormality detection rate
The high-grade abnormality rate is the proportion of women (screened by Pap test) who had a high-grade abnormal result on histology, expressed as number per 1,000 women screened. 
Cytology-histology correlation
Cytology-histology correlation measures the agreement between a Pap test result and later histology test. This measure is restricted to women who had a histology test within a six month period following a Pap test. Within each category of Pap test result, the correlation is measured as the proportion of women in each histology result category. For women who had more than one histology test, the most serious disease category is used to determine the histology result.  
Age-specific and age-adjusted rates
Cancer incidence and mortality rates, and screening participation rates, were calculated as age-specific rates in ten-year age-groups and as the age-adjusted rate for all age-groups combined. For screening participation rates, the age-adjusted rate was calculated for the age range of the screening target population, 20-69 years for cervical screening and 50-69 years for breast screening. The direct method of age-standardisation was used to allow comparison between populations of different ethnicities or regions or time periods. The age distribution of the total Australian Estimated Resident Population (ERP) at 30 June 2001 was used for the standard weighting for calculation of age-adjusted rates. 
Cervical screening for Indigenous women
Indigenous status is not recorded on the PSR because it is not included on pathology request and report forms (the source of PSR data), so Indigenous participation rates for cervical screening cannot be directly calculated from PSR data. Participation rates for Indigenous women have been calculated for those Statistical Local Areas (SLAs) in which Indigenous women constitute more than 60% of the population in the 20-69 year age-group, using an indirect estimation method that has previously been demonstrated to produce reasonably reliable estimates.11 This measurement is based on the assumption that participation by non-Indigenous women, in all communities and all age-groups, was the same as the national average participation during 1996-2010. Non-Indigenous women’s participation for this period was approximately 61% for two-year participation, 74% for three-year participation and 86% for five-year participation9. The number of non-Indigenous women screened was estimated (for each period, age-group and SLA) by multiplying the estimated resident non-Indigenous female population by the national participation rate. The number of Indigenous women screened was then estimated by subtracting the estimated number of non-Indigenous women screened from the number of screened women recorded in the NT PSR. The estimated Indigenous participation rate is then calculated by dividing the estimated number of Indigenous women screened by the Indigenous ERP. 
The estimation method is less reliable for areas where Indigenous women comprise a small percentage of the total population, and therefore has not been used to estimate Indigenous screening participation for the total NT. It cannot be used to investigate rescreening and Pap test abnormality rates because these analyses require specific identification of the Pap tests of Indigenous and non-Indigenous women, so separate rescreening and abnormality statistics are not presented in this report.
Indigenous status is recorded by breastScreenNT, so breast screening participation rates for Indigenous and non-Indigenous women were calculated directly from breastScreenNT data. 
Analysis at regional levels
Cancer incidence, mortality and survival rates are presented for the total NT only; analysis for regions within the NT was not undertaken because only a small number of people are diagnosed with, and even fewer die from, any specific type of cancer in the small NT population each year, so that the number of cases/deaths for most regions within the NT, even with many years data combined, is too small to produce reliable incidence and death rates. 
Screening participation and some related statistics have been analysed at regional level within the NT because a large number of women are screened each year, so that the numbers available for analysis are sufficiently large in most regions to produce reasonably reliable regional statistics
The breastScreenNT and the PSR record only the current address of each woman; if a woman changes her place of residence or postal address the previous address is replaced by her new address. As a result, analyses by region within the NT are based on the most recent place of residence of each woman; the results for earlier periods are therefore less accurate than the results for more recent periods. For a small proportion of women the postal address is different to the residential address. This may result in some degree of inaccuracy in allocation of region for those records.
Regional variation within the NT was examined in four ways, based on the place of residence of women as recorded in the Pap Smear Register or breastScreenNT database:
1.	By remoteness category, using the 2006 version of Accessibility/Remoteness Index of Australia (i.e. ARIA+) classification based on 2006 SLAs. Note that locations within the NT fall into only three of the five ARIA categories, Outer Regional (Darwin, Palmerston and Litchfield area), Remote (the towns of Alice Springs and Katherine and the surrounding areas of Darwin-Palmerston-Litchfield), and Very Remote (the rest of the NT). 
2.	Top End and Central Australia: the Top End consists of the Darwin Urban, Darwin Rural, East Arnhem and Katherine administrative health districts; Central Australia consists of the Barkly, Alice Springs Urban, and Alice Springs Rural districts.
3.	By remoteness category separately for Top End and Central Australia. 
4.	Health Service Delivery Area groups (Figure 1): the NT health providers have recently re-organised administration of health services in remote areas into 13 ‘Health Service Delivery Areas’ (HSDA). The exact boundaries of three HSDAs in Central Australia had not been finalised at the time this report was being prepared, so these three HSDAs were combined as a single area. Two HSDAs in the Top End, West Arnhem and Maningrida, were also combined in the effort of aligning with SLA boundaries for the purpose of obtaining corresponding ERP data. Together with three urban areas they form 13 HSDA groups. Screening participation rates have been calculated for each of these areas to inform service delivery managers and staff, and health service governing board members, about screening participation levels in their areas. Only screening participation rates are presented for HSDA groups because of the small number of women and test events available for analysis due to the relatively small populations of each area.

Figure 1 Map of Health Service Delivery Areas

Note: The boundaries of proposed HSDAs are not defined yet, in particularly of Central Australia region

Limitations
There are several limitations to the results presented in this report:
Identification of Indigenous status in the NT Cancer Register is not completely accurate. A data quality assessment conducted by the Cancer Registry estimates that cancer incidence rates for the Indigenous population are under-estimated by 15-20%.
As described above, Indigenous status is not recorded in the PSR, so Indigenous Pap test participation rates could only be estimated by an indirect method and only for areas where Indigenous people comprise 60% or more of the total population. This method has been used previously and sensitivity analysis indicated that the method is reliable, but it has not been independently validated.
The PSR does not include all women who have Pap tests; it does not include information for all NT residents who have Pap tests interstate, and some women ‘opt off’ being included in the PSR. The NT PSR does not have an estimate of the proportion of women who ‘opt off’ as their test results are not sent to the PSR at all, but estimates from the NSW and Victorian Pap test registers indicate that the proportion is very small (less than 1%).
BreastScreenNT data does not include screening mammograms for NT residents that are performed interstate or by private radiologists, but does receive information on investigation and treatment of women screened in the NT and who travel interstate for investigation after an abnormal mammogram. 
HREC approval
Data analysis for this report involved access to and linkage of multiple data sources and use of innovative data analysis methods, which were not routine analyses of Departmental data for statistical reports. Approval for this project was therefore obtained from the Human Research Ethics Committee of the NT Department of Health and the Menzies School of Health Research (approval number 2010-1372) before work on the report commenced.

3. Cancers
3.1 Most common cancers in NT women
For non-Indigenous women, breast cancer was the most common cancer followed by melanoma, colorectal, cancer and cervical cancer. This is similar to the most common cancers for Australian women overall, with the exception of cancer of the cervix which is more common for NT non-Indigenous women than Australian women generally1.
For Indigenous women, breast cancer was also the most common cancer (although the incidence rate was about half that of non-Indigenous women), followed by cancer of the lung, unspecified site, cervix and uterus. Melanoma, which is the second most common cancer for non-Indigenous women, was much less common among Indigenous women. 
The ten most common cancers are based on the number of cases in the period 2001-2008, rather than the age-adjusted incidence rate. 

Figure 2 Ten most common cancers, incidence and mortality, by Indigenous status, NT, 2001-2008

Notes: 
Rates are expressed as number of cases or deaths per 100,000 population and standardised to 2001 Australia ERP.
Data included are 2001-2008 for cancer incidence data; 2001-2006 for cancer mortality data. 

Table 1 Ten most common cancers, incidence and mortality, NT non-Indigenous, 2001-2008
 	Case	 	Death	
Site	Number	Rate1	(95%CI)	 	Number	Rate1	(95%CI)	
Breast	437	98.9	(88.2-109.6)		42	15.6	(10.1-21.1)	
Melanoma	159	33.3	(27.3-39.4)		5	1.8	(0.0-3.7)	
Colorectal	150	48.9	(39.9-57.8)		33	19.0	(11.8-26.2)	
Lung	98	33.6	(26.0-41.1)		50	27.2	(18.8-35.6)	
Cervix	50	9.6	(6.5-12.7)		5	1.1	(0.1-2.1)	
Lymphoma	49	12.9	(8.6-17.2)		9	5.1	(1.4-8.8)	
Uterus	47	13.2	(8.8-17.7)		6	4.3	(0.8-7.8)	
Unspecified	43	15.8	(10.4-21.2)		29	17.6	(10.5-24.6)	
Ovary	40	8.5	(5.5-11.6)		10	3.0	(0.9-5.2)	
Thyroid	37	6.7	(4.4-9.1)	 	0	0.0	(0.0-0.0)	
Notes:
1. Rates are expressed as number of cases or deaths per 100,000 population and standardised to 2001 Australia ERP.
Data included are 2001-2008 for cancer incidence data; 2001-2006 for cancer mortality data. 

Table 2 Ten most common cancers, incidence and mortality, NT Indigenous, 2001-2008
 	Case	 	Death	
Site	Number	Rate1	(95%CI)	 	Number	Rate1	(95%CI)	
Breast	69	53.1	(39.6-66.6)		19	21.6	(10.3-32.9)	
Lung	53	45.6	(32.6-58.6)		28	35.8	(21.6-50.1)	
Unspecified	38	34.2	(22.4-46.0)		15	22.8	(9.8-35.9)	
Cervix	31	21.2	(12.4-30.0)		7	10.9	(1.4-20.5)	
Uterus	30	21.6	(13.3-30.0)		3	4.6	(0.0-10.7)	
Lip & oral	25	18.8	(10.4-27.1)		7	9.5	(1.1-18.0)	
Colorectal	19	15.1	(7.5-22.7)		8	10.3	(2.4-18.2)	
Thyroid	19	12.7	(6.1-19.4)		2	4.6	(0.0-11.0)	
Vulva	17	10.3	(4.2-16.4)		2	1.9	(0.0-4.5)	
Leukaemia	15	10.1	(3.8-16.4)	 	8	6.3	(1.0-11.5)	
Notes:
1. Rates are expressed as number of cases or deaths per 100,000 population and standardised to 2001 Australia ERP.
Data included are 2001-2008 for cancer incidence data; 2001-2006 for cancer mortality data. 

3.2 Cancer of the breast
For non-Indigenous women, the breast cancer incidence rate remained stable between 1991 and 2008, at approximately 100 per 100,000 women per year (Figure 3, Table 4), which was slightly lower than the national rate (109.2 per 100,000 in 2007).1 The breast cancer mortality rate was considerably lower in 2001-2006 than in previous periods, and was considerably lower than the national rate (23.6 per 100,000 in 2005)12. Their five-year survival rate was 86.0% for the entire period, and had remained fairly constant between 1991 and 2006 (Figure 4, Table 8); this is similar to the national rate (87.8% for women diagnosed with breast cancer in 1998-2004)6.
For Indigenous women, the incidence rate was much lower than the NT non-Indigenous and national rates throughout this period, although the rate increased considerably from 1991-1995 to later periods. However, their mortality rate was higher than that for non-Indigenous women (except in 1991-1995) (Table 4). The lower incidence but higher mortality reflects the lower survival of Indigenous women; for the entire period, their five-year survival rate was 67.8% (Table 8). The survival rate for Indigenous women with breast cancer increased considerably, from 46.7% in 1991-1995 to 75.3% in 2001-2006, but remained lower than for non-Indigenous women in the NT and for Australian women generally. 
There was little difference between the Top End and Central Australia in breast cancer incidence or mortality, for either non-Indigenous or Indigenous women (Table 5, Table 6). Similarly, there was little difference between women living in Outer Regional areas and those in Remote and Very Remote areas in breast cancer incidence or mortality, with the exception of lower incidence in Remote and Very Remote areas for non-Indigenous women. The higher mortality rate for Indigenous women in Outer Regional areas was based on very small number of deaths and the difference with the rate in Remote/Very Remote areas was not statistically significant (Table 7).

Figure 3 Cancer of the breast, incidence and mortality, by Indigenous status and period, NT

Note: Data included are 1991-2008 for cancer incidence data; 1991-2006 for cancer mortality data. 

Figure 4 Cancer of the breast, survival rate, by Indigenous status and period, NT

Table 3 Cancer of the breast, number of cases and deaths, by Indigenous status and year, NT
 	Indigenous	 	Non-Indigenous	 	All	
	Cases	Deaths	 	Cases	Deaths	 	Cases	Deaths	
1991	2	3		31	8		33	11	
1992	3	2		29	5		32	7	
1993	1	0		26	10		27	10	
1994	5	0		43	3		48	3	
1995	3	1		30	8		33	9	
1996	5	3		43	6		48	9	
1997	7	2		44	6		51	8	
1998	13	2		35	6		48	8	
1999	7	9		39	18		46	27	
2000	6	3		51	11		57	14	
2001	10	2		61	4		71	6	
2002	6	7		50	4		56	11	
2003	7	3		59	13		66	16	
2004	11	4		42	6		53	10	
2005	7	2		54	10		61	12	
2006	8	1		54	5		62	6	
2007	9	na		52	na		61	na	
2008	11	na		65	na		76	na	
									
All years	121	44	 	808	123	 	929	167	
na. not available. 

Table 4 Cancer of the breast, incidence and mortality, by Indigenous status and period, NT
 	Indigenous	 	Non-Indigenous	 	All	
 	No.1	Rate2	(95%CI)	 	No.1	Rate2	(95%CI)	 	No.1	Rate2	(95%CI)	
Incidence												
 1991-1995	14	24.5	(9.6-39.4)		159	98.2	(79.5-116.9)		173	78.4	(64.4-92.5)	
 1996-2000	38	68.0	(42.6-93.5)		212	100.7	(84.7-116.7)		250	93.1	(79.5-106.7)	
 2001-2008	69	53.1	(39.6-66.6)		437	98.9	(88.2-109.6)		506	88.8	(80.0-97.6)	
												
1991-2008	121	50.6	(40.5-60.8)		808	98.9	(90.9-106.9)		929	87.9	(81.3-94.4)	
												
Mortality												
 1991-1995	6	14.2	(1.4-27.0)		34	23.3	(14.1-32.5)		40	20.5	(13.1-27.9)	
 1996-2000	19	39.0	(17.5-60.5)		47	29.0	(19.5-38.5)		66	30.8	(22.2-39.4)	
 2001-2006	19	21.6	(10.3-32.9)		42	15.6	(10.1-21.1)		61	17.6	(12.5-22.7)	
												
 1991-2006	44	24.7	(16.0-33.4)	 	123	21.2	(16.9-25.5)	 	167	22.1	(18.2-26.0)	
Notes: 
1. No. stands for number.
2. Rates are expressed as number of cases or deaths per 100,000 population and standardised to 2001 Australia ERP.

Table 5 Cancer of the breast, incidence and mortality, by Indigenous status and period, Top End
 	Indigenous	 	Non-Indigenous	 	All	
 	No.1	Rate2	(95%CI)	 	No.1	Rate2	(95%CI)	 	No.1	Rate2	(95%CI)	
Incidence												
 1991-2000	31	41.6	(24.3-58.9)		300	98.7	(85.5-111.9)		331	86.7	(75.7-97.8)	
 2001-2008	49	54.7	(38.2-71.2)		361	102.1	(89.9-114.3)		410	93.5	(83.0-103.9)	
												
 1991-2008	80	48.5	(36.6-60.4)		661	100.3	(91.4-109.3)		741	90.5	(82.9-98.1)	
												
Mortality												
 1991-2000	17	31.9	(12.6-51.2)		64	22.4	(16.2-28.6)		81	23.9	(17.8-30.0)	
 2001-2006	9	15.6	(4.6-26.6)		37	17.3	(10.8-23.8)		46	17.4	(11.6-23.2)	
												
 1991-2006	26	24.1	(12.8-35.4)	 	101	19.8	(15.4-24.3)	 	127	20.7	(16.6-24.9)	
Notes: 
1. No. stands for number.
2. Rates are expressed as number of cases per 100,000 population and standardised to 2001 Australia ERP.

Table 6 Cancer of the breast, incidence and mortality, by Indigenous status and period, Central Australia
 	Indigenous	 	Non-Indigenous	 	All	
 	No.1	Rate2	(95%CI)	 	No.1	Rate2	(95%CI)	 	No.1	Rate2	(95%CI)	
Incidence												
 1991-2000	21	56.0	(29.0-83.1)		71	104.3	(73.9-134.8)		92	86.1	(65.0-107.2)	
 2001-2008	20	47.0	(25.2-68.8)		76	86.7	(64.4-109.0)		96	73.4	(57.3-89.5)	
												
 1991-2008	41	51.3	(34.2-68.4)		147	93.4	(75.6-111.3)		188	78.8	(66.0-91.6)	
												
Mortality												
 1991-2000	8	24.2	(5.0-43.4)		17	44.2	(20.9-67.4)		25	34.0	(18.7-49.2)	
 2001-2006	9	27.6	(6.6-48.6)		5	8.8	(0.6-17.0)		14	17.0	(7.1-27.0)	
												
 1991-2006	17	25.3	(11.4-39.2)	 	22	26.8	(14.3-39.4)	 	39	25.5	(16.4-34.7)	
Notes: 
1. No. stands for number.
2. Rates are expressed as number of deaths per 100,000 population and standardised to 2001 Australia ERP.

Table 7 Cancer of the breast, incidence and mortality, by Indigenous status and remoteness category, NT, 1996-2008
 	Indigenous	 	Non-Indigenous	 	All	
	No.1	Rate2	(95%CI)	 	No.1	Rate2	(95%CI)	 	No.1	Rate2	(95%CI)	
Incidence												
Outer Regional	24	59.9	(34.0-85.8)		475	107.2	(96.0-118.5)		499	103.9	(93.2-114.6)	
Remote & 
Very Remote	84	59.5	(44.9-74.1)		173	85.8	(70.2-101.4)		257	75.6	(64.6-86.5)	
												
Mortality												
Outer Regional	6	60.0	(0.0-141.8)		67	21.0	(15.2-26.7)		73	22.0	(16.1-27.8)	
Remote & 
Very Remote	31	29.9	(16.6-43.3)	 	22	22.0	(11.0-33.1)	 	53	25.7	(17.3-34.1)	
Notes: 
1. No. stands for number.
2. Rates are expressed as number of cases or deaths per 100,000 population and standardised to 2001 Australia ERP.
Data included are 1996-2008 for cancer incidence data; 1996-2006 for cancer mortality data. 

Table 8 Cancer of the breast, survival rate, by Indigenous status and period, NT
 	 	Indigenous	 	Non-Indigenous	
 	 	Rate1	(95%CI)	 	Rate1	(95%CI)	
One-year survival	 1991-1995	73.1	(41.6-90.2)		98.2	(94.2-99.8)	
	 1996-2000	86.6	(69.7-95.5)		95.9	(92.0-98.1)	
	 2001-2006	89.8	(76.5-96.5)		98.4	(96.0-99.5)	
							
	 1991-2006	86.3	(77.2-92.3)		97.6	(96.0-98.6)	
							
Five-year survival	 1991-1995	46.7	(19.3-71.9)		84.4	(77.2-89.9)	
	 1996-2000	64.7	(45.0-80.8)		87.4	(81.6-91.8)	
	 2001-2006	75.3	(51.7-91.4)		85.9	(80.1-90.3)	
							
 	 1991-2006	67.8	(55.2-78.5)	 	86.0	(82.7-88.9)	
Note: 
1. Rate as relative survival proportion (%).

3.3 Cancer of the cervix
For non-Indigenous women, the cervical cancer incidence rate decreased by 40% between 1991-1995 and 2001-2006 (Figure 5, Table 10). However the incidence rate of 9.6 in 2001-2006 was higher than the national rate, which had been approximately 7 per 100,000 each year between 2001 and 20061.Cervical cancer mortality rate for NT non-Indigenous women was much lower in 2001-2006 than in previous periods, and was similar to the national rate (1.8 in 20071). Their five-year survival rate was 76.7% for the entire period, and was higher in 2001-2006 than in 1991-2000 (Figure 6, Table 14); this was higher than the national rate (71.8% for women diagnosed with cervical cancer in 1998-20046).
For Indigenous women, the incidence rate was much higher than the NT non-Indigenous and national rates throughout this period, although incidence decreased by more than 50% from 1991-1995 to 2001-2008 (Table 10). The mortality rate for Indigenous women was much higher than that for non-Indigenous women, but was much lower in 2001-2006 than in earlier periods. The five-year survival rate for Indigenous women was much lower than for non-Indigenous women, and increased by only a small amount between 1991-2000 and 2001-2006. The decrease in cervical cancer mortality for Indigenous women was predominantly due to the decreasing incidence of cervical cancer rather than improved survival. 
There was little difference between the Top End and Central Australia in cervical cancer incidence or mortality, for either non-Indigenous or Indigenous women. Mortality rates for Indigenous women were higher in Central Australia than the Top End, but confidence intervals overlapped indicating that the difference may be due to random variation in the small number of deaths in each region (Table 11,
Table 12). Similarly, there was little difference between women living in Outer Regional areas and those in Remote and Very Remote areas in cervical cancer incidence or mortality for non-Indigenous women, but for Indigenous women mortality was higher for Remote/Very Remote than Outer Regional residents although these mortality rates were based on a small number of deaths (
Table 13).

Figure 5 Cancer of the cervix, incidence and mortality, by Indigenous status and period, NT

Data included are 1991-2008 for cancer incidence data; 1991-2006 for cancer mortality data. 

Figure 6 Cancer of the cervix, survival rate, by Indigenous status and period, NT

Table 9 Cancer of the cervix, number of cases and deaths, by Indigenous status and year, NT
 	Indigenous	 	Non-Indigenous	 	All	
 	Cases	Deaths	 	Cases	Deaths	 	Cases	Deaths	
1991	4	7		7	2		11	9	
1992	4	5		13	2		17	7	
1993	6	4		4	1		10	5	
1994	4	3		7	1		11	4	
1995	4	2		4	4		8	6	
1996	5	5		12	2		17	7	
1997	5	0		7	1		12	1	
1998	3	1		6	1		9	2	
1999	4	2		5	4		9	6	
2000	3	3		3	1		6	4	
2001	5	0		5	2		10	2	
2002	4	1		10	2		14	3	
2003	1	2		4	0		5	2	
2004	2	1		5	1		7	2	
2005	2	0		7	0		9	0	
2006	10	3		4	0		14	3	
2007	3	-		7	-		10	-	
2008	4	-		8	-		12	-	
									
All years	73	39	 	118	24	 	191	63	

Table 10 Cancer of the cervix, incidence and mortality by Indigenous status and period, NT
 	Indigenous	 	Non-Indigenous	 	All	
 	No.1	Rate2	(95%CI)	 	No.1	Rate2	(95%CI)	 	No.1	Rate2	(95%CI)	
Incidence												
 1991-1995	22	44.8	(23.2-66.5)		35	16.1	(9.4-22.8)		57	23.9	(16.2-31.6)	
 1996-2000	20	27.8	(13.7-42.0)		33	13.6	(7.8-19.3)		53	17.0	(11.4-22.5)	
 2001-2008	31	21.2	(12.4-30.0)		50	9.6	(6.5-12.7)		81	12.4	(9.3-15.6)	
												
 1991-2008	73	27.7	(20.3-35.2)		118	11.7	(9.2-14.3)		191	15.7	(13.0-18.3)	
												
Mortality												
 1991-1995	21	44.5	(22.0-67.0)		10	7.7	(1.8-13.7)		31	17.5	(9.9-25.1)	
 1996-2000	11	21.9	(6.6-37.2)		9	4.9	(0.9-9.0)		20	9.1	(4.3-13.9)	
 2001-2006	7	10.9	(1.4-20.5)		5	1.1	(0.1-2.1)		12	3.4	(1.1-5.6)	
												
 1991-2006	39	22.6	(14.2-31.0)	 	24	3.7	(1.9-5.6)	 	63	8.4	(5.9-10.9)	
Notes: 
1. No. stands for number.
2. Rates are expressed as number of cases or deaths per 100,000 population and standardised to 2001 Australia ERP.

Table 11 Cancer of the cervix, incidence and mortality, by Indigenous status and period, Top End
 	Indigenous	 	Non-Indigenous	 	All	
 	No.1	Rate2	(95%CI)	 	No.1	Rate2	(95%CI)	 	No.1	Rate2	(95%CI)	
Incidence												
 1991-2000	27	32.0	(18.5-45.5)		58	15.3	(10.5-20.1)		85	18.7	(13.9-23.4)	
 2001-2008	21	22.2	(10.8-33.6)		42	9.1	(6.1-12.1)		63	11.7	(8.4-15.0)	
												
 1991-2008	48	26.7	(17.9-35.4)		100	11.7	(9.0-14.4)		148	14.7	(11.9-17.4)	
												
Mortality												
 1991-2000	17	24.0	(10.6-37.3)		17	6.2	(2.5-9.9)		34	9.8	(5.8-13.8)	
 2001-2006	3	9.5	(0.0-22.3)		5	1.4	(0.2-2.6)		8	2.6	(0.4-4.8)	
												
 1991-2006	20	17.6	(8.0-27.1)	 	22	3.9	(1.9-6.0)	 	42	6.6	(4.1-9.0)	
Notes: 
1. No. stands for number.
2. Rates are expressed as number of cases or deaths per 100,000 population and standardised to 2001 Australia ERP.

Table 12 Cancer of the cervix, incidence and mortality, by Indigenous status and period, Central Australia
 	Indigenous	 	Non-Indigenous	 	All	
 	No.1	Rate2	(95%CI)	 	No.1	Rate2	(95%CI)	 	No.1	Rate2	(95%CI)	
Incidence												
 1991-2000	15	38.1	(15.9-60.3)		10	12.6	(2.1-23.1)		25	23.3	(12.1-34.6)	
 2001-2008	10	19.5	(5.5-33.4)		8	10.7	(1.8-19.7)		18	14.3	(6.5-22.1)	
												
 1991-2008	25	28.3	(15.5-41.1)		18	11.3	(4.7-18.0)		43	18.2	(11.7-24.8)	
												
Mortality												
 1991-2000	15	40.9	(18.0-63.9)		2	6.1	(0.0-15.5)		17	20.5	(9.4-31.6)	
 2001-2006	4	14.6	(0.0-30.9)		0	0.0	(0.0-0.0)		4	5.8	(0.0-12.3)	
												
 1991-2006	19	29.5	(14.6-44.4)	 	2	3.0	(0.0-7.7)	 	21	13.7	(7.0-20.4)	
Notes: 
1. No. stands for number.
2. Rates are expressed as number of deaths per 100,000 population and standardised to 2001 Australia ERP.

Table 13 Cancer of the cervix, incidence and mortality, by Indigenous status and remoteness category, NT, 1996-2008
 	Indigenous	 	Non-Indigenous	 	All	
ARIA category	No.1	Rate2	(95%CI)	 	No.1	Rate2	(95%CI)	 	No.1	Rate2	(95%CI)	
Incidence												
Outer Regional	11	17.5	(6.5-28.5)		61	10.9	(7.8-14.0)		72	11.4	(8.5-14.4)	
Remote & 
Very Remote	40	25.5	(15.9-35.1)		22	11.2	(4.8-17.6)		62	18.0	(12.3-23.7)	
												
Mortality												
Outer Regional	1	2.5	(0.0-7.4)		11	2.6	(0.8-4.5)		12	2.6	(0.8-4.4)	
Remote & 
Very Remote	17	20.6	(8.3-32.9)	 	3	3.0	(0.0-7.2)	 	20	10.9	(5.1-16.6)	
Notes: 
1. No. stands for number.
2. Rates are expressed as number of deaths per 100,000 population and standardised to 2001 Australia ERP.
Data included are 1996-2008 for cancer incidence data; 1996-2006 for cancer mortality data. 

Table 14 Cancer of the cervix, survival rate, by Indigenous status and period, NT
 	 	Indigenous	 	Non-Indigenous	
 	 	Rate1	(95%CI)	 	Rate1	(95%CI)	
One-year survival	 1991-2000	58.5	(41.9-72.1)		93.0	(83.5-97.2)	
	 2001-2006	72.4	(49.4-86.7)		91.7	(76.0-97.5)	
							
	 1991-2006	63.6	(50.4-74.3)		92.5	(85.4-96.4)	
							
Five-year survival	 1991-2000	36.3	(21.5-51.7)		73.2	(60.7-82.5)	
	 2001-2006	39.4	(16.3-62.8)		86.3	(69.0-94.7)	
							
 	 1991-2006	38.0	(25.3-50.9)	 	76.7	(66.7-84.1)	
Note: 
1. Rate as relative survival proportion (%).

3.4 Cancer of the uterus
There was no definite difference between incidence, mortality or survival rates between Indigenous and non-Indigenous women in the NT for cancer of the uterus, and no clear time trends for either group (Figure 7, Table 15, Table 16). 
The NT incidence rates were similar to national rates (16.5 per 100,000 in 20071), but NT mortality rates were higher than national rates (2.7 in 20071). Five-year survival rates were lower in the NT than national rates (82.1% for women diagnosed in 1998-20046).

Figure 7 Cancer of the uterus, incidence, mortality and survival rate, by Indigenous status, NT, 1991-2008

Data included are 1991-2008 for cancer incidence data; 1991-2006 for cancer mortality and survival data. 

 
Table 15 Cancer of the uterus, incidence and mortality rate, by Indigenous status and period, NT
 	Indigenous	 	Non-Indigenous	 	All	
 	No.1	Rate2	(95%CI)	 	No.1	Rate2	(95%CI)	 	No.1	Rate2	(95%CI)	
Incidence												
 1991-2000	17	12.8	(6.5-19.0)		44	17.1	(11.4-22.8)		61	15.7	(11.2-20.1)	
 2001-2008	30	21.6	(13.3-30.0)		47	13.2	(8.8-17.7)		77	15.0	(11.1-18.9)	
												
 1991-2008	47	17.5	(12.2-22.9)		91	14.6	(11.2-18.1)		138	15.1	(12.2-18.0)	
												
Mortality												
 1991-2000	6	7.7	(0.6-14.8)		9	5.2	(1.6-8.8)		15	5.8	(2.6-9.1)	
 2001-2006	3	4.6	(0.0-10.7)		6	4.3	(0.8-7.8)		9	4.2	(1.3-7.2)	
												
 1991-2006	9	6.3	(1.6-11.1)	 	15	4.7	(2.2-7.2)	 	24	5.0	(2.8-7.2)	
Notes: 
1. No. stands for number.
2. Rates are expressed as number of cases or deaths per 100,000 population and standardised to 2001 Australia ERP.

Table 16 Cancer of the uterus, survival rate, by Indigenous status, NT 1991-2006
 	Indigenous	 	Non-Indigenous	
 	Rate1	(95%CI)	 	Rate1	(95%CI)	
One-year survival	82.7	(65.6-92.3)		85.2	(74.8-91.8)	
Five-year survival	69.3	(48.3-84.8)	 	68.1	(54.5-78.9)	
Note: 
1. Rate as relative survival proportion (%).

3.5 Cancer of the ovary
There was no definite difference between incidence, mortality or survival rates between Indigenous and non-Indigenous women in the NT for cancer of the ovary, and no clear time trends for either group (Figure 8, Table 17, Table 18). 
The NT incidence rates were similar to national rates (10.8 per 100,000 in 20071), but NT mortality rates were higher than national rates (7.0 in 20071). Five-year survival rates were lower in the NT than national rates (73.2% for women diagnosed in 1998-20046).

Figure 8 Cancer of the ovary, incidence, mortality and survival rate, by Indigenous status, NT, 1991-2008

Data included are 1991-2008 for cancer incidence data; 1991-2006 for cancer mortality and survival data. 

 
Table 17 Cancer of the ovary, incidence and mortality rate, by Indigenous status and period, NT
 	Indigenous	 	Non-Indigenous	 	All	
 	No.1	Rate2	(95%CI)	 	No.1	Rate2	(95%CI)	 	No.1	Rate2	(95%CI)	
Incidence												
 1991-2000	6	5.5	(1.1-9.9)		33	9.9	(5.7-14.1)		39	9.1	(5.7-12.5)	
 2001-2008	10	9.8	(2.2-17.5)		40	8.5	(5.5-11.6)		50	8.8	(5.9-11.7)	
												
 1991-2008	16	7.9	(3.3-12.6)		73	9.1	(6.6-11.6)		89	8.8	(6.6-11.0)	
												
Mortality												
 1991-2000	8	8.1	(2.2-14.0)		14	5.2	(1.8-8.5)		22	6.2	(3.2-9.3)	
 2001-2006	1	2.8	(0.0-8.2)		10	3.0	(0.9-5.2)		11	3.0	(0.9-5.0)	
												
 1991-2006	9	5.8	(1.7-9.9)	 	24	4.1	(2.1-6.1)	 	33	4.7	(2.8-6.6)	
Notes: 
1. No. stands for number.
2. Rates are expressed as number of cases or deaths per 100,000 population and standardised to 2001 Australia ERP.

Table 18 Cancer of the ovary, survival rate, by Indigenous status, NT, 1991-2006
 	Indigenous	 	Non-Indigenous	
 	Rate1	(95%CI)	 	Rate1	(95%CI)	
One-year survival	75.6	(38.5-93.8)		83.9	(72.3-91.2)	
Five-year survival	48.7	(14.3-81.8)	 	46.2	(32.3-59.1)	
Note: 
1. Rate as relative survival proportion (%).

3.6 Cancers of the vulva and vagina
Cancer of the vulva is a very rare cancer in most populations. Only 18 non-Indigenous women were diagnosed with this cancer between 1991 and 2008, with only two deaths. However, the incidence rate for Indigenous women was almost four times higher than that for non-Indigenous women in 1991-2008, and the mortality rate five times higher (Figure 9, Table 19). The higher incidence of vulvar cancer in Indigenous women is almost entirely because of a cluster of this rare cancer in younger Aboriginal women in Arnhem Land communities, the cause of which is currently under investigation13.
Cancer of the vagina is a very rare cancer; only five women were diagnosed with this cancer in seventeen years, and only two women died (Table 21, Table 22).

Figure 9 Cancer of the vulva, incidence, mortality and survival rate, by Indigenous status, NT, 1991-2008

Notes: 
1. Bars show 95%CI.
Data included are 1991-2008 for cancer incidence data; 1991-2006 for cancer mortality and survival data. 

Table 19 Cancer of the vulva, incidence and mortality rate, by Indigenous status and period, NT
 	Indigenous	 	Non-Indigenous	 	All	
 	No.1	Rate2	(95%CI)	 	No.1	Rate2	(95%CI)	 	No.1	Rate2	(95%CI)	
Incidence												
 1991-1995	18	13.1	(6.1-20.1)		5	1.1	(0.0-2.2)		23	4.2	(2.1-6.2)	
 2001-2008	17	10.3	(4.2-16.4)		13	4.3	(1.6-7.0)		30	5.8	(3.3-8.3)	
												
 1991-2008	35	11.5	(6.9-16.1)		18	3.0	(1.3-4.6)		53	5.1	(3.4-6.8)	
												
Mortality												
 1991-2006	5	2.0	(0.2-3.8)	 	2	0.4	(0.0-0.9)	 	7	0.8	(0.2-1.3)	
Notes: 
1. No. stands for number.
2. Rates are expressed as number of cases or deaths per 100,000 population and standardised to 2001 Australia ERP.

Table 20 Cancer of the vulva, survival rate, by Indigenous status, NT, 1991-2006
 	Indigenous	 	Non-Indigenous	
 	Rate1	(95%CI)	 	Rate1	(95%CI)	
One-year survival	75.2	(54.0-88.0)		102.1	(102.1-102.1)2	
Five-year survival	54.5	(33.1-72.4)	 	47.6	(14.9-77.3)	
Note: 
1. Rate as relative survival proportion (%).
2. There were no deaths in the first year after diagnosis. The use of relative survival method has resulted in an estimated survival greater than the general population.

Table 21 Cancer of the vagina, incidence and mortality rate, by Indigenous status, NT
 	Indigenous	 	Non-Indigenous	 	All	
 	No.1	Rate2	(95%CI)	 	No.1	Rate2	(95%CI)	 	No.1	Rate2	(95%CI)	
Incidence												
 1991-2008	1	0.4	(0.0-1.2)		4	0.8	(0.0-1.8)		5	0.7	(0.0-1.5)	
Mortality												
 1991-2006	0	0.0	(0.0-0.0)	 	2	0.5	(0.0-1.3)	 	2	0.4	(0.0-1.0)	
Notes: 
1. No. stands for number.
2. Rates are expressed as number of cases or deaths per 100,000 population and standardised to 2001 Australia ERP.

Table 22 Cancer of the vagina, survival rate, by Indigenous status, NT, 1991-2006
 	Indigenous	 	Non-Indigenous	
 	Rate1	(95%CI)	 	Rate1	(95%CI)	
One-year survival	102.1	(102.1-102.1)2		76.0	(13.0-97.4)	
Five-year survival	0.0	 (0.0-0.0)	 	53.4	(6.2-90.3)	
Note: 
1. Rate as relative survival proportion (%).
2. There were no deaths in the first year after diagnosis. The use of relative survival method has resulted in an estimated survival greater than the general population.

4. Breast screening
4.1 Participation
Two-year participation
The two-year participation rates measure the proportion of women in the target age-group of 50-69 years who were participated in breast screening with a two-year interval.
The breast screening participation rate for non-Indigenous women in the NT in the target age-group (50-69 years) decreased progressively from 58% in 1997-1998 to 45% in 2005-2006 and has remained at that level since then (Figure 10, Table 25). The decrease was much greater for the 50-59 age-group than for the 60-69 age-group. This is considerably lower than the national rate of 55.2% in 2008-200914.
The participation rate for Indigenous women was much lower than that for non-Indigenous women in all periods, but did increase from 18% in 1997-1998 to 24% by 2007-2008. Breast screening participation is also lower for NT Indigenous women than for Indigenous women elsewhere in Australia; the national participation rate for Indigenous women was 36.3% in the period 1996-2005.15
The participation rate decreased in the 40-49 and 70+ age-groups for both Indigenous and non-Indigenous women (Table 25), indicating that the screening program is being better targeted at the 50-69 age-group. 

Figure 10 Two-year participation in breast screening, age-standardised rates1, by Indigenous status, NT, aged 50-69 years

Note: 
1. Rates are expressed as number of women screened as a percentage of the eligible female population and are age-standardised to 2001 Australia ERP.

Regions and remoteness
For Indigenous women there was little difference between the Top End and Central Australia in screening participation (Table 26). For non-Indigenous women, screening participation decreased more in Central Australia than in the Top End (Table 27).
Screening participation is much lower in Very Remote than in Outer Regional and Remote areas, for both Indigenous and non-Indigenous women (Table 28, Table 29). 
For non-Indigenous women, participation was higher in Remote than Outer Regional areas in earlier periods, but decreased more in Remote areas to be lower than Outer Regional in later periods (Table 29). Participation was higher in Remote areas of Central Australia than the Top End (Figure 11), but decreased in both (Table 30). There was little change in the participation rate in Very Remote areas, for either the Top End or Central Australia (Table 30).
For Indigenous women, participation was higher in Remote than Outer Regional areas in all except the first period; in 2009-2010, the participation rate was 35% in Remote areas compared to only 27% in Outer Regional areas(Table 28). In the Top End participation remained constant in Remote areas but increased considerably in Very Remote areas but the opposite occurred in Central Australia, where participation increased considerably in Remote but not Very Remote areas (Table 30). 
There was considerable variation in participation rates between Health Service Delivery Areas. For non-Indigenous women, participation rates were lower in the remote than urban areas, and very low in areas such as Katherine West and the Central group of HSDAs (Table 32). For Indigenous women participation was very low in some areas (e.g. West Arnhem and Maningrida, East Arnhem and the Central group), but increased considerably for several areas such as Katherine East, Katherine West and Borroloola (Table 31). 

Figure 11 Two-year participation in breast screening, age-standard rates1, by Indigenous status and remoteness category, aged 50-69 years, NT, 2009-2010

Note: 1. Rates are expressed as number of women screened as a percentage of the eligible female population and are age-standardised to 2001 Australia ERP.

Three-year participation
Three-year participation rates indicate the proportion of women who have a breast screen less frequently than is recommended, but are still having screening mammograms at some time. This indictor is not reported by the National BreastScreen Program.
In 2008-2010, the three-year participation rate in the target age-group was 52% for non-Indigenous women and 30% for Indigenous women, both moderately higher than the two-year participation rates (45% and 24% respectively) (Table 25, Table 33). For Indigenous women in the most recent period, three-year participation rates were considerably higher than two-year rates in Outer Regional (35% c/w 27%) and Remote (46% c/w 35%) areas but there was less of a difference in Very Remote areas (23% c/w 18%), indicating that few Indigenous women in remote areas participate in breast screening at all (Table 28, Table 35).
For Indigenous women, participation was higher in Remote and Very Remote areas of Central Australia than the Top End (Figure 12)

Figure 12 Three-year participation in breast screening, age-standard rates1, by Indigenous status and remoteness category, aged 50-69 years, NT, 2008-2010

Note: 1. Rates are expressed as number of women screened as a percentage of the eligible female population and are age-standardised to 2001 Australia ERP.

Table 23 Two-year participation in breast screening, number of women screened, by NT residency, 1997-2010
 	Aged 40+ years	 	Aged 50-69 years	
 	NT	Non-NT	 	NT	Non-NT	
1997-1998	7,163	253			4,737	180		
1999-2000	7,743	225			5,230	160		
2001-2002	8,094	195			5,519	148		
2003-2004	8,074	160			5,809	132		
2005-2006	8,089	152			6,369	139		
2007-2008	8,416	138			6,955	120		
2009-2010	9,087	79		 	7,794	71		

Table 24 Two-year participation in breast screening, number of women screened, by Indigenous status and age-group, NT, 1997-2010
 	Age-group (years)	Aged	Aged	
 	40-49	50-59	60-69	70+	40+ years	50-69 years	
	Indigenous	
1997-1998	208	272	144	40	664	416	
1999-2000	214	317	146	54	731	463	
2001-2002	263	352	196	75	886	548	
2003-2004	246	417	209	63	935	626	
2005-2006	203	441	261	49	954	702	
2007-2008	164	530	295	41	1,030	825	
2009-2010	120	590	322	29	1,061	912	
	Non-Indigenous	
1997-1998	1,923	3,287	1,031	254	6,495	4,318	
1999-2000	1,854	3,604	1,158	387	7,003	4,762	
2001-2002	1,801	3,645	1,321	433	7,200	4,966	
2003-2004	1,521	3,593	1,567	425	7,106	5,160	
2005-2006	1,333	3,846	1,806	128	7,113	5,652	
2007-2008	1,134	3,952	2,139	116	7,341	6,091	
2009-2010	985	4,276	2,564	148	7,973	6,840	
	All	
1997-1998	2,131	3,561	1,176	295	7,163	4,737	
1999-2000	2,070	3,925	1,305	443	7,743	5,230	
2001-2002	2,067	4,002	1,517	508	8,094	5,519	
2003-2004	1,777	4,030	1,779	488	8,074	5,809	
2005-2006	1,542	4,298	2,071	178	8,089	6,369	
2007-2008	1,304	4,509	2,446	157	8,416	6,955	
2009-2010	1,115	4,897	2,897	178	9,087	7,794	

Table 25 Two-year participation in breast screening, age-specific and age-standard rates1, by Indigenous status, NT, 1997-2010
 	Age group (years)	Aged	Aged	
 	40-49	50-59	60-69	70+	40+ years2	50-69 years2	
	Indigenous	
1997-1998	7.9	18.5	16.3	8.5	12 (11-13)	18 (16-19)	
1999-2000	7.4	20.0	15.9	10.7	13 (12-14)	18 (17-20)	
2001-2002	8.5	20.5	20.3	13.7	15 (14-16)	20 (19-22)	
2003-2004	7.5	21.8	20.3	10.1	14 (13-15)	21 (20-23)	
2005-2006	5.8	20.9	23.9	7.0	14 (13-14)	22 (21-24)	
2007-2008	4.6	23.4	23.7	5.2	13 (13-14)	24 (22-25)	
2009-2010	3.2	24.5	22.5	3.3	13 (12-13)	24 (22-25)	
	Non-Indigenous	
1997-1998	18.9	60.2	53.5	18.2	36 (35-37)	58 (56-59)	
1999-2000	17.5	55.7	54.5	25.4	36 (35-37)	55 (54-56)	
2001-2002	16.4	49.1	51.4	25.2	34 (33-34)	50 (49-51)	
2003-2004	13.5	44.4	52.1	24.1	31 (30-32)	47 (46-48)	
2005-2006	11.5	42.5	49.4	6.7	26 (25-26)	45 (44-46)	
2007-2008	9.6	40.6	48.8	5.4	24 (24-25)	44 (43-44)	
2009-2010	8.1	41.2	50.9	6.2	24 (24-25)	45 (44-46)	
	All	
1997-1998	16.6	51.4	41.9	15.9	30 (30-31)	48 (47-49)	
1999-2000	15.4	48.7	42.9	21.9	31 (30-31)	46 (45-47)	
2001-2002	14.7	43.8	42.9	22.4	29 (29-30)	43 (43-44)	
2003-2004	12.2	40.2	44.0	20.4	27 (27-28)	42 (41-43)	
2005-2006	10.2	38.5	43.6	6.8	23 (23-24)	40 (40-41)	
2007-2008	8.5	37.6	43.4	5.3	22 (22-22)	40 (39-40)	
2009-2010	7.0	38.3	44.8	5.4	22 (21-22)	41 (40-41)	
Notes: 
1. Rates are expressed as number of women screened as a percentage of the eligible female population.
2. Rates (95%CI) are age-standardised to 2001 Australia ERP.

Table 26 Two-year participation in breast screening, age-specific and age-standard rates1, by region, NT Indigenous, 1997-2010
 	Age-group (years)	Aged	Aged	
 	40-49	50-59	60-69	70+	40+ years2	50-69 years2	
	Top End	
1997-1998	6.7	19.4	18.2	10.0	13 (12-14)	19 (17-21)	
1999-2000	6.2	19.6	18.9	12.7	13 (12-15)	19 (17-21)	
2001-2002	8.2	20.9	23.7	14.5	16 (14-17)	22 (20-24)	
2003-2004	6.2	21.1	22.0	12.4	14 (13-15)	22 (20-23)	
2005-2006	5.8	19.8	22.2	5.1	13 (12-14)	21 (19-23)	
2007-2008	4.1	23.5	22.2	4.7	13 (12-14)	23 (21-25)	
2009-2010	2.6	24.5	22.1	3.3	12 (11-13)	24 (22-25)	
	Central Australia	
1997-1998	8.6	20.4	20.7	10.2	15 (13-16)	20 (18-23)	
1999-2000	8.5	22.2	17.4	10.9	14 (13-16)	20 (18-23)	
2001-2002	8.0	19.7	17.7	13.7	15 (13-16)	19 (17-22)	
2003-2004	9.0	24.0	19.4	9.1	15 (14-17)	23 (20-25)	
2005-2006	5.5	23.0	25.7	10.3	15 (14-16)	24 (22-27)	
2007-2008	5.5	23.3	24.4	6.2	14 (13-15)	24 (21-26)	
2009-2010	4.5	24.0	21.1	3.4	13 (12-14)	23 (21-25)	
Notes: 
1. Rates are expressed as number of women screened as a percentage of the eligible female population.
2. Rates (95%CI) are age-standardised to 2001 Australia ERP.

Table 27 Two-year participation in breast screening, age-specific and age-standard rates1, by region, NT non-Indigenous, 1997-2010
 	Age-group (years)	Aged	Aged	
 	40-49	50-59	60-69	70+	40+ years2	50-69 years2	
	Top End	
1997-1998	17.8	58.9	49.5	19.4	35 (34-35)	55 (54-56)	
1999-2000	15.3	54.1	51.8	26.6	34 (33-35)	53 (52-54)	
2001-2002	14.4	47.3	49.4	26.0	32 (31-33)	48 (47-49)	
2003-2004	11.2	42.9	50.7	25.2	30 (29-30)	46 (45-47)	
2005-2006	10.5	42.3	49.9	6.2	25 (25-26)	45 (44-46)	
2007-2008	8.9	41.0	51.4	5.1	24 (24-25)	45 (44-46)	
2009-2010	7.3	41.1	53.5	5.3	24 (24-25)	46 (45-47)	
	Central Australia	
1997-1998	25.2	60.2	53.8	21.9	40 (38-41)	58 (55-60)	
1999-2000	28.3	60.4	54.2	31.4	43 (41-44)	58 (56-61)	
2001-2002	25.6	56.8	57.8	36.6	42 (41-44)	57 (55-60)	
2003-2004	23.1	49.8	56.5	25.2	37 (35-38)	52 (50-55)	
2005-2006	15.9	43.1	49.1	9.1	28 (27-29)	45 (43-48)	
2007-2008	12.8	39.3	40.9	7.1	24 (23-25)	40 (38-42)	
2009-2010	11.5	42.1	42.9	9.7	25 (24-26)	43 (41-45)	
Notes: 
1. Rates are expressed as number of women screened as a percentage of the eligible female population.
2. Rates (95%CI) are age-standardised to 2001 Australia ERP.

Table 28 Two-year participation in breast screening, age-specific and age-standard rates1, by remoteness category, NT Indigenous, 1997-2010
 	Age-group (years)	Aged	Aged	
 	40-49	50-59	60-69	70+	40+ years2	50-69 years2	
	Outer Regional area	
1997-1998	8.8	32.4	36.2	8.1	21 (18-23)	35 (31-40)	
1999-2000	7.6	24.9	31.9	12.0	18 (15-20)	29 (24-33)	
2001-2002	8.4	22.6	30.9	15.5	18 (16-21)	26 (23-30)	
2003-2004	5.6	21.8	27.7	13.3	15 (13-17)	24 (21-28)	
2005-2006	4.8	22.9	25.9	2.3	14 (12-15)	25 (22-28)	
2007-2008	5.0	27.6	29.3	2.8	15 (14-17)	29 (26-32)	
2009-2010	4.3	26.6	26.6	2.4	14 (13-16)	27 (24-30)	
	Remote area	
1997-1998	11.3	29.5	30.7	5.6	19 (16-21)	30 (26-34)	
1999-2000	12.1	32.0	30.0	10.5	20 (18-23)	31 (27-35)	
2001-2002	11.1	27.9	27.1	11.4	19 (17-21)	28 (24-31)	
2003-2004	13.2	31.4	33.0	8.7	21 (19-23)	32 (28-36)	
2005-2006	11.1	28.5	41.9	10.5	21 (19-23)	34 (30-37)	
2007-2008	6.7	28.2	40.4	5.8	18 (17-20)	33 (30-36)	
2009-2010	7.0	35.9	34.9	4.3	19 (18-21)	35 (32-39)	
	Very Remote area	
1997-1998	5.1	11.4	11.3	13.3	10 (9-11)	11 (10-13)	
1999-2000	4.8	14.3	11.1	12.4	11 (9-12)	13 (11-15)	
2001-2002	6.9	16.7	16.9	14.9	14 (12-15)	17 (15-19)	
2003-2004	5.5	18.5	15.0	11.3	12 (11-13)	17 (15-19)	
2005-2006	4.1	17.1	16.5	7.6	11 (10-12)	17 (15-19)	
2007-2008	3.6	19.9	14.9	6.1	11 (10-12)	18 (17-20)	
2009-2010	1.5	18.9	15.6	3.2	9 (8-10)	18 (16-19)	
Notes: 
1. Rates are expressed as number of women screened as a percentage of the eligible female population.
2. Rates (95%CI) are age-standardised to 2001 Australia ERP.

Table 29 Two-year participation in breast screening, age-specific and age-standard rates1, by remoteness category, NT non-Indigenous, 1997-2010
 	Age-group (years)	Aged	Aged	
 	40-49	50-59	60-69	70+	40+ years2	50-69 years2	
	Outer Regional area	
1997-1998	16.6	61.7	51.6	19.2	35 (34-36)	58 (56-59)	
1999-2000	14.4	55.8	53.6	25.8	35 (34-35)	55 (53-56)	
2001-2002	13.7	48.7	51.2	24.9	32 (31-33)	50 (49-51)	
2003-2004	11.1	44.1	52.6	25.1	30 (30-31)	47 (46-49)	
2005-2006	10.2	43.8	52.3	5.9	26 (25-26)	47 (46-48)	
2007-2008	8.8	42.4	54.2	5.0	25 (25-26)	47 (46-48)	
2009-2010	7.1	43.0	56.0	5.2	25 (25-26)	48 (47-49)	
	Remote area	
1997-1998	24.9	63.5	59.4	22.6	41 (40-43)	62 (59-64)	
1999-2000	27.5	63.6	59.7	33.6	45 (43-46)	62 (60-64)	
2001-2002	25.5	58.8	58.9	38.7	43 (42-45)	59 (57-61)	
2003-2004	21.5	50.5	57.4	25.2	37 (35-38)	53 (51-55)	
2005-2006	15.9	43.7	48.5	10.0	28 (27-29)	46 (44-48)	
2007-2008	12.4	40.4	41.5	7.0	24 (23-25)	41 (39-43)	
2009-2010	11.7	43.4	44.1	9.2	26 (25-27)	44 (42-46)	
	Very Remote area	
1997-1998	26.1	31.9	10.7	17.2	23 (20-26)	24 (20-27)	
1999-2000	19.5	33.4	17.1	19.4	22 (19-25)	26 (23-29)	
2001-2002	16.1	29.3	21.7	20.7	21 (17-24)	25 (22-28)	
2003-2004	12.1	29.7	23.0	29.2	22 (18-26)	27 (24-30)	
2005-2006	11.4	29.9	25.2	0.0	17 (15-18)	28 (25-31)	
2007-2008	9.6	28.2	24.1	4.5	16 (14-18)	26 (24-29)	
2009-2010	6.2	24.1	27.7	6.3	14 (12-16)	24 (22-27)	
Notes: 
1. Rates are expressed as number of women screened as a percentage of the eligible female population.
2. Rates (95%CI) are age-standardised to 2001 Australia ERP.

Table 30 Two-year participation in breast screening, age-standard rate1, by Indigenous status, region and remoteness category, aged 50-69 years, NT, 1997-2010
 	Top End	 	Central Australia	
 	Outer Regional area	Remote area	Very Remote area	 	Remote area	Very Remote area	
	Indigenous	
1997-1998	35 (31-40)	25 (19-32)	9 (7-11)		33 (27-39)	15 (12-18)	
1999-2000	29 (24-33)	28 (22-34)	12 (10-14)		33 (28-39)	14 (12-17)	
2001-2002	26 (23-30)	27 (22-33)	18 (16-21)		28 (23-33)	15 (12-18)	
2003-2004	24 (21-28)	27 (22-32)	18 (16-21)		35 (30-41)	16 (13-19)	
2005-2006	25 (22-28)	28 (23-33)	17 (15-19)		39 (34-44)	18 (15-20)	
2007-2008	29 (26-32)	25 (20-29)	20 (17-22)		39 (34-44)	16 (14-19)	
2009-2010	27 (24-30)	27 (23-32)	21 (19-23)	 	43 (38-47)	13 (11-15)	
	Non-Indigenous	
1997-1998	58 (56-59)	52 (47-57)	26 (21-31)		65 (63-68)	21 (17-25)	
1999-2000	55 (53-56)	53 (48-57)	28 (24-32)		66 (63-68)	22 (18-27)	
2001-2002	50 (49-51)	49 (45-53)	24 (20-28)		63 (60-65)	27 (22-32)	
2003-2004	47 (46-49)	44 (40-48)	27 (23-32)		57 (54-59)	28 (23-33)	
2005-2006	47 (46-48)	39 (36-43)	26 (22-30)		48 (46-50)	31 (26-36)	
2007-2008	47 (46-48)	36 (32-39)	27 (23-31)		43 (41-46)	24 (20-29)	
2009-2010	48 (47-49)	37 (34-40)	26 (23-30)	 	47 (45-49)	22 (18-26)	
Note: 
1. Rates (95%CI) are the number of women screened as a percentage of the eligible female population and age-standardised using 2001 Australian female population.

Table 31 Two-year participation in breast screening, age-standard rate1, by health service area, aged 50-69 years, NT Indigenous, 1997-2010
 	Darwin Urban	Darwin Rural	Tiwi	Top End West	West Arnhem & Maningrida	East   Arnhem		
1997-1998	34 (29-39)	41 (33-49)	2 (0-5)	15 (8-23)	1 (0-2)	10 (7-14)		
1999-2000	27 (22-31)	36 (27-45)	3 (0-7)	13 (7-20)	4 (1-7)	10 (6-13)		
2001-2002	22 (19-26)	41 (31-51)	6 (1-10)	3 (0-6)	4 (1-7)	19 (15-23)		
2003-2004	22 (18-26)	29 (20-37)	35 (26-45)	16 (10-22)	5 (1-8)	11 (7-14)		
2005-2006	25 (21-28)	20 (13-27)	10 (4-17)	18 (11-25)	5 (2-8)	9 (6-12)		
2007-2008	29 (25-32)	29 (21-37)	16 (9-23)	18 (12-25)	4 (2-6)	14 (11-17)		
2009-2010	27 (24-31)	21 (15-28)	21 (14-28)	30 (23-38)	6 (3-9)	16 (13-19)	 	
 	Katherine Urban	Katherine East	Katherine West	Borroloola	Barkly	Alice Springs Urban	Central	
1997-1998	54 (43-65)	3 (0-6)	21 (12-30)	0 (0-0)	39 (31-47)	33 (27-39)	6 (4-9)	
1999-2000	53 (42-63)	24 (16-32)	36 (27-45)	2 (0-6)	42 (33-50)	36 (30-42)	6 (3-8)	
2001-2002	53 (43-63)	27 (19-35)	55 (45-65)	4 (0-9)	44 (36-52)	29 (24-34)	7 (4-9)	
2003-2004	45 (36-54)	27 (20-35)	51 (41-60)	4 (0-9)	31 (24-38)	36 (31-42)	11 (9-14)	
2005-2006	48 (40-56)	37 (29-45)	44 (34-53)	36 (22-49)	26 (20-32)	41 (36-46)	14 (12-17)	
2007-2008	38 (30-45)	47 (39-55)	40 (31-49)	32 (19-44)	18 (12-23)	40 (36-45)	16 (13-19)	
2009-2010	30 (23-37)	46 (38-53)	45 (37-54)	27 (15-39)	15 (10-19)	44 (39-48)	13 (11-16)	
Note: 
1. Rates (95%CI) are the number of women screened as a percentage of the eligible female population and age-standardised using 2001 Australian female population.

Table 32 Two-year participation in breast screening, age-standard rate1, by health service area, aged 50-69 years, NT non-Indigenous, 1997-2010
 	Darwin Urban	Darwin Rural	Tiwi	Top End West	West Arnhem & Maningrida	East   Arnhem		
1997-1998	59 (58-61)	51 (47-54)	26 (8-43)	22 (12-33)	28 (22-34)	34 (26-43)		
1999-2000	56 (54-57)	50 (47-54)	21 (4-38)	21 (12-31)	15 (9-21)	35 (29-40)		
2001-2002	51 (50-53)	44 (41-47)	12 (0-25)	33 (23-43)	13 (8-19)	30 (24-37)		
2003-2004	48 (47-50)	43 (40-45)	13 (0-26)	33 (22-45)	31 (26-37)	36 (28-44)		
2005-2006	48 (47-49)	42 (39-44)	30 (21-40)	36 (25-46)	31 (26-36)	36 (28-45)		
2007-2008	47 (46-48)	44 (41-46)	28 (17-39)	30 (20-39)	32 (27-37)	33 (26-41)		
2009-2010	48 (47-49)	46 (43-48)	39 (27-50)	28 (19-37)	18 (13-23)	38 (30-46)	 	
 	Katherine Urban	Katherine East	Katherine West	Borroloola	Barkly	Alice Springs Urban	Central	
1997-1998	59 (54-65)	20 (11-28)	6 (0-12)	7 (0-15)	32 (26-38)	66 (63-68)	8 (4-13)	
1999-2000	60 (55-65)	25 (15-35)	9 (1-16)	7 (0-14)	36 (30-42)	65 (63-68)	9 (4-14)	
2001-2002	55 (50-60)	15 (8-23)	13 (0-26)	11 (3-19)	46 (38-54)	63 (60-65)	11 (6-15)	
2003-2004	51 (46-55)	14 (6-22)	12 (0-25)	22 (7-38)	48 (40-56)	57 (54-59)	8 (4-12)	
2005-2006	44 (40-49)	15 (7-22)	4 (0-7)	21 (10-32)	45 (38-52)	48 (46-51)	14 (8-20)	
2007-2008	40 (36-44)	22 (13-30)	9 (3-15)	21 (8-34)	33 (27-39)	43 (41-46)	14 (9-19)	
2009-2010	40 (36-44)	14 (8-21)	8 (2-14)	20 (9-32)	32 (26-37)	47 (45-49)	9 (5-13)	
Note: 
1. Rates (95%CI) are the number of women screened as a percentage of the eligible female population and age-standardised using 2001 Australian female population.

Table 33 Three-year participation in breast screening, age-specific and age-standard rates1, by Indigenous status, NT, 1996-2010
 	Age-group (years)	Aged	Aged	
 	40-49	50-59	60-69	70+	40+ years2	50-69 years2	
	Indigenous	
1996-1998	9.7	22.6	19.2	12.6	16 (14-17)	21 (20-23)	
1999-2001	10.6	26.5	24.5	17.3	19 (18-20)	26 (24-27)	
2002-2004	9.8	27.0	24.3	14.0	18 (17-19)	26 (24-28)	
2005-2007	7.2	27.3	30.0	9.3	17 (16-18)	29 (27-30)	
2008-2010	4.4	31.0	29.6	5.1	16 (16-17)	30 (29-32)	
	Non-Indigenous	
1996-1998	21.6	68.6	59.9	20.7	41 (40-42)	65 (64-66)	
1999-2001	20.9	63.0	62.7	30.8	42 (41-43)	63 (62-64)	
2002-2004	16.2	52.9	60.6	30.5	37 (37-38)	56 (55-57)	
2005-2007	12.6	49.6	58.7	8.9	30 (30-31)	53 (52-54)	
2008-2010	9.3	47.4	59.4	8.0	28 (28-29)	52 (51-53)	
	All	
1996-1998	19.1	58.6	47.1	18.7	35 (34-35)	54 (53-55)	
1999-2001	18.7	56.0	51.5	27.6	36 (36-37)	54 (53-55)	
2002-2004	14.8	48.2	51.2	26.3	33 (32-33)	49 (49-50)	
2005-2007	11.5	45.6	52.4	9.0	28 (27-28)	48 (48-49)	
2008-2010	8.2	44.6	53.0	7.3	26 (25-26)	48 (47-49)	
Notes: 
1. Rates are expressed as number of women screened as a percentage of the eligible female population.
2. Rates (95%CI) are age-standardised to 2001 Australia ERP.

Table 34 Three-year participation in breast screening, age-standard rates1, by Indigenous status and region, aged 50-69 years, NT, 1996-2010
 	Indigenous	Non-Indigenous	All	
	Top End	
1996-1998	23 (21-26)	62 (61-63)	55 (54-56)	
1999-2001	28 (26-30)	61 (59-62)	55 (54-56)	
2002-2004	26 (24-28)	54 (53-56)	49 (48-50)	
2005-2007	27 (25-29)	54 (53-55)	49 (48-50)	
2008-2010	30 (28-31)	53 (52-54)	49 (48-50)	
	Central Australia	
1996-1998	25 (22-28)	66 (63-69)	52 (49-54)	
1999-2001	26 (23-29)	68 (65-70)	53 (51-55)	
2002-2004	29 (26-32)	62 (59-64)	51 (49-52)	
2005-2007	31 (29-34)	53 (51-55)	46 (45-48)	
2008-2010	31 (28-33)	50 (48-52)	44 (43-46)	
Note: 
1. Rates (95%CI) are the number of women screened as a percentage of the eligible female population and age-standardised using 2001 Australian female population.

Table 35 Three-year participation in breast screening, age-standard rates1, by Indigenous status and remoteness category, aged 50-69 years, NT, 1996-2010
 	Indigenous	Non-Indigenous	All	
	Outer Regional	
1996-1998	40 (36-45)	65 (63-66)	63 (61-64)	
1999-2001	33 (29-38)	62 (61-63)	60 (59-61)	
2002-2004	29 (26-33)	56 (55-57)	54 (53-55)	
2005-2007	32 (28-35)	56 (55-57)	54 (53-55)	
2008-2010	35 (31-38)	55 (54-56)	54 (53-55)	
	Remote	
1996-1998	38 (34-43)	70 (68-72)	63 (61-66)	
1999-2001	39 (34-43)	72 (70-74)	65 (63-67)	
2002-2004	40 (36-44)	63 (61-65)	59 (57-61)	
2005-2007	42 (38-45)	53 (51-55)	51 (50-53)	
2008-2010	46 (42-49)	51 (49-53)	51 (49-52)	
	Very Remote	
1996-1998	14 (12-16)	31 (27-34)	20 (18-22)	
1999-2001	22 (19-24)	34 (30-37)	27 (25-29)	
2002-2004	21 (19-23)	31 (28-34)	25 (23-26)	
2005-2007	23 (21-25)	36 (33-39)	28 (26-30)	
2008-2010	23 (21-24)	31 (28-34)	26 (25-27)	
Note: 
1. Rates (95%CI) are the number of women screened as a percentage of the eligible female population and age-standardised using 2001 Australian female population.

4.2 Detection of breast cancer
Performance indicators relating to the detection of invasive cancer and ductal carcinoma in-situ (DCIS) of breast in screening are not reported in detail in this report because the number of cancers detected, even over a 13-year period, is too small for analysis at the regional level. These indicators have been reported at the NT level in the national BreastScreen Program’s annual performance reports, but the very small number of cancers detected each year, even at the total NT level, make annual reports difficult to interpret. 
In this report, these are presented for the whole of the NT for 3-5 year periods, using annual data from the national BreastScreen performance reports. The detection rates of cancer were age-standardised to the population of women attending a BreastScreen Australia service in 2008 (which was obtained from the AIHW). 

Table 36 Invasive breast cancer detection, by screening round and period, aged 50-69 years, 1996-2008
 	NT	 	Australia	
 	Number	Rate1	(95%CI)	 	Rate1	(95%CI)	
First screening round							
    1996-2000	20	42.5	(21.2-63.9)		60.9	(58.7-63.1)	
    2001-2005	14	65.5	(23.6-107.4)		75.0	(71.4-78.5)	
    2006-2008	15	109.2	(39.8-178.7)		72.8	(68.5-77.0)	
Subsequent screening rounds							
    1996-2000	21	35.3	(19.1-51.5)		39.1	(38.2-40.0)	
    2001-2005	53	44.1	(31.8-56.4)		43.2	(42.4-44.0)	
    2006-2008	34	40.2	(26.5-53.9)	 	44.4	(43.4-45.3)	
Note: 
1. Rates (95%CI) are the number of women with invasive cancers detected per 10,000 women screened and age standardised to the population of women attending a BreastScreen Australia service in 2008.

Table 37 Small (<15mm) invasive breast cancer, all screening rounds, by period, aged 50-69 years, 1996-2008
 	NT	 	Australia	
 	Number	Rate1	(95%CI)	 	Rate1	(95%CI)	
1996-2000	27	27.2	(16.0-38.3)		28.45	(27.8-29.1)	
2001-2005	42	28.6	(19.4-37.8)		29.42	(28.8-30.0)	
2006-2008	22	20.8	(11.8-29.7)	 	29.28	(28.5-30.0)	
Note: 
1. Rates (95%CI) are the number of women with small (<15mm) invasive cancers detected per 10,000 women screened and age standardised to the population of women attending a BreastScreen Australia service in 2008.

Table 38 DCIS detection, by screening round, aged 50-69 years, 1996-2008
 	NT	 	Australia	
 	Number	Rate1	(95%CI)	 	Rate1	(95%CI)	
First screening round	13	15.1	(5.4-24.9)		15.5	(14.7-16.2)	
Subsequent screening rounds	34	12.4	(8.1-16.7)	 	10.0	(9.7-10.2)	
Note: 
1. Rates (95%CI) are the number of women with DCIS detected per 10,000 women screened and age standardised to the population of women attending a BreastScreen Australia service in 2008.

5. Cervical screening
Nationally, Pap test registers, including the NT Pap Smear Register (PSR), do not include data on Indigenous status, so most analyses of cervical screening participation and abnormalities presented in this report are for Indigenous and non-Indigenous women combined.
Limited information is provided on participation rates for Indigenous women in remote areas where Indigenous women comprise 60% or more of the female population. For these areas, the Indigenous participation rate was estimated by an indirect method (see page 8 for details of the method used). 
5.1 Participation
Two-year participation
The NT two-year participation rate (for the target 20-69 year age-group) decreased from 58-60% in 1997-2002 to 55% in the most recent periods (Table 41). The NT rate was lower than the national rate of 60-63% between 1997 and 20089. The decrease in the NT participation rate was most apparent in the younger age-groups; the rate in the 20-29 age-group decreased from around 60% to around 50%, and in the 30-39 age-group from 62% to around 55%, while there was little or no decrease for women aged between 40 and 69 years.
Regions and remoteness
Participation is higher in the Top End than in Central Australia (Figure 13, Table 43), and higher in Outer Regional and Remote than Very Remote areas (Figure 14, Table 45). Participation in Remote areas is higher in Central Australia (i.e. mainly the Alice Springs town area) than in the Top End, but in Very Remote areas participation is lower in Central Australia than the Top End (Figure 15, Table 46). Remote areas in the Central region have participation rates almost as high as the Outer Regional areas in the Top End (i.e. Darwin, Palmerston and Litchfield area), which indicates the importance of access to health service facilities available in urban areas.
There was considerable variation in participation rates between Health Service Delivery Area (HSDA) groups (Table 47). In urban areas (Darwin, Katherine, Alice Springs) participation rates were between 50% and 60% in 2009-2010, but had been higher in earlier periods. In remote areas, participation rates in 2009-2010 ranged from 42% to 72%, with participation in most HSDAs higher than in earlier years. The HSDAs with the largest increase were Borroloola (from 27% in 1997-1998 to 72% in 2009-2010) and Katherine East (from 48% to 69%). In the Tiwi HSDA, participation increased from 46% in 1997-1998 to 66% in 1999-2000 and was sustained at that level for several years, but decreased to only 50% in 2009-2010. 

Figure 13 Two-year participation in cervical screening, age-standard rate1, by region, aged 20-69 years, NT, 1997-2010

Notes: 
1. Rates are expressed as number of women screened as a percentage of the eligible female population and are age-standardised to 2001 Australia ERP.
Data are for Indigenous and non-Indigenous women combined. 

Figure 14 Two-year participation in cervical screening, age-standard rate1, by remoteness category, aged 20-69 years, NT, 1997-2010

Notes: 
1. Rates are expressed as number of women screened as a percentage of the eligible female population and are age-standardised to 2001 Australia ERP.
Data are for Indigenous and non-Indigenous women combined. 

Figure 15 Two-year participation in cervical screening, age-standard rates1, by region and remoteness category, aged 20-69 years, NT, 2009-2010

Notes: 
1. Rates are expressed as number of women screened as a percentage of the eligible female population and are age-standardised to 2001 Australia ERP.
Data are for Indigenous and non-Indigenous women combined. 

Estimated Indigenous participation
The participation rate for Indigenous women, in remote areas only, was estimated indirectly as described in the Methods section (see page 8). Indigenous two-year participation in remote areas increased from an estimated 31% in 1997-1998 to an estimated 46% in 2009-2010 (Table 48). Participation rates were similar in the Top End and Central Australia in 1997-1998, but have increased more in the Top End than Central Australia since then (Figure 16, Table 48). The participation rate for Indigenous women varied considerably between HSDAs (Table 49), ranging from 39-40% in Top End West, East Arnhem and the Central group of HSDAs to 73-74% (better than the national rate) in Borroloola and Katherine East in 2009-2010; in Borroloola, participation by Indigenous women was only 15% in 1997-1998. 

Figure 16 Estimated Indigenous two-year participation in cervical screening, age-standard rates1, by region, NT, 1997-2010

Note: 
1. Rates are expressed as number of women screened as a percentage of the eligible female population and are age-standardised to 2001 Australia ERP.

Three-year and five-year participation
Three-year and five-year participation rates indicate the proportion of women who have a Pap screen less frequently than recommended by the current cervical screening program, but are still being screened to some extent.  For example, the estimated five-year participation rate for Indigenous women in remote areas was 66% in 2006-2010 (Figure 17, Table 62), compared to the two-year rate of 46% in 2009-2010, indicating that two-thirds of Indigenous women are receiving some cervical screening, although not all of them are being screened as regularly as currently recommended. 
The five-year participation rate is probably a slight over-estimate because of the high level of interstate migration of the NT population, particularly the non-Indigenous population. For example, in the 20-29 year and 30-39 year age-groups the five-year participation rate is 100% in some tables (
Table 57, Table 58, Table 59); it is unlikely that every woman in these age-groups has a Pap test in each five-year period. The five-year rate is probably an over-estimate because women who have a Pap test while living in the NT for only a short period of time (a few months or a year or two) will have their Pap test counted when calculating the five-year rate even though they do not live in the NT for five years, thereby inflating the number of Pap tests disproportionately to the estimated resident population. 

Figure 17 Two-, three- and five-year participations in cervical screening, age-standard rate1, aged 20-69 years, total NT and estimated Indigenous (remote areas only), most recent period

Note: 
1. Rates are expressed as number of women screened as a percentage of the eligible female population and are age-standardised to 2001 Australia ERP.

Table 39 Two-year participation in cervical screening, number of women screened, by residency, 1997-2010
 	All ages	 	Aged 20-69 years	
 	NT	Non-NT	 	NT	Non-NT	
1997-1998	33,236	1,211		31,028	1,079	
1999-2000	34,545	1,364		32,236	1,234	
2001-2002	34,939	1,162		32,537	1,041	
2003-2004	33,704	1,213		31,510	1,105	
2005-2006	32,725	1,072		30,923	986	
2007-2008	35,546	1,076		33,642	983	
2009-2010	36,739	1,077	 	35,070	1,011	
Note: Data are for Indigenous and non-Indigenous women combined. 

Table 40 Two-year participation in cervical screening, number of women screened, by age-group, NT, 1997-2010
 	Age-group (years)	Aged	All	
 	<20	20-29	30-39	40-49	50-59	60-69	70+	20-69 years	ages	
1997-1998	2,019	10,658	9,927	6,752	2,885	806	189	31,028	33,236	
1999-2000	2,089	10,227	10,186	7,247	3,562	1,014	220	32,236	34,545	
2001-2002	2,172	9,767	10,287	7,403	3,932	1,148	230	32,537	34,939	
2003-2004	2,002	8,907	9,792	7,341	4,195	1,275	192	31,510	33,704	
2005-2006	1,657	8,561	9,241	7,240	4,433	1,448	145	30,923	32,725	
2007-2008	1,731	9,396	9,736	7,679	5,044	1,787	173	33,642	35,546	
2009-2010	1,501	9,572	9,797	8,085	5,484	2,132	168	35,070	36,739	
Note: Data are for Indigenous and non-Indigenous women combined. 

Table 41 Two-year participation in cervical screening, age-specific and age-standardised rates1, NT, 1997-2010
 	Age-group (years)	Aged	
 	20-29	30-39	40-49	50-59	60-69	20-69 years2	
1997-1998	61	62	61	57	42	58 (58-59)	
1999-2000	60	62	62	61	49	60 (59-60)	
2001-2002	59	61	60	59	48	59 (58-59)	
2003-2004	55	58	58	58	46	56 (56-56)	
2005-2006	50	54	55	55	45	53 (52-53)	
2007-2008	52	56	58	58	47	55 (55-55)	
2009-2010	50	55	59	60	48	55 (54-55)	
Notes: 
1. Rates are expressed as number of women screened as a percentage of the eligible female population.
2. Rates (95%CI) are age-standardised to 2001 Australia ERP.
Data are for Indigenous and non-Indigenous women combined. 

Table 42 Two-year participation in cervical screening, number of women screened, by region and age-group, NT, 1997-2010
 	Age-group (years)	Aged	
 	20-29	30-39	40-49	50-59	60-69	20-69 years	
	Top End	
1997-1998	8,282	7,753	5,252	2,226	582	24,095	
1999-2000	8,079	8,045	5,688	2,799	771	25,382	
2001-2002	7,599	8,156	5,726	3,120	911	25,512	
2003-2004	6,852	7,729	5,721	3,303	1,010	24,615	
2005-2006	6,575	7,327	5,685	3,496	1,165	24,248	
2007-2008	7,246	7,713	5,969	3,971	1,422	26,321	
2009-2010	7,425	7,738	6,315	4,298	1,731	27,507	
	Central Australia	
1997-1998	2,292	2,082	1,396	601	184	6,555	
1999-2000	2,101	2,069	1,487	718	197	6,572	
2001-2002	2,120	2,086	1,639	781	222	6,848	
2003-2004	2,038	2,045	1,609	877	265	6,834	
2005-2006	1,976	1,900	1,547	926	281	6,630	
2007-2008	2,140	2,012	1,705	1,064	362	7,283	
2009-2010	2,140	2,054	1,756	1,182	396	7,528	
Note: Data are for Indigenous and non-Indigenous women combined. 

Table 43 Two-year participation in cervical screening, age-specific and age-standardised rates1, by region and age-group, NT, 1997-2010
 	Age-group (years)	Aged	
 	20-29	30-39	40-49	50-59	60-69	20-69 years2	
	Top End	
1997-1998	62	63	61	57	41	59 (58-59)	
1999-2000	61	63	63	61	50	61 (60-61)	
2001-2002	60	63	61	60	50	60 (59-60)	
2003-2004	56	60	59	59	48	57 (56-58)	
2005-2006	51	55	56	56	47	54 (53-54)	
2007-2008	53	57	58	60	48	56 (55-56)	
2009-2010	51	55	59	61	51	56 (55-56)	
	Central Australia	
1997-1998	54	57	56	53	38	53 (52-54)	
1999-2000	52	55	56	56	38	53 (52-54)	
2001-2002	55	55	59	55	39	54 (53-55)	
2003-2004	53	54	55	55	41	53 (52-54)	
2005-2006	48	51	52	51	38	49 (48-50)	
2007-2008	50	53	57	55	42	52 (51-53)	
2009-2010	47	52	57	57	40	52 (51-53)	
Notes: 
1. Rates are the number of women screened as a percentage of the eligible female population.
2. Rates (95%CI) are age-standardised to 2001 Australia ERP.
Data are for Indigenous and non-Indigenous women combined. 

Table 44 Two-year participation in cervical screening, number of women screened, by remoteness category and age-group, NT, 1997-2010
 	Age-group (years)	Aged	
 	20-29	30-39	40-49	50-59	60-69	20-69 years	
	Outer Regional area		
1997-1998	6,231	6,078	4,308	1,918	506	19,041		
1999-2000	5,876	6,085	4,446	2,295	637	19,339		
2001-2002	5,447	6,047	4,513	2,552	767	19,326		
2003-2004	4,909	5,716	4,474	2,718	852	18,669		
2005-2006	4,584	5,355	4,382	2,839	976	18,136		
2007-2008	5,005	5,569	4,589	3,151	1,211	19,525		
2009-2010	5,180	5,581	4,831	3,408	1,471	20,471		
	Remote area		
1997-1998	2,195	2,160	1,407	573	166	6,501		
1999-2000	2,068	2,212	1,611	735	184	6,810		
2001-2002	1,972	2,217	1,692	800	228	6,909		
2003-2004	1,857	2,117	1,660	881	267	6,782		
2005-2006	1,882	1,984	1,629	937	307	6,739		
2007-2008	1,890	2,006	1,698	1,111	345	7,050		
2009-2010	1,938	2,027	1,747	1,222	401	7,335		
	Very Remote area		
1997-1998	2,148	1,597	933	336	94	5,108		
1999-2000	2,236	1,817	1,118	487	147	5,805		
2001-2002	2,300	1,978	1,160	549	138	6,125		
2003-2004	2,124	1,941	1,196	581	156	5,998		
2005-2006	2,085	1,888	1,221	646	163	6,003		
2007-2008	2,491	2,150	1,387	773	228	7,029		
2009-2010	2,447	2,184	1,493	850	255	7,229		
Note: Data are for Indigenous and non-Indigenous women combined. 

Table 45 Two-year participation in cervical screening, age-specific and age-standardised rates1, by remoteness category, NT, 1997-2010
 	Age-group (years)	Aged	
 	20-29	30-39	40-49	50-59	60-69	20-69 years2	
	Outer Regional area	
1997-1998	68	69	65	64	47	64 (64-65)	
1999-2000	65	67	65	65	56	64 (63-65)	
2001-2002	63	65	64	63	56	63 (62-63)	
2003-2004	58	62	62	62	53	60 (60-61)	
2005-2006	53	58	59	59	51	56 (56-57)	
2007-2008	54	59	60	61	53	58 (57-58)	
2009-2010	53	57	61	62	56	58 (57-58)	
	Remote area	
1997-1998	59	59	57	54	41	55 (54-56)	
1999-2000	59	59	62	59	41	58 (57-59)	
2001-2002	61	59	62	57	44	58 (57-59)	
2003-2004	58	58	58	56	44	56 (55-57)	
2005-2006	54	55	56	52	43	53 (52-54)	
2007-2008	51	55	58	58	41	54 (53-55)	
2009-2010	50	54	58	60	41	53 (52-54)	
	Very Remote area	
1997-1998	46	47	45	35	22	41 (40-42)	
1999-2000	49	51	50	45	32	47 (46-48)	
2001-2002	51	53	48	47	27	47 (46-48)	
2003-2004	47	50	46	45	29	45 (44-46)	
2005-2006	43	47	45	45	27	43 (42-44)	
2007-2008	49	52	50	49	32	48 (47-49)	
2009-2010	46	51	52	51	31	48 (47-48)	
Notes: 
1. Rates are the number of women screened as a percentage of the eligible female population.
2. Rates (95%CI) are age-standardised to 2001 Australia ERP.
Data are for Indigenous and non-Indigenous women combined. 

Table 46 Two-year participation in cervical screening, age-standardised rate1, by region and remoteness category, aged 20-69 years, NT, 1997-2010
 	Top End	 	Central Australia	
 	Outer Regional area	Remote area	Very Remote area	 	Remote area	Very Remote area	
1997-1998	64 (64-65)	43 (41-45)	42 (40-43)		61 (60-62)	40 (38-41)	
1999-2000	64 (63-65)	51 (49-53)	52 (50-53)		61 (60-62)	39 (37-41)	
2001-2002	63 (62-63)	49 (47-51)	52 (50-53)		62 (61-63)	39 (38-41)	
2003-2004	60 (60-61)	46 (44-47)	48 (47-50)		61 (59-62)	39 (37-41)	
2005-2006	56 (56-57)	44 (43-46)	47 (46-49)		57 (56-58)	35 (33-36)	
2007-2008	58 (57-58)	45 (44-47)	52 (50-53)		58 (57-59)	42 (40-43)	
2009-2010	58 (57-58)	46 (45-48)	50 (49-52)	 	57 (56-58)	43 (41-44)	
Notes: 
1. Rates (95%CI) are the number of women screened as a percentage of the eligible female population and age-standardised to 2001 Australia ERP.
na stands for not applicable.
Data are for Indigenous and non-Indigenous women combined. 

Table 47 Two-year participation in cervical screening, age-standardised rate1, by health service delivery area group, aged 20-69 years, NT, 1997-2010
 	Darwin Urban	Darwin Rural	Tiwi	Top End West	West Arnhem & Maningrida	East Arnhem	 	
1997-1998	68 (68-69)	43 (42-45)	46 (42-51)	32 (29-36)	33 (30-35)	43 (41-45)		
1999-2000	68 (67-69)	43 (42-45)	66 (62-71)	47 (43-50)	42 (39-45)	54 (52-56)		
2001-2002	66 (65-66)	45 (44-47)	66 (62-70)	49 (45-53)	41 (38-44)	50 (48-51)		
2003-2004	63 (62-64)	47 (46-49)	65 (60-69)	41 (37-44)	42 (39-44)	48 (46-50)		
2005-2006	59 (58-59)	45 (44-47)	45 (41-50)	49 (45-52)	38 (35-40)	47 (45-49)		
2007-2008	60 (60-61)	47 (46-48)	55 (51-59)	44 (41-48)	43 (41-46)	46 (45-48)		
2009-2010	60 (60-61)	47 (46-49)	50 (46-54)	47 (44-50)	46 (44-48)	47 (45-48)		
 	Katherine Urban	Katherine East	Katherine West	Borroloola	Barkly	Alice Springs Urban	Central	
1997-1998	51 (48-53)	48 (44-51)	35 (31-39)	27 (22-31)	43 (40-46)	61 (60-63)	37 (35-39)	
1999-2000	59 (56-61)	54 (50-58)	41 (37-45)	23 (18-27)	41 (39-44)	61 (60-62)	38 (36-40)	
2001-2002	57 (55-59)	62 (59-66)	41 (37-45)	45 (40-50)	46 (43-49)	62 (61-64)	36 (34-38)	
2003-2004	53 (50-55)	55 (52-58)	34 (31-38)	34 (30-39)	46 (43-48)	61 (60-62)	36 (34-38)	
2005-2006	50 (48-52)	49 (46-52)	49 (45-53)	49 (44-54)	37 (35-39)	57 (56-58)	34 (33-36)	
2007-2008	52 (50-54)	64 (62-67)	49 (45-53)	75 (70-79)	40 (37-42)	58 (57-59)	44 (42-46)	
2009-2010	51 (49-53)	69 (66-71)	42 (38-45)	72 (67-76)	51 (49-53)	57 (56-58)	39 (38-41)	
Note: 
1. Rates (95%CI) are the number of women screened as a percentage of the eligible female population and age-standardised to 2001 Australia ERP.
Data are for Indigenous and non-Indigenous women combined. 

Table 48 Estimated Indigenous two-year participation in cervical screening, age-standardised rate1, by region, aged 20-69 years, NT, 1997-2010
 	Top End	Central Australia	NT	
1997-1998	30 (29-31)	33 (31-35)	31 (30-33)	
1999-2000	44 (42-45)	36 (34-38)	41 (40-43)	
2001-2002	45 (43-46)	33 (31-35)	41 (40-42)	
2003-2004	42 (40-43)	33 (31-35)	39 (38-40)	
2005-2006	43 (42-45)	32 (30-34)	40 (38-41)	
2007-2008	48 (47-50)	44 (42-46)	47 (46-48)	
2009-2010	48 (47-49)	41 (39-43)	46 (45-47)	
Note: 
1. Rates (95%CI) are the number of women screened as a percentage of the eligible female population and age-standardised to 2001 Australia ERP.

Table 49 Estimated Indigenous two-year participation in cervical screening, age-standardised rate1, by health service delivery area group, aged 20-69 years, NT, 1997-2010
 	Darwin Rural	Tiwi	Top End West	West Arnhem & Maningrida	East Arnhem	
1997-1998	24 (13-34)	44 (40-49)	18 (15-21)	33 (29-37)	27 (25-29)	
1999-2000	23 (14-33)	67 (62-72)	37 (32-41)	44 (40-48)	42 (40-45)	
2001-2002	29 (20-38)	67 (63-71)	39 (35-43)	43 (39-47)	35 (33-38)	
2003-2004	56 (46-65)	66 (61-70)	34 (30-38)	44 (41-48)	36 (34-38)	
2005-2006	33 (24-41)	43 (38-47)	45 (41-49)	37 (34-40)	39 (36-41)	
2007-2008	50 (45-55)	54 (50-58)	39 (35-42)	45 (41-48)	38 (36-40)	
2009-2010	51 (43-58)	49 (46-53)	40 (36-44)	45 (42-48)	40 (37-42)	
 	Katherine East	Katherine West	Borroloola	Barkly	Central	
1997-1998	44 (39-48)	37 (32-42)	15 (11-18)	39 (34-44)	32 (30-34)	
1999-2000	54 (50-58)	46 (41-52)	10 (7-14)	35 (31-40)	35 (33-37)	
2001-2002	64 (60-67)	49 (43-54)	37 (32-42)	33 (28-37)	32 (30-34)	
2003-2004	56 (52-61)	35 (30-40)	23 (19-28)	43 (38-48)	32 (29-34)	
2005-2006	50 (46-54)	63 (58-68)	41 (36-47)	40 (36-44)	31 (29-33)	
2007-2008	74 (70-77)	63 (58-68)	80 (76-84)	45 (40-50)	44 (42-46)	
2009-2010	74 (71-77)	50 (46-55)	73 (69-78)	54 (50-58)	39 (37-41)	
Note: 
1. Rates (95%CI) are the number of women screened as a percentage of the eligible female population and age-standardised to 2001 Australia ERP.
 
Table 50 Three-year participation in cervical screening, age-specific and age-standardised rates1, NT, 1996-2010
 	Age-group (years)	Aged	
 	20-29	30-39	40-49	50-59	60-69	20-69 years2	
1996-1998	77	77	74	69	50	71 (71-72)	
1999-2001	79	78	76	73	58	74 (74-74)	
2002-2004	75	75	73	71	55	71 (71-72)	
2005-2007	67	69	69	67	53	66 (66-67)	
2008-2010	67	71	73	72	57	69 (69-69)	
Notes: 
1. Rates are the number of women screened as a percentage of the eligible female population.
2. Rates (95%CI) are age-standardised to 2001 Australia ERP.
Data are for Indigenous and non-Indigenous women combined. 

Table 51 Three-year participation in cervical screening, age-specific and age-standardised rates1, by region, NT, 1996-2010
 	Age-group (years)	Aged	
 	20-29	30-39	40-49	50-59	60-69	20-69 years2	
	Top End	
1996-1998	80	78	74	69	48	72 (72-73)	
1999-2001	81	80	77	73	59	75 (75-76)	
2002-2004	75	77	74	72	58	72 (72-73)	
2005-2007	68	71	69	68	55	67 (67-68)	
2008-2010	69	72	73	73	59	70 (70-70)	
	Central Australia	
1996-1998	67	69	67	62	45	64 (63-65)	
1999-2001	70	70	71	67	46	67 (66-68)	
2002-2004	72	69	70	68	48	67 (66-68)	
2005-2007	64	65	67	64	49	63 (62-64)	
2008-2010	63	67	72	70	49	66 (65-66)	
Notes: 
1. Rates are the number of women screened as a percentage of the eligible female population.
2. Rates (95%CI) are age-standardised to 2001 Australia ERP.
Data are for Indigenous and non-Indigenous combined. 

Table 52 Three-year participation in cervical screening, age-specific and age-standardised rates1, by remoteness category, NT, 1996-2010
 	Age-group (years)	Aged	
 	20-29	30-39	40-49	50-59	60-69	20-69 years2	
	Outer Regional area	
1996-1998	87	84	80	76	56	79 (78-79)	
1999-2001	86	84	79	77	64	79 (79-80)	
2002-2004	80	80	78	76	63	77 (76-77)	
2005-2007	71	73	72	70	59	70 (70-71)	
2008-2010	72	74	76	75	65	73 (72-73)	
	Remote area	
1996-1998	74	73	68	65	48	68 (67-69)	
1999-2001	79	74	77	70	51	72 (71-73)	
2002-2004	78	75	73	70	51	71 (70-72)	
2005-2007	71	70	70	66	52	67 (66-68)	
2008-2010	67	69	72	73	50	68 (67-68)	
	Very Remote area	
1996-1998	58	58	56	42	28	51 (50-52)	
1999-2001	62	64	62	57	39	59 (58-60)	
2002-2004	62	62	59	57	37	57 (56-58)	
2005-2007	57	60	58	56	36	55 (54-56)	
2008-2010	60	64	64	64	39	60 (59-61)	
Notes: 
1. Rates are the number of women screened as a percentage of the eligible female population.
2. Rates (95%CI) are age-standardised to 2001 Australia ERP.
Data are for Indigenous and non-Indigenous women combined. 

Table 53 Three-year participation in cervical screening, age-standardised rate1, by region and remoteness category, aged 20-69 years, NT, 1996-2010
 	Top End	 	Central Australia	
	Outer Regional area	Remote area	Very Remote area		Remote area	Very Remote area	
1996-1998	79 (78-79)	55 (53-57)	53 (51-54)		74 (72-75)	47 (46-49)	
1999-2001	79 (79-80)	64 (62-66)	64 (63-65)		76 (75-77)	50 (48-52)	
2002-2004	77 (76-77)	59 (58-61)	61 (60-63)		77 (76-78)	50 (49-52)	
2005-2007	70 (70-71)	57 (55-58)	60 (58-61)		72 (71-73)	47 (46-49)	
2008-2010	73 (72-73)	58 (57-60)	63 (62-64)	 	72 (71-73)	54 (52-55)	
Notes: 
1. Rates (95%CI) are the number of women screened as a percentage of the eligible female population and age-standardised to 2001 Australia ERP.
Data are for Indigenous and non-Indigenous women combined. 

Table 54 Three-year participation in cervical screening, age-standardised rate1, by health service delivery area group, aged 20-69 years, NT, 1997-2010
 	Darwin Urban	Darwin Rural	Tiwi	Top End West	West Arnhem & Maningrida	East Arnhem	 	
1996-1998	83 (83-84)	53 (51-55)	55 (50-59)	44 (40-47)	45 (42-48)	53 (51-55)		
1999-2001	84 (83-84)	55 (54-57)	77 (73-81)	56 (52-59)	54 (51-57)	67 (65-68)		
2002-2004	80 (80-81)	59 (57-60)	78 (75-82)	55 (52-59)	52 (49-55)	60 (58-62)		
2005-2007	73 (72-73)	57 (56-59)	58 (54-62)	59 (55-62)	49 (46-51)	59 (57-60)		
2008-2010	76 (75-76)	60 (59-61)	67 (63-71)	59 (56-62)	56 (53-58)	59 (58-61)		
 	Katherine Urban	Katherine East	Katherine West	Borroloola	Barkly	Alice Springs Urban	Central	
1996-1998	64 (62-67)	60 (57-64)	47 (42-51)	32 (27-37)	50 (47-52)	74 (73-75)	46 (44-48)	
1999-2001	75 (73-77)	72 (69-76)	48 (43-52)	38 (33-43)	56 (53-59)	77 (76-78)	47 (45-49)	
2002-2004	69 (67-71)	67 (64-70)	49 (45-53)	48 (43-53)	59 (56-61)	78 (77-79)	46 (44-48)	
2005-2007	64 (62-66)	67 (64-70)	56 (53-60)	66 (61-71)	48 (45-50)	73 (71-74)	48 (46-50)	
2008-2010	65 (63-67)	79 (77-81)	54 (51-58)	82 (78-85)	61 (59-63)	72 (71-73)	51 (49-53)	
Notes: 
1. Rates (95%CI) are the number of women screened as a percentage of the eligible female population and age-standardised to 2001 Australia ERP.
Data are for Indigenous and non-Indigenous women combined. 

Table 55 Estimated Indigenous three-year participation in cervical screening, age-standardised rate1, by region, aged 20-69 years, NT, 1996-2010
 	Top End	Central Australia	NT	
1996-1998	39 (38-41)	40 (38-42)	40 (38-41)	
1999-2001	54 (52-55)	43 (41-45)	50 (49-52)	
2002-2004	53 (52-55)	43 (41-45)	50 (49-51)	
2005-2007	54 (53-55)	46 (44-48)	52 (50-53)	
2008-2010	60 (59-61)	52 (50-54)	57 (56-59)	
Note: 
1. Rates (95%CI) are the number of women screened as a percentage of the eligible female population and age-standardised to 2001 Australia ERP.

Table 56 Estimated Indigenous three-year participation in cervical screening, age-standardised rate1, by health service delivery area group, aged 20-69 years, NT, 1996-2010
 	Darwin Rural	Tiwi	Top End West	West Arnhem & Maningrida	East Arnhem	
1996-1998	45 (34-57)	53 (48-57)	26 (22-29)	49 (45-53)	32 (30-34)	
1999-2001	37 (28-46)	77 (73-81)	42 (38-47)	55 (51-59)	51 (48-53)	
2002-2004	56 (48-65)	78 (75-82)	47 (42-51)	55 (52-59)	44 (41-46)	
2005-2007	40 (31-49)	56 (51-61)	52 (48-57)	47 (43-50)	47 (45-49)	
2008-2010	54 (47-62)	66 (63-70)	54 (50-58)	55 (52-58)	50 (48-52)	
 	Katherine East	Katherine West	Borroloola	Barkly	Central	
1996-1998	56 (51-60)	51 (45-57)	20 (15-24)	43 (39-48)	40 (37-42)	
1999-2001	68 (65-72)	53 (48-59)	24 (20-28)	42 (38-47)	43 (41-46)	
2002-2004	68 (64-72)	58 (53-64)	35 (30-39)	55 (50-60)	41 (39-43)	
2005-2007	72 (69-75)	72 (68-77)	60 (54-67)	50 (46-54)	46 (44-48)	
2008-2010	80 (78-83)	68 (63-72)	80 (75-84)	66 (62-69)	50 (48-52)	
Note: 
1. Rates (95%CI) are the number of women screened as a percentage of the eligible female population and age-standardised to 2001 Australia ERP.

Table 57 Five-year participation in cervical screening, age-specific and age-standardised rates1, NT, 1996-2010
 	Age-group (years)	Aged	
 	20-29	30-39	40-49	50-59	60-69	20-69 years2	
1996-2000	100	98	91	82	63	90 (89-90)	
2001-2005	100	97	89	82	62	89 (88-89)	
2006-2010	92	91	87	83	62	85 (85-86)	
Notes: 
1. Rates are the number of women screened as a percentage of the eligible female population.
2. Rates (95%CI) are age-standardised to 2001 Australia ERP.
Data are for Indigenous and non-Indigenous women combined. 

Table 58 Five-year participation in cervical screening, age-specific and age-standardised rates1, by region, NT, 1996-2010
 	Age-group (years)	Aged	
 	20-29	30-39	40-49	50-59	60-69	20-69 years2	
	Top End	
1996-2000	100	98	90	80	59	89 (88-89)	
2001-2005	100	97	88	81	62	88 (88-88)	
2006-2010	93	90	86	82	62	85 (84-85)	
	Central Australia	
1996-2000	92	87	83	74	57	81 (80-82)	
2001-2005	95	88	86	78	55	83 (82-84)	
2006-2010	83	83	85	82	55	80 (79-81)	
Notes: 
1. Rates are the number of women screened as a percentage of the eligible female population.
2. Rates (95%CI) are age-standardised to 2001 Australia ERP.
Data are for Indigenous and non-Indigenous women combined. 

Table 59 Five-year participation in cervical screening, age-specific and age-standardised rates1, by remoteness category, NT, 1996-2010
 	Age-group (years)	Aged	
 	20-29	30-39	40-49	50-59	60-69	20-69 years2	
	Outer Regional area	
1996-2000	100	100	95	85	64	92 (91-92)	
2001-2005	100	100	92	84	66	91 (90-91)	
2006-2010	99	95	90	84	68	89 (89-90)	
	Remote area	
1996-2000	100	93	87	79	58	86 (85-87)	
2001-2005	100	96	91	80	57	88 (87-88)	
2006-2010	91	88	85	84	56	83 (83-84)	
	Very Remote area	
1996-2000	76	74	72	59	44	68 (67-69)	
2001-2005	77	76	72	69	45	70 (69-71)	
2006-2010	73	76	74	73	44	71 (70-71)	
Notes: 
1. Rates are the number of women screened as a percentage of the eligible female population.
2. Rates (95%CI) are age-standardised to 2001 Australia ERP.
Data are for Indigenous and non-Indigenous women combined. 

Table 60 Five-year participation in cervical screening, age-standardised rate1, by region and remoteness category, aged 20-69 years, NT, 1997-2010
 	Top End	 	Central Australia	
	Outer Regional area	Remote 
area	Very Remote area	 	Remote 
area	Very Remote area	
1996-1998	92 (91-92)	75 (74-77)	71 (70-73)		89 (88-90)	62 (60-63)	
2001-2003	91 (90-91)	75 (74-77)	75 (74-76)		92 (91-92)	62 (61-64)	
2006-2008	89 (89-90)	72 (70-73)	74 (73-75)	 	89 (88-90)	64 (63-66)	
Notes: 
1. Rates (95%CI) are the number of women screened as a percentage of the eligible female population and age-standardised to 2001 Australia ERP.
Data are for Indigenous and non-Indigenous women combined. 

Table 61 Five-year participation in cervical screening, age-standardised rate1, by health service delivery area group, aged 20-69 years, NT, 1997-2010
 	Darwin Urban	Darwin Rural	Tiwi	Top End West	West Arnhem & Maningrida	East Arnhem	 	
1996-2000	95 (95-95)	65 (63-66)	75 (71-79)	61 (57-65)	60 (57-63)	75 (73-77)		
2001-2005	94 (94-95)	69 (67-70)	85 (82-88)	68 (65-71)	63 (60-65)	76 (74-77)		
2006-2010	92 (92-93)	71 (70-72)	77 (74-80)	66 (63-69)	65 (63-67)	72 (71-74)		
	Katherine Urban	Katherine East	Katherine West	Borroloola	Barkly	Alice Springs Urban	Central	
1996-2000	86 (85-88)	76 (73-80)	57 (52-61)	42 (37-47)	66 (64-69)	89 (88-90)	59 (57-61)	
2001-2005	86 (85-88)	78 (75-81)	58 (55-62)	67 (62-72)	72 (70-75)	92 (91-93)	57 (55-59)	
2006-2010	80 (79-82)	87 (85-89)	63 (60-67)	84 (80-88)	69 (67-72)	89 (89-90)	62 (61-64)	
Notes: 
1. Rates (95%CI) are the number of women screened as a percentage of the eligible female population and age-standardised to 2001 Australia ERP.
Data are for Indigenous and non-Indigenous women combined. 

Table 62 Estimated Indigenous five-year participation in cervical screening, age-standardised rate1, by region, aged 20-69 years, NT, 1996-2010
 	Top End	Central Australia	NT	
1996-2000	57 (55-58)	53 (51-55)	56 (54-57)	
2001-2005	65 (63-66)	53 (51-55)	61 (60-62)	
2006-2010	67 (66-69)	62 (60-64)	66 (65-67)	
Note: 
1. Rates (95%CI) are the number of women screened as a percentage of the eligible female population and age-standardised to 2001 Australia ERP.

Table 63 Estimated Indigenous five-year participation in cervical screening, age-standardised rate1, by health service delivery area group, aged 20-69 years, NT, 1996-2010
 	Darwin Rural	Tiwi	Top End West	West Arnhem & Maningrida	East Arnhem	
1996-2000	46 (38-53)	74 (70-78)	43 (38-47)	64 (60-68)	52 (50-55)	
2001-2005	56 (47-65)	85 (82-88)	58 (53-62)	62 (59-66)	57 (55-59)	
2006-2010	73 (68-79)	77 (74-80)	59 (55-63)	62 (59-65)	57 (55-60)	
	Katherine East	Katherine West	Borroloola	Barkly	Central	
1996-2000	70 (66-74)	64 (59-70)	27 (22-31)	59 (54-64)	52 (50-55)	
2001-2005	77 (73-80)	71 (66-75)	54 (49-60)	63 (59-68)	51 (49-53)	
2006-2010	91 (89-93)	78 (74-81)	81 (76-86)	67 (63-70)	60 (58-62)	
Note: 
1. Rates (95%CI) are the number of women screened as a percentage of the eligible female population and age-standardised to 2001 Australia ERP.

5.2 Early rescreening
The ‘early rescreening’ indicator measures the percentage of women who have a one or more repeat Pap tests earlier than is necessary. It is calculated as the proportion of women with a normal Pap test in each two-year period, and no cervical abnormalities in the preceding three years, who have one or more Pap tests within the following 21 months. The early rescreening indicator measures compliance with the recommended two-year screening interval.
Early rescreening is measured slightly differently in this report to the AIHW statistical reports of the National Cervical Screening Program. The AIHW reports measure early rescreening only for women screened in February each year.9-10 In the current report, early rescreening is measured for all women screened in each two-year period (as described on page 7), because of the small number of women screened in the NT each month. The early rescreening percentage reported here is therefore not directly comparable to national figures. 
Almost a quarter (24.3%) of women screened during 1997-1998 had a repeat screen within twenty-one months, but this decreased progressively to 15% in 2007-2008, indicating a better compliance with screening recommendations and a reduction of over-screening of women (Table 64). In 2007-2008 the early rescreening rate was lower in the Top End than in Central Australia (Table 65), and lower in Outer Regional than Remote and Very Remote areas (Table 66). The early rescreening rate in 2007-2008 was less than 14% in Darwin Urban and Katherine Urban areas, but approximately 20% in the Katherine East and Barkly areas (Table 68).

Figure 18 Proportion (%) of women rescreening early, by remoteness category and two-year period, aged 20-69 years, NT, 1997-2008

Note: Data are for Indigenous and non-Indigenous women combined. 

Table 64 Proportion (%) of women rescreening early, by number of repeats and two-year period, aged 20-69 years, NT, 1997-2008
 	No repeat	1 repeat	2 or more repeats	1 or more repeats	
1997-1998	75.7	21.9	2.4	24.3	
1999-2000	79.0	19.3	1.7	21.0	
2001-2002	79.5	19.0	1.5	20.5	
2003-2004	81.9	17.0	1.1	18.1	
2005-2006	83.0	16.1	0.9	17.0	
2007-2008	85.0	14.3	0.7	15.0	
Note: Data are for Indigenous and non-Indigenous women combined. 

Table 65 Proportion (%) of women rescreening early, by region and two-year period, aged 20-69 years, NT, 1997-2008
 	Top End	Central Australia	All NT1	
1997-1998	24.4	24.2	24.3	
1999-2000	20.8	22.1	21.0	
2001-2002	20.1	22.4	20.5	
2003-2004	18.1	18.4	18.1	
2005-2006	16.2	19.9	17.0	
2007-2008	14.2	17.9	15.0	
Notes: 
1. including NT women with unknown localities
Data are for Indigenous and non-Indigenous women combined. 

Table 66 Proportion (%) of women rescreening early, by remoteness category and two-year period, aged 20-69 years, NT, 1997-2008
 	Outer Regional area	Remote area	Very Remote area	All NT1	
1997-1998	23.2	25.5	27.0	24.3	
1999-2000	20.3	22.5	22.1	21.0	
2001-2002	19.7	21.2	22.5	20.5	
2003-2004	17.6	18.6	19.1	18.1	
2005-2006	15.7	17.5	20.6	17.0	
2007-2008	13.4	16.8	17.7	15.0	
Notes: 
1. including NT women with unknown localities
Data are for Indigenous and non-Indigenous women combined. 

Table 67 Proportion (%) of women rescreening early, by community population characteristics1, remoteness category and two-year period, aged 20-69 years, NT, 1997-2008
 	Outer Regional area	Remote area	Very Remote area	All NT1	
	Communities where population is not predominantly Indigenous	
1997-1998	23.3	25.4	24.3	23.9	
1999-2000	20.3	22.6	19.7	20.8	
2001-2002	19.7	21.0	22.3	20.2	
2003-2004	17.7	18.7	16.9	17.9	
2005-2006	15.7	17.7	19.3	16.4	
2007-2008	13.4	16.7	14.6	14.3	
	Communities with predominantly Indigenous population	
1997-1998	na	32.2	28.9	29.1	
1999-2000	na	26.9	23.5	23.7	
2001-2002	na	28.7	22.7	23.1	
2003-2004	na	19.7	20.3	20.3	
2005-2006	na	15.0	21.2	20.7	
2007-2008	na	17.8	18.9	18.8	
Notes:
1. Communities classified as predominantly of Indigenous include SLAs with Indigenous making 60% and over of female population in 20-69 year age-group.
Data are for Indigenous and non-Indigenous women combined. 

Table 68 Proportion (%) of women rescreening early, by health service delivery area group and two-year period, aged 20-69 years, NT, 1997-2008
 	Darwin Urban	Darwin Rural	Tiwi	Top End West	West Arnhem & Maningrida	East Arnhem		
1997-1998	23.1	24.8	43.0	36.7	27.4	27.9		
1999-2000	20.0	22.4	37.7	25.9	18.5	21.1		
2001-2002	19.6	21.3	22.6	23.5	19.6	23.5		
2003-2004	17.4	19.6	16.1	19.7	17.3	20.4		
2005-2006	15.6	16.3	16.5	18.1	18.3	18.5		
2007-2008	13.3	14.4	16.5	16.9	16.6	17.0		
	Katherine Urban	Katherine East	Katherine West	Borroloola	Barkly	Alice Springs Urban	Central	
1997-1998	26.7	26.4	29.7	20.2	23.7	24.8	22.1	
1999-2000	20.1	23.7	27.0	19.3	20.0	23.3	18.9	
2001-2002	16.4	24.1	23.2	14.1	24.3	22.4	21.4	
2003-2004	18.3	23.5	20.0	20.2	16.9	18.8	17.5	
2005-2006	14.2	21.9	19.3	22.4	24.0	18.9	21.8	
2007-2008	13.6	20.6	14.9	17.6	19.9	17.9	17.1	
Note: Data are for Indigenous and non-Indigenous women combined. 

5.3 Cytology
The proportion of screened women with an abnormal Pap test decreased from 9.8% in 1997-1998 to 5.5% in 2009-2010, and the proportion of women with a normal smear correspondingly increased from 88% to 92% (Table 69). The decrease was restricted to the low-grade abnormalities (low-grade squamous intra-epithelial abnormality (LSIL) and possible LSIL) (Figure 19). The proportion of women with high-grade abnormalities (high-grade squamous intra-epithelial abnormality (HSIL); possible HSIL; endocervical dysplasia; and adenocarcinoma in situ) did not decrease. 
The decrease in the low-grade abnormality rate before 2005-2006 occurred among all age-groups except the 20-29 age-group (Figure 20, Table 71). The decrease in the low-grade abnormality rate after 2005-2006, including a considerable decrease in the 20-29 age-group, is at least partly because of the change to the national guidelines for management of low-grade abnormalities in 2006; the new guidelines recommended less frequent follow-up Pap tests after a low-grade abnormal test than the previous guidelines. The recent decline in the 20-29 age-group may also be partly a result of the national HPV vaccination program that started in 2007, although there was no decrease in the high-grade abnormality rate in this age-group (Figure 21, Table 71).
The decrease in the low-grade abnormality rate between 1997-1998 and 2005-2006 may be an indication of reduced disease prevalence since the start of the National Cervical Screening Program in early 1990s, but this is not supported by the absence of a decrease in the high-grade abnormality rate (which is most directly relevant to the development of cervical cancer). 

Figure 19 Age-standardised rate1 of cytology result category, by two-year period, aged 20-69 years, NT, 1997-2010

Notes:  
1. Rates are the number of tests in each category as a percentage of total cytology. 
Data are for Indigenous and non-Indigenous women combined. 

Figure 20 Age-specific rate1 of low-grade abnormality detection in cytology tests, by two-year period, NT, 1997-2010

Notes:  
1. Rates are the number of tests in each category as a percentage of total cytology. 
Data are for Indigenous and non-Indigenous women combined. 

Figure 21 Age-specific rate1 of high-grade abnormality detection in cytology tests, by two-year period, NT, 1997-2010

Notes:  
1. Rates are the number of tests in each category as a percentage of total cytology. 
Data are for Indigenous and non-Indigenous women combined. 

Squamous cell abnormalities are more commonly detected in younger women.10 Squamous cell low-grade abnormality was the major contributor to the decrease in Pap test abnormality, decreasing from 7.7% in 1997-98 to 3.7% in 2009-10 (Table 70). 
The proportion of cervical cytology tests without an adequate endocervical component has increased markedly, despite a stable proportion of overall unsatisfactory tests (Table 72). This finding is consistent with national data over the same period.  Although presence of an adequate endocervical component may indicate sampling of the inner cervical epithelium, the significance of its absence is unclear, as is the importance or otherwise of this trend.
The proportion of women with high-grade abnormalities increased with increasing remoteness (i.e. from Outer Regional to Remote to Very Remote categories), although the proportion with low-grade abnormalities was similar in all remoteness categories (Table 73). Within each remoteness category, both low- and high-grade abnormalities were more common in the Top End than in Central Australia (Table 74). High-grade abnormalities were more common in most (but not all) remote HSDAs than in urban areas (Table 76), reflecting the higher prevalence of high-grade abnormalities in more remote areas. The higher prevalence of high-grade abnormalities in remote areas may be due to the lower screening participation in those areas, so that a high proportion of women who have a Pap test are having their first smear for many years, or first ever smear. Within each remoteness category, communities with a predominantly Indigenous female population also have higher abnormalities than other communities (Table 75). This may reflect the lower participation of Indigenous women in general in the cervical screening program.

Table 69 Age-standardised rate1 of cytology result category, by two-year period, aged 20-69 years, NT, 1997-2010
 	Age-standardised rate (95%CI)	Total	
 	Unsatis-factory	Negative	Low-grade abnormalities	High-grade abnormalities	All abnormalities	number of tests	
1997-1998	2.1 (1.9-2.3)	88.1 (87.7-88.5)	7.9 (7.6-8.2)	1.9 (1.7-2.0)	9.8 (9.5-10.1)	39,131	
1999-2000	2.3 (2.2-2.5)	89.6 (89.3-90.0)	6.3 (6.1-6.6)	1.7 (1.5-1.8)	8.0 (7.7-8.3)	39,758	
2001-2002	3.2 (3.0-3.4)	87.1 (86.8-87.5)	7.8 (7.5-8.1)	1.8 (1.7-2.0)	9.7 (9.4-10.0)	40,191	
2003-2004	2.0 (1.8-2.1)	91.0 (90.7-91.3)	5.7 (5.5-5.9)	1.3 (1.2-1.4)	7.0 (6.8-7.3)	37,822	
2005-2006	1.7 (1.6-1.9)	90.9 (90.6-91.2)	5.7 (5.5-6.0)	1.6 (1.5-1.8)	7.4 (7.1-7.6)	36,096	
2007-2008	2.0 (1.9-2.2)	91.5 (91.2-91.8)	4.6 (4.4-4.8)	1.8 (1.7-1.9)	6.4 (6.2-6.7)	38,298	
2009-2010	2.3 (2.1-2.4)	92.3 (92.0-92.5)	3.7 (3.5-3.9)	1.8 (1.6-1.9)	5.5 (5.3-5.7)	39,575	
Notes:  
1. Rates (95%CI) are the number of tests in each category as a percentage of total cytology tests and age-standardised to 2001 Australia ERP. 
Data are for Indigenous and non-Indigenous women combined. 

Table 70 Age-standardised rate1 of squamous cell cytology result category, by two-year period, aged 20-69 years, NT, 1996-2010
 	Squamous cell low-grade abnormalities	Squamous cell high-grade abnormalities	Squamous cell 
all 
abnormalities	
1997-1998	7.7 (7.4-8.0)	1.8 (1.7-1.9)	9.6 (9.2-9.9)	
1999-2000	6.2 (6.0-6.5)	1.6 (1.5-1.8)	7.9 (7.6-8.2)	
2001-2002	7.7 (7.4-8.0)	1.8 (1.7-1.9)	9.5 (9.2-9.8)	
2003-2004	5.7 (5.4-5.9)	1.3 (1.2-1.4)	6.9 (6.7-7.2)	
2005-2006	5.7 (5.4-5.9)	1.6 (1.5-1.7)	7.3 (7.0-7.5)	
2007-2008	4.6 (4.4-4.8)	1.8 (1.6-1.9)	6.4 (6.1-6.6)	
2009-2010	3.7 (3.5-3.9)	1.7 (1.6-1.9)	5.4 (5.2-5.7)	
Notes:  
1. Rates (95%CI) are the number of tests in each category as a percentage of total cytology tests and age-standardised to 2001 Australia ERP. 
Data are for Indigenous and non-Indigenous women combined. 

Table 71 Age-specific rate1 of abnormality detection in cytology tests, by two-year period, NT, 1997-2010
 	Aged 20-29	Aged 30-39	Aged 40-49	Aged 50-59	Aged 60-69	
	Log-grade abnormalities	
1997-1998	11.6	7.5	7.6	7.0	3.5	
1999-2000	10.6	6.3	5.9	4.0	3.0	
2001-2001	13.0	7.7	6.9	5.0	4.4	
2003-2004	11.3	5.4	4.2	3.7	2.4	
2005-2006	11.6	5.8	4.0	2.8	2.2	
2007-2008	  9.5	4.4	3.3	2.3	2.4	
2009-2010	  7.6	3.9	2.5	1.8	1.3	
	High-grade abnormalities	
1997-1998	2.9	2.3	1.5	1.3	0.9	
1999-2000	2.8	1.9	1.3	1.0	0.9	
2001-2001	3.4	1.9	1.1	1.0	1.3	
2003-2004	2.3	1.7	0.9	0.6	0.8	
2005-2006	2.9	2.0	1.0	0.7	1.1	
2007-2008	3.4	2.3	1.2	0.7	0.9	
2009-2010	3.3	2.0	1.3	1.0	0.7	
Notes:  
1. Rates are the number of tests in each category as a percentage of total cytology tests. 
Data are for Indigenous and non-Indigenous women combined. 

Table 72 Age-standardised rate1 of endocervical cytology result category, by two-year period, aged 20-69 years, NT, 1996-2010
	No 
endocervical component	Endocervical 
low-grade abnormalities	Endocervical high-grade abnormalities	Endocervical 
all 
abnormalities	
1997-1998	14.3 (13.9-14.8)	0.2 (0.1-0.3)	0.1 (0.1-0.1)	0.3 (0.2-0.4)	
1999-2000	16.3 (15.8-16.8)	0.1 (0.1-0.2)	0.1 (0.1-0.1)	0.2 (0.2-0.3)	
2001-2002	19.4 (18.9-19.9)	0.1 (0.1-0.2)	0.1 (0.0-0.1)	0.2 (0.2-0.3)	
2003-2004	21.2 (20.7-21.6)	0.1 (0.1-0.1)	0.1 (0.0-0.1)	0.2 (0.1-0.2)	
2005-2006	23.2 (22.7-23.7)	0.1 (0.0-0.1)	0.1 (0.0-0.1)	0.1 (0.1-0.2)	
2007-2008	23.5 (23.1-24.0)	0.0 (0.0-0.0)	0.1 (0.1-0.1)	0.1 (0.1-0.2)	
2009-2010	24.9 (24.4-25.3)	0.0 (0.0-0.0)	0.1 (0.0-0.1)	0.1 (0.1-0.1)	
Notes:  
1. Rates (95%CI) are the number of tests in each category as a percentage of total cytology tests and age-standardised to 2001 Australia ERP. 
Data are for Indigenous and non-Indigenous women combined. 

Table 73 Age-standardised rate1 of cytology result category, by remoteness category and five-year period, aged 20-69 years, NT, 1996-2010
 	 	Outer Regional	Remote	Very Remote	
1996-2000							
	Unsatisfactory	2.4	(2.2-2.5)	2.0	(1.8-2.3)	3.1	(2.8-3.5)	
	Negative	88.9	(88.6-89.2)	88.9	(88.4-89.4)	87.3	(86.7-87.9)	
	Low-grade abnormalities	7.1	(6.9-7.4)	7.4	(7.0-7.8)	7.1	(6.6-7.6)	
	High-grade abnormalities	1.6	(1.5-1.7)	1.7	(1.5-1.9)	2.4	(2.1-2.7)	
	All abnormalities	8.7	(8.5-9.0)	9.1	(8.6-9.5)	9.6	(9.0-10.1)	
								
 	Total number of tests	 	57,178	 	20,148	 	16,892	
2001-2005							
	Unsatisfactory	2.2	(2.1-2.4)	2.1	(1.9-2.3)	3.2	(2.8-3.5)	
	Negative	89.5	(89.2-89.7)	89.9	(89.5-90.4)	88.2	(87.6-88.7)	
	Low-grade abnormalities	6.8	(6.6-7.0)	6.4	(6.0-6.7)	6.4	(6.0-6.8)	
	High-grade abnormalities	1.4	(1.3-1.5)	1.5	(1.4-1.7)	2.2	(1.9-2.5)	
	All abnormalities	8.3	(8.0-8.5)	8.0	(7.6-8.3)	8.7	(8.2-9.2)	
								
 	Total number of tests	 	56,619	 	20,932	 	18,816	
2006-2010							
	Unsatisfactory	1.9	(1.8-2.0)	2.2	(2.0-2.4)	2.9	(2.6-3.2)	
	Negative	92.1	(91.9-92.3)	91.5	(91.2-91.9)	90.1	(89.6-90.6)	
	Low-grade abnormalities	4.5	(4.3-4.6)	4.5	(4.2-4.8)	4.4	(4.1-4.8)	
	High-grade abnormalities	1.5	(1.4-1.6)	1.7	(1.6-1.9)	2.5	(2.2-2.8)	
	All abnormalities	6.0	(5.8-6.2)	6.3	(6.0-6.6)	7.0	(6.6-7.4)	
								
 	Total number of tests	 	54,641	 	20,251	 	20,329	
Note:  
1. Rates (95%CI) are the number of tests in each category as a percentage of total cytology tests and age-standardised to 2001 Australia ERP. 
Data are for Indigenous and non-Indigenous women combined. 

Table 74 Age-standardised rate1 of cytology result category, by remoteness category and region, aged 20-69 years, NT, 2006-2010
 	Outer Regional	Remote	Very Remote	
	Top End	
Unsatisfactory	1.9	(1.8-2.0)	1.6	(1.2-2.0)	2.9	(2.5-3.2)	
Negative	92.1	(91.9-92.3)	91.4	(90.6-92.1)	89.7	(89.1-90.4)	
Low-grade abnormalities	4.5	(4.3-4.6)	5.1	(4.5-5.7)	4.8	(4.3-5.2)	
High-grade abnormalities	1.5	(1.4-1.6)	1.9	(1.6-2.2)	2.6	(2.3-2.9)	
All abnormalities	6.0	(5.8-6.2)	7.0	(6.3-7.6)	7.4	(6.9-7.9)	
							
Total number of tests	 	54,641	 	5,712	 	13,822	
	Central Australia	
Unsatisfactory		na	2.4	(2.1-2.7)	3.1	(2.6-3.5)	
Negative		na	91.6	(91.2-92.1)	90.7	(89.9-91.5)	
Low-grade abnormalities		na	4.3	(4.0-4.6)	3.9	(3.4-4.3)	
High-grade abnormalities		na	1.7	(1.5-1.9)	2.3	(1.9-2.7)	
All abnormalities		na	6.0	(5.6-6.4)	6.2	(5.6-6.9)	
							
Total number of tests	 	na	 	14,539	 	6,507	
Notes:  
1. Rates (95%CI) are the number of tests in each category as a percentage of total cytology tests and age-standardised to 2001 Australia ERP. 
na – not applicable
Data are for Indigenous and non-Indigenous women combined. 

Table 75 Age-standardised rate1 of cytology result category, by remoteness category and community population characteristics2, aged 20-69 years, NT, 2006-2010
 	Outer Regional	Remote	Very Remote	
	Communities where population is not predominantly Indigenous	
Unsatisfactory	1.9	(1.8-2.0)	2.2	(2.0-2.4)	2.3	(1.8-2.8)	
Negative	92.1	(91.9-92.3)	91.5	(91.1-91.9)	91.4	(90.5-92.2)	
Low-grade abnormalities	4.5	(4.3-4.6)	4.5	(4.2-4.8)	4.4	(3.8-5.0)	
High-grade abnormalities	1.5	(1.4-1.6)	1.8	(1.6-2.0)	1.9	(1.6-2.2)	
All abnormalities	6.0	(5.8-6.2)	6.3	(6.0-6.6)	6.3	(5.6-7.0)	
							
Total number of tests	 	54,641	 	19,218	 	5,867	
	Communities with predominantly Indigenous population	
Unsatisfactory		na	2.3	(1.3-3.3)	3.2	(2.8-3.5)	
Negative		na	90.1	(87.7-92.4)	89.6	(89.0-90.2)	
Low-grade abnormalities		na	6.3	(4.2-8.3)	4.5	(4.1-4.9)	
High-grade abnormalities		na	1.3	(0.6-2.0)	2.7	(2.4-3.1)	
All abnormalities		na	7.6	(5.4-9.7)	7.2	(6.7-7.8)	
							
Total number of tests	 	na	 	1,033	 	14,462	
Notes: 
1. Rates (95%CI) are the number of tests in each category as a percentage of total cytology tests and age-standardised to 2001 Australia ERP.
2. Communities classified as predominantly of Indigenous include SLAs with Indigenous making 60% and over of female population in 20-69 year age-group.
Data are for Indigenous and non-Indigenous women combined. 

Table 76 Age-standardised rate1 of cytology result category, by health service delivery area group, aged 20-69 years, NT, 2006-2010
 	Darwin Urban	Darwin Rural	Tiwi			
Unsatisfactory	1.9	(1.8-2.0)	1.8	(1.5-2.2)	2.5	(1.6-3.4)			
Negative	92.1	(91.9-92.3)	92.1	(91.5-92.8)	88.0	(85.8-90.1)			
Low-grade abnormalities	4.4	(4.3-4.6)	4.6	(4.1-5.1)	5.6	(4.0-7.3)			
High-grade abnormalities	1.6	(1.5-1.7)	1.4	(1.1-1.7)	3.8	(2.6-5.1)			
All abnormalities	6.0	(5.8-6.2)	6.0	(5.5-6.6)	9.6	(7.6-11.6)			
									
Total number of tests	 	48,312	 	6,540	 	1,087			
	Top End West	West Arnhem & Maningrida	East Arnhem			
Unsatisfactory	2.6	(1.6-3.5)	1.9	(1.3-2.5)	2.1	(1.6-2.6)			
Negative	88.2	(86.1-90.2)	90.2	(87.9-92.4)	90.9	(89.9-91.9)			
Low-grade abnormalities	7.2	(5.6-8.9)	5.0	(2.9-7.0)	4.3	(3.7-5.0)			
High-grade abnormalities	2.1	(1.2-2.9)	3.0	(2.2-3.7)	2.6	(1.9-3.2)			
All abnormalities	9.3	(7.5-11.1)	7.9	(5.7-10.1)	7.0	(6.1-7.9)			
									
Total number of tests	 	1,385	 	2,467	 	6,139			
	Katherine Urban	Katherine East	Katherine West			
Unsatisfactory	1.6	(1.1-2.0)	3.8	(2.7-4.8)	3.1	(1.9-4.3)			
Negative	91.1	(90.2-92.1)	90.5	(89.1-91.9)	91.9	(90.1-93.6)			
Low-grade abnormalities	5.5	(4.8-6.2)	3.7	(2.9-4.4)	3.8	(2.7-5.0)			
High-grade abnormalities	1.8	(1.4-2.2)	2.0	(1.4-2.6)	1.2	(0.5-1.8)			
All abnormalities	7.3	(6.5-8.1)	5.7	(4.8-6.7)	5.0	(3.7-6.3)			
									
Total number of tests	 	3,955	 	2,330	 	1,087			
	Borroloola	Barkly	Alice Springs Urban	Central	
Unsatisfactory	5.9	(3.8-7.9)	3.0	(2.3-3.7)	2.4	(2.1-2.7)	3.0	(2.4-3.6)	
Negative	85.1	(82.4-87.9)	88.8	(87.5-90.2)	91.6	(91.1-92.0)	91.7	(90.8-92.6)	
Low-grade abnormalities	5.1	(3.7-6.5)	5.0	(4.0-6.0)	4.3	(4.0-4.6)	3.5	(2.9-4.0)	
High-grade abnormalities	3.9	(2.6-5.2)	3.2	(2.5-3.9)	1.7	(1.5-1.9)	1.7	(1.3-2.2)	
All abnormalities	9.0	(7.1-10.9)	8.2	(7.0-9.4)	6.0	(5.7-6.4)	5.3	(4.5-6.0)	
									
Total number of tests	 	873	 	2,308	 	14,265	 	4,473	
Notes:  
1. Rates (95%CI) are the number of tests in each category as a percentage of total cytology tests and age-standardised to 2001 Australia ERP. 
Data are for Indigenous and non-Indigenous women combined. 

5.4 Histology
The overall proportion of cytology tests which subsequently had a cervical histology test has remained constant at between 5 and 6 percent since 1997 (Table 77). A decrease in the 20-29 age-group occurred gradually over the entire period, but with some fluctuation between periods (Figure 22).  
Among women who had a cervical histology test, the proportion of women with any abnormal histology test was relatively constant between 1997 and 2010 (between 51% and 54% in most two-year periods), but the proportion of low-grade abnormalities decreased (from 27% to 17%) while the proportion of high-grade abnormalities increased (from 25% to 35%) (Table 78). The decreasing proportion of low-grade abnormal histology tests is almost certainly due to the 2006 changes in the guidelines for management of low-grade cytology abnormalities detected by screening, which specifically reduced the indication for referral of screen-detected low-grade cytology abnormalities for colposcopy and biopsy.
The proportion of low-grade histology tests decreased for residents in all remoteness categories (Table 81). The proportion of high-grade abnormal histology tests was higher for Very Remote than Outer Regional and Remote residents, and increased for all three remoteness categories. 

Figure 22 Histology tests as proportion (%) of cytology tests, by age-group and two-year period, NT, 1997-2010

Note: Data are for Indigenous and non-Indigenous women combined. 

Table 77 Histology test as proportion (%) of cytology test, by age-group and two-year period, NT, 1997-2010
 	Age-group (years)	Aged 20-69	
 	20-29	30-39	40-49	50-59	60-69	years	
1997-1998	7.8	5.7	4.7	4.8	3.3	6.1	
1999-2000	7.1	5.0	4.2	2.7	3.4	5.2	
2001-2002	6.9	4.5	4.5	2.9	2.2	5.0	
2003-2004	6.3	4.3	4.4	3.2	3.4	4.7	
2005-2006	6.6	4.8	4.9	3.5	2.4	5.0	
2007-2008	6.0	5.2	5.6	3.7	2.8	5.2	
2009-2010	6.4	5.0	5.2	4.4	2.8	5.2	
Note: Data are for Indigenous and non-Indigenous women combined. 

Table 78 Age-standardised rate1 of histology result category, by two-year period, aged 20-69 years, NT, 1997-2010
 	Age-standardised rate (%)	Total	
 	Low-grade abnormalities	High-grade abnormalities	All abnormalities	number of tests	
1997-1998	27 (25-29)	25 (21-28)	53 (50-57)	2,380	
1999-2000	23 (21-26)	27 (25-30)	52 (49-55)	2,065	
2001-2002	28 (25-30)	29 (26-32)	58 (55-61)	2,000	
2003-2004	25 (23-27)	25 (23-27)	51 (48-54)	1,791	
2005-2006	19 (17-21)	32 (30-35)	53 (50-56)	1,814	
2007-2008	17 (15-19)	36 (33-38)	55 (52-57)	1,985	
2009-2010	17 (16-19)	35 (33-37)	54 (51-56)	2,061	
Note: 
1. Rates (95%CI) are the number of tests in each category as a percentage of total histology tests and age-standardised to 2001 Australia ERP. 
Data are for Indigenous and non-Indigenous women combined. 

Table 79 Age-standardised rate1 of squamous cell histology result category, by two-year period, aged 20-69 years, NT, 1996-2010
 	Low-grade	High-grade	All abnormalities2	
1997-1998	27 (25-29)	25 (21-28)	53 (49-57)	
1999-2000	23 (21-26)	27 (24-29)	51 (48-54)	
2001-2002	28 (26-30)	28 (25-31)	57 (54-61)	
2003-2004	25 (23-28)	25 (22-27)	50 (47-53)	
2005-2006	19 (17-21)	32 (29-34)	52 (50-55)	
2007-2008	17 (15-19)	35 (33-38)	54 (52-57)	
2009-2010	18 (16-19)	34 (32-36)	53 (51-55)	
Notes: 
1. Rates (95%CI) are the number of tests in each category as a percentage of total histology tests and age-standardised to 2001 Australia ERP. 
2. All abnormalities include low-grade, high-grade and cancer in squamous cells. 
Data are for Indigenous and non-Indigenous women combined. 

Table 80 Age-standardised rate1 of endocervical histology result category, by two-year period, aged 20-69 years, NT, 1996-2010
	High-grade	Cancer	All abnormalities2	
1997-1998	0.2 (0.1-0.4)	0.3 (0.0-0.6)	0.5 (0.2-0.9)	
1999-2000	0.6 (0.3-1.0)	0.2 (0.0-0.5)	0.8 (0.4-1.3)	
2001-2002	0.7 (0.4-1.0)	0.3 (0.0-0.6)	1.0 (0.5-1.4)	
2003-2004	0.5 (0.2-0.8)	0.2 (0.0-0.5)	0.7 (0.3-1.1)	
2005-2006	1.4 (0.9-1.9)	0.4 (0.1-0.8)	1.9 (1.2-2.5)	
2007-2008	1.0 (0.4-1.6)	0.6 (0.0-1.1)	1.6 (0.8-2.3)	
2009-2010	0.6 (0.3-0.9)	0.5 (0.2-0.9)	1.1 (0.7-1.6)	
Notes: 
1. Rates (95%CI) are the number of tests in each category as a percentage of total histology tests and age-standardised to 2001 Australia ERP. 
2. All abnormalities include low-grade, high-grade and cancer in endocervical cells. 
Data are for Indigenous and non-Indigenous women combined. 

Table 81 Age-standardised rate1 of histology result category, by remoteness category and five-year period, aged 20-69 years, NT
 	 	Outer Regional	Remote	Very Remote	All NT2	
1996-2000									
	Low-grade abnormalities	26	(24-28)	25	(23-28)	27	(23-32)	26	(24-28)	
	High-grade abnormalities	24	(22-26)	22	(19-25)	33	(29-37)	25	(24-27)	
	All abnormalities	52	(49-55)	49	(45-53)	62	(57-67)	53	(51-55)	
										
 	Total number of tests	 	3,092	 	1,148	 	995	 	5,235	
2001-2005									
	Low-grade abnormalities	23	(21-24)	32	(29-36)	24	(20-29)	25	(24-27)	
	High-grade abnormalities	25	(23-27)	23	(20-25)	39	(34-43)	27	(25-29)	
	All abnormalities	49	(47-51)	57	(53-61)	64	(60-68)	53	(52-55)	
										
 	Total number of tests	 	2,829	 	1,058	 	809	 	4,696	
2006-2010									
	Low-grade abnormalities	16	(15-18)	21	(18-23)	19	(16-22)	18	(17-19)	
	High-grade abnormalities	35	(33-36)	31	(29-34)	41	(38-44)	35	(34-37)	
	All abnormalities	53	(51-55)	53	(50-56)	62	(59-65)	55	(53-56)	
										
 	Total number of tests	 	2,715	 	1,094	 	1,135	 	4,944	
Notes: 
1. Rates (95%CI) are the number of tests in each category as a percentage of total histology tests and age-standardised to 2001 Australia ERP.
2. include those with unknown localities.
Data are for Indigenous and non-Indigenous women combined. 

Table 82 Age-standardised rate1 of histology result category, by remoteness category and region, aged 20-69 years, NT, 2006-2010
 	Outer Regional	Remote	Very Remote	
	Top End	
Low-grade abnormalities	16	(15-18)	17	(12-21)	20	(16-23)	
High-grade abnormalities	35	(33-36)	37	(33-42)	40	(36-44)	
All abnormalities	53	(51-55)	56	(50-61)	63	(58-67)	
							
Total number of tests	 	2,715	 	300	 	771	
	Central Australia	
Low-grade abnormalities		na	22	(19-25)	18	(14-23)	
High-grade abnormalities		na	29	(26-33)	42	(36-47)	
All abnormalities		na	52	(48-56)	61	(55-67)	
							
Total number of tests	 	na	 	794	 	364	
Notes: 
1. Rates (95%CI) are the number of tests in each category as a percentage of total histology tests and age-standardised to 2001 Australia ERP. 
na – not applicable
Data are for Indigenous and non-Indigenous women combined. 

5.5 High-grade abnormality detection
The detection of high-grade abnormalities is a performance indicator of the National Cervical Screening Program. The high-grade abnormality detection rate is calculated as the proportion of screened women (expressed as the rate per 1,000 women screened) who have a histology-confirmed high-grade cervical abnormality. It assesses how well the cervical screening program detects these abnormalities.
The high-grade abnormality detection rate was much higher in the 20-29 age-group than in older women (Table 84), and higher for residents of Very Remote than Outer Regional or Remote areas, in all time periods (Figure 23, Table 85). 
In Very Remote areas (but not in Remote areas), the high-grade abnormality detection rate was considerably higher for residents of communities with predominantly (60% or more) Indigenous populations than in other communities (Table 87). 

Figure 23 High-grade abnormality detection, age-standardised rate1, by remoteness category and five-year period, aged 20-69 years, NT

Notes: 
1. Rates are expressed as number of women with high-grade abnormality detected by histology per 1,000 women screened and age-standardised to 2001 Australia ERP.
2. Bars show 95%CI.
Data are for Indigenous and non-Indigenous women combined. 

Table 83 High-grade abnormality detection, number and age-standardised rate, by two-year period, aged 20-69 years, NT
 	Number	Rate1	(95%CI)	
1997-1998	528	11.9	(10.8-13.1)	
1999-2000	503	11.5	(10.4-12.7)	
2001-2002	516	12.1	(10.9-13.3)	
2003-2004	444	10.6	(9.6-11.7)	
2005-2006	505	13.0	(11.8-14.2)	
2007-2008	601	14.3	(13.1-15.5)	
2009-2010	612	14.2	(13.1-15.4)	
Notes: 
1. Rates are expressed as number of women with high-grade abnormality detected by histology per 1,000 women screened and age-standardised to 2001 Australia ERP.
Data are for Indigenous and non-Indigenous women combined. 

Table 84 High-grade abnormality detection, age-specific and age-standardised rate1, by 10-year age-group and two-year period, NT
 	Age-group (years)	 	Aged 20-69 years2	
 	20-29	30-39	40-49	50-59	60-69	 	Rate	(95%CI)	
1997-1998	14.5	10.1	8.3	5.5	9.2	 	11.9	(10.7-13.0)	
1999-2000	22.0	15.4	7.5	7.0	3.4		11.4	(10.3-12.6)	
2001-2002	21.1	14.3	8.3	4.3	4.5		11.9	(10.7-13.0)	
2003-2004	25.1	11.8	8.1	3.6	7.1		10.4	(9.4-11.5)	
2005-2006	23.3	11.8	5.8	3.6	4.4		12.9	(11.7-14.1)	
2007-2008	27.4	15.8	6.1	4.1	5.8		14.2	(13.0-15.4)	
2009-2010	27.3	18.4	11.0	3.7	4.2	 	14.1	(13.0-15.3)	
Notes: 
1. Rates are expressed as number of women with high-grade abnormality detected by histology per 1,000 women screened.
2. Rates for aged 20-69 years are age-standardised to 2001 Australia ERP.
Data are for Indigenous and non-Indigenous women combined. 

Table 85 High-grade abnormality detection, age-standardised rate1, by remoteness category and five-year period, aged 20-69 years, NT
 	Outer Regional	Remote	Very Remote	All NT	
1996-2000	10.3 (  9.4-11.2)	11.3 (  9.5-13.0)	16.0 (13.6-18.4)	11.4 (10.6-12.1)	
2001-2005	11.1 (10.2-12.0)	10.8 (  9.5-12.2)	13.6 (11.5-15.7)	11.3 (10.6-12.0)	
2006-2010	13.4 (12.5-14.3)	13.1 (11.6-14.6)	18.8 (16.6-21.0)	14.3 (13.6-15.1)	
Notes: 
1. Rates are expressed as number of women with high-grade abnormality detected by histology per 1,000 women screened and age-standardised to 2001 Australia ERP.
Data are for Indigenous and non-Indigenous women combined. 

Table 86 High-grade abnormality detection, age-standardised rate1, by remoteness category, region and five-year period, aged 20-69 years, NT
 	Outer Regional	Remote	Very Remote	
	Top End	
1996-2000	10.3 (  9.4-11.2)	16.5 (11.4-21.5)	18.0 (15.3-20.7)	
2001-2005	11.1 (10.2-12.0)	11.5 (  8.9-14.2)	14.4 (11.5-17.2)	
2006-2010	13.4 (12.5-14.3)	15.8 (12.7-18.8)	19.4 (16.5-22.3)	
	Central Australia	
1996-2000	na	9.3 (  7.8-10.8)	10.4 (  7.1-13.7)	
2001-2005	na	10.6 (  9.0-12.2)	12.2 (  9.0-15.5)	
2006-2010	na	12.0 (10.2-13.7)	17.8 (14.3-21.3)	
Note: 
1. Rates are expressed as number of women with high-grade abnormality detected by histology per 1,000 women screened and age-standardised to 2001 Australia ERP.
Data are for Indigenous and non-Indigenous women combined. 

Table 87 High-grade abnormality detection, age-standardised rate1, by remoteness category, community population characteristics2 and five-year period, aged 20-69 years, NT
 	Outer Regional	Remote	Very Remote	All NT	
	Communities where population is not predominantly Indigenous	
1996-2000	10.3	(9.4-11.2)	11.2	(9.4-12.9)	6.7	(6.7-19.3)	10.6	(9.8-11.4)	
2001-2005	11.1	(10.2-12.0)	10.9	(9.5-12.3)	8.0	(8.0-14.0)	11.0	(10.3-11.8)	
2006-2010	13.4	(12.5-14.3)	13.4	(11.8-15.0)	13.9	(13.9-20.0)	13.7	(12.9-14.5)	
	Communities with predominantly Indigenous population	
1996-2000		na	12.9	(1.8-23.9)	18.9	(15.8-22.0)	18.7	(15.7-21.7)	
2001-2005		na	8.8	(3.4-14.2)	14.7	(12.1-17.4)	14.4	(11.8-16.9)	
2006-2010	 	na	9.5	(3.9-15.1)	19.6	(16.8-22.4)	18.8	(16.2-21.5)	
 	All communities	
1996-2000	10.3	(9.4-11.2)	11.3	(9.5-13.0)	16.0	(13.6-18.4)	11.4	(10.6-12.1)	
2001-2005	11.1	(10.2-12.0)	10.8	(9.5-12.2)	13.6	(11.5-15.7)	11.3	(10.6-12.0)	
2006-2010	13.4	(12.5-14.3)	13.1	(11.6-14.6)	18.8	(16.6-21.0)	14.3	(13.6-15.1)	
Notes: 
1. Rates are expressed as number of women with high-grade abnormality detected by histology per 1,000 women screened and age-standardised to 2001 Australia ERP.
2. Communities classified as predominantly of Indigenous include SLAs with Indigenous making 60% and over of female population in 20-69 year age-group.
Data are for Indigenous and non-Indigenous women combined. 

Table 88 High-grade abnormality detection, age-standardised rate1, by region, community population characteristics2 and five-year period, aged 20-69 years, NT
 	Top End	Central	 	All NT	
	Communities where population is not predominantly Indigenous	
1996-2000	10.6	(9.8-11.5)	10.3	(8.6-12.0)		10.6	(9.8-11.4)	
2001-2005	11.1	(10.3-11.9)	10.8	(9.3-12.2)		11.0	(10.3-11.8)	
2006-2010	13.9	(13.0-14.8)	12.9	(11.2-14.6)		13.7	(12.9-14.5)	
	Communities with predominantly Indigenous population	
1996-2000	23.1	(19.2-27.0)	6.8	(3.4-10.2)		18.7	(15.7-21.7)	
2001-2005	15.3	(12.0-18.6)	12.3	(8.0-16.5)		14.4	(11.8-16.9)	
2006-2010	19.4	(16.1-22.7)	17.8	(13.3-22.2)	 	18.8	(16.2-21.5)	
 	All communities	
1996-2000	11.9	(11.0-12.7)	9.7	(8.1-11.2)		11.4	(10.6-12.1)	
2001-2005	11.5	(10.6-12.3)	11.0	(9.6-12.4)		11.3	(10.6-12.0)	
2006-2010	14.5	(13.7-15.4)	13.6	(12.1-15.2)	 	14.3	(13.6-15.1)	
Notes: 
1. Rates are expressed as number of women with high-grade abnormality detected by histology per 1,000 women screened and age-standardised to 2001 Australia ERP.
2. Communities classified as predominantly of Indigenous include SLAs with Indigenous making 60% and over of female population in 20-69 year age-group.
Data are for Indigenous and non-Indigenous women combined. 

5.6 Cytology-histology correlation
The sensitivity of the Pap test (cytology) for detecting high-grade squamous cell abnormalities fluctuated between 56% and 65% and the positive predictive value fluctuated between 67% and 71% between 1997 and 2010 (Table 91). This compares to the national figures of 77.6% for sensitivity and 69.6% for positive predictive value in 200810.
The correlations are between the squamous or endocervical cytology prediction and the most serious squamous or endocervical histology within 6 months following the cytology test. The tabulation provides percentages of cytology tests within each histological reporting category by cytological result. Sensitivity and positive predictive value (PPV), which measure the accuracy of cytological predictions, can then be calculated from the correlations.

Table 89 Correlation between squamous cytology and squamous histology, by five-year period, aged 20-69 years, NT
 	 	Histology finding	 		
		HS01		HS02		HS03		HS04			
Cytology predication	Negative		Low-grade		High-grade		SCC		All 
histology tests	
 	 	n	%	 	n	%	 	n	%	 	n	%	 	n	%	
		1996 – 2000	
S1	Negative	1,175	58.4		694	34.5		143	7.1		1	0.0		2,013	100.0	
S2	Possible low-grade	342	34.2		467	46.7		191	19.1		0	0.0		1,000	100.0	
S3	Low-grade	168	21.8		410	53.2		192	24.9		1	0.1		771	100.0	
S4	Possible high-grade	70	23.9		88	30.0		133	45.4		2	0.7		293	100.0	
S5	High-grade	99	8.8		181	16.1		831	73.8		15	1.3		1,126	100.0	
S6	High-grade plus	3	8.1		0	0.0		28	75.7		6	16.2		37	100.0	
S7	SCC	1	6.7	 	0	0.0	 	6	40.0	 	8	53.3	 	15	100.0	
		2001 – 2005	
S1	Negative	801	52.1		562	36.6		174	11.3		0	0.0		1,537	100.0	
S2	Possible low-grade	171	29.8		262	45.6		141	24.6		0	0.0		574	100.0	
S3	Low-grade	155	16.5		498	53.0		287	30.5		0	0.0		940	100.0	
S4	Possible high-grade	69	25.4		76	27.9		126	46.3		1	0.4		272	100.0	
S5	High-grade	74	8.0		151	16.3		692	74.9		7	0.8		924	100.0	
S6	High-grade plus	1	2.4		2	4.9		26	63.4		12	29.3		41	100.0	
S7	SCC	2	12.5	 	0	0.0	 	4	25.0	 	10	62.5	 	16	100.0	
		2006 – 2010	
S1	Negative	699	52.8		388	29.3		236	17.8		0	0.0		1,323	100.0	
S2	Possible low-grade	98	20.2		201	41.5		183	37.8		2	0.4		484	100.0	
S3	Low-grade	55	15.1		171	47.0		138	37.9		0	0.0		364	100.0	
S4	Possible high-grade	81	16.6		99	20.3		300	61.5		8	1.6		488	100.0	
S5	High-grade	82	9.0		110	12.1		704	77.5		12	1.3		908	100.0	
S6	High-grade plus	1	3.3		0	0.0		21	70.0		8	26.7		30	100.0	
S7	SCC	0	0.0	 	0	0.0	 	1	11.1	 	8	88.9	 	9	100.0	
Notes: 
SCC stands for Squamous cell carcinoma
Data are for Indigenous and non-Indigenous women combined. 

Table 90 Correlation between endocervical cytology and endocervical histology, by five-year period, aged 20-69 years, NT
 	 	Histology finding1	 	 	
		HE01		HE03		HE04		All	
Cytology predication2	Negative		High-grade		Adeno-carcinoma		histology tests	
 	 	n	%	 	n	%	 	n	%	 	n	%	
		1996 – 2000	
E1	Negative	4,601	99.5		19	0.4		3	0.1		4,623	100.0	
E2	AECUS	25	100.0		0	0.0		0	0.0		25	100.0	
E3	Possible high-grade	18	75.0		5	20.8		1	4.2		24	100.0	
E4	AIS	8	44.4		9	50.0		1	5.6		18	100.0	
E5	AIS plus	0	-		0	-		0	-		0	-	
E6	Adenocarcinoma	0	0.0	 	1	100.0	 	0	0.0	 	1	100.0	
		2001 – 2005	
E1	Negative	2,803	99.3		19	0.7		1	0.0		2,823	100.0	
E2	AECUS	15	83.3		3	16.7		0	0.0		18	100.0	
E3	Possible high-grade	18	75.0		6	25.0		0	0.0		24	100.0	
E4	AIS	5	25.0		15	75.0		0	0.0		20	100.0	
E5	AIS plus	0	-		0	-		0	-		0	-	
E6	Adenocarcinoma	3	100.0	 	0	0.0	 	0	0.0	 	3	100.0	
		2006 – 2010	
E1	Negative	2,589	99.4		15	0.6		1	0.0		2,605	100.0	
E2	AECUS	11	84.6		2	15.4		0	0.0		13	100.0	
E3	Possible high-grade	22	78.6		6	21.4		0	0.0		28	100.0	
E4	AIS	3	20.0		12	80.0		0	0.0		15	100.0	
E5	AIS plus	0	-		0	-		0	-		0	-	
E6	Adenocarcinoma	0	 -	 	0	 -	 	0	 -	 	0	 -	
Notes:
1. Endocervical atypia (HE 02) is not coded in NT PSR.
2. AECUS stands for Atypical endocervical cells of uncertain significance; AIS stands for Adenocarcinoma in-situ. AIS plus stands for Adenocarcinoma in-situ invasion;
Data are for Indigenous and non-Indigenous women combined. 

Table 91 Sensitivity and positive predictive value (PPV) of squamous and endocervical abnormalities, aged 20-69 years, NT
 	High-grade	 	Cancer	
 	Sensitivity1	PPV2	 	Sensitivity1	Complete sensitivity (high-grade) 3	Complete sensitivity (abnormal) 4	PPV5	
	Squamous abnormalities	
1996-2000	61.7	67.5		23.5	91.2	94.1	53.3	
2001-2005	56.5	67.0		32.3	96.8	96.8	62.5	
2006-2010	64.5	71.4		21.1	94.7	100.0	88.9	
1996-2010	61.0	68.7	 	25.2	94.2	97.1	65.0	
	Endocervical abnormalities	
1996-2010	47.3	41.9	 	0.0	28.6	28.6	0.0	
Notes:
1. Sensitivity is defined as the proportion of histology-confirmed cytology prediction of disease (high-grade or cancer) over the total number of histology finding of disease (high grade or cancer).
2. PPV for high-grade is defined as the proportion of cytology results of possible or definite high-grade that were confirmed on histology to be a high-grade or cancer.  
3. Complete sensitivity (high-grade) is defined as the proportion of histology tests showing cancer where the cytology test predicted a cancer.
4. Complete sensitivity (abnormal) is defined as the proportion of histology tests finding cancer where the cytology test predicted an abnormal (low-grade, high-grade or cancer). 
5. PPV for cancer is defined the proportion of cytology results of cancer that were confirmed on histology to be a cancer. 
Data are for Indigenous and non-Indigenous women combined. 

Table 92 Counts for calculating sensitivity and positive predictive value (PPV) of squamous and endocervical abnormalities, aged 20-69 years, NT
 	High-grade	 	Cancer	
 	Sensitivity	PPV	 	Sensitivity	Complete sensitivity (high-grade)	Complete sensitivity (abnormal)	PPV	
	Squamous abnormalities	
1996-2000	  992 / 1607	  992 / 1470		  8 / 34	31 / 34	32 / 34	  8 / 15	
2001-2005	  844 / 1493	  844 / 1260		10 / 31	30 / 31	30 / 31	10 / 16	
2006-2010	1025 / 1588	1025 / 1435		  8 / 38	36 / 38	38 / 38	8 / 9	
1996-2010	2861 / 4688	2861 / 4165		26 / 103	  97 / 103	100 / 103	26 / 40	
	Endocervical abnormalities	
1996-2010	  53 / 112	  54 / 129	 	0 / 7	2 / 7	2 / 7	0 / 4	
Note: Data are for Indigenous and non-Indigenous women combined. 

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12.	Australian Institute of Health and Welfare, Australasian Association of Cancer Registries. Cancer in Australia: an overview, 2008. Cancer series No. 46. Cat. no. CAN 42. Canberra: AIHW, 2008.
13.	Condon JR, Rumbold AR, Thorn JC, O'Brien MM, Davy MJ, Zardawi I. A cluster of vulvar cancer and vulvar intraepithelial neoplasia in young Australian indigenous women. Cancer Causes Control 2009;20(1):67-74.
14.	Australian Institute of Health and Welfare. BreastScreen Australia monitoring report 2008–2009. Cancer Series No. 63. Cat. No. CAN 60. Canberra: AIHW, 2011.
15.	Roder D, Webster F, Zorbas H, S S. Breast screening and breast cancer survival in Aboriginal And Torres Strait Islander women of Australia. Asian Pacific J Cancer Prev 2012;12(1):147-55.

Appendix

Table A1 National hysterectomy fractions derived from the ABS 2001 National Health Survey
Age group (years)	Percentage of women
who have not had a hysterectomy	
20-24	100.0		
25-29	100.0		
30-34	98.9		
35-39	95.6		
40-44	90.6		
45-49	82.6		
50-54	76.5		
55-59	66.2		
60-64	68.9		
65-69	66.8		

Table A2 List of communities with predominantly Indigenous population
Region	HSDA group	2006 SLA name	
Top End	Darwin Rural	Belyuen (CGC)	
	Tiwi	Tiwi Islands (CGC)	
	Top End West	Daly	
		Nauiyu Nambiyu (CGC)	
	 	Thamarrurr (CGC)	
	West Arnhem & Maningrida	Kunbarllanjnja (CGC)	
	 	West Arnhem	
	East Arnhem	Angurugu (CGC)	
		East Arnhem - Bal	
		Marngarr (CGC)	
	 	Numbulwar Numburindi (CGC)	
	Katherine East	Binjari (CGC)	
		Jilkminggan (CGC)	
		Nyirranggulung Mardrulk Ngadberre (CGC)	
	 	Yugul Mangi (CGC)	
	Katherine West	Daguragu (CGC)	
		Lajamanu (CGC)	
	 	Walangeri Ngumpinku (CGC)	
	Borroloola	Borroloola (CGC)	
 	 	Gulf	
Central 	Barkly	Alpurrurulam (CGC)	
Australia		Elliott District (CGC)	
	 	Tennant Creek - Bal	
	Central	Anmatjere (CGC)	
		Arltarlpilta (CGC)	
		Hanson	
		Ltyentye Purte (CGC)	
		Sandover	
		Tanami	
		Tapatjatjaka (CGC)	
		Wallace Rockhole (CGC)	
		Watiyawanu (CGC)	
 	 	Yuendumu (CGC)	
Note: The communities in this table are these 2006 SLAs with Indigenous counting at least 60% of the total female population in the 20-69 age-group. The make-up of Indigenous in most of the communities in the list, except for Daly and Gulf, is actually over 70%. 

List of tables
Table 1 Ten most common cancers, incidence and mortality, NT non-Indigenous, 2001-2008
Table 2 Ten most common cancers, incidence and mortality, NT Indigenous, 2001-2008
Table 3 Cancer of the breast, number of cases and deaths, by Indigenous status and year, NT
Table 4 Cancer of the breast, incidence and mortality, by Indigenous status and period, NT
Table 5 Cancer of the breast, incidence and mortality, by Indigenous status and period, Top End
Table 6 Cancer of the breast, incidence and mortality, by Indigenous status and period, Central Australia
Table 7 Cancer of the breast, incidence and mortality, by Indigenous status and remoteness category, NT, 1996-2008
Table 8 Cancer of the breast, survival rate, by Indigenous status and period, NT
Table 9 Cancer of the cervix, number of cases and deaths, by Indigenous status and year, NT
Table 10 Cancer of the cervix, incidence and mortality by Indigenous status and period, NT
Table 11 Cancer of the cervix, incidence and mortality, by Indigenous status and period, Top End
Table 12 Cancer of the cervix, incidence and mortality, by Indigenous status and period, Central Australia
Table 13 Cancer of the cervix, incidence and mortality, by Indigenous status and remoteness category, NT, 1996-2008
Table 14 Cancer of the cervix, survival rate, by Indigenous status and period, NT
Table 15 Cancer of the uterus, incidence and mortality rate, by Indigenous status and period, NT
Table 16 Cancer of the uterus, survival rate, by Indigenous status, NT 1991-2006
Table 17 Cancer of the ovary, incidence and mortality rate, by Indigenous status and period, NT
Table 18 Cancer of the ovary, survival rate, by Indigenous status, NT, 1991-2006
Table 19 Cancer of the vulva, incidence and mortality rate, by Indigenous status and period, NT
Table 20 Cancer of the vulva, survival rate, by Indigenous status, NT, 1991-2006
Table 21 Cancer of the vagina, incidence and mortality rate, by Indigenous status, NT
Table 22 Cancer of the vagina, survival rate, by Indigenous status, NT, 1991-2006
Table 23 Two-year participation in breast screening, number of women screened, by NT residency, 1997-2010
Table 24 Two-year participation in breast screening, number of women screened, by Indigenous status and age-group, NT, 1997-2010
Table 25 Two-year participation in breast screening, age-specific and age-standard rates1, by Indigenous status, NT, 1997-2010
Table 26 Two-year participation in breast screening, age-specific and age-standard rates1, by region, NT Indigenous, 1997-2010
Table 27 Two-year participation in breast screening, age-specific and age-standard rates1, by region, NT non-Indigenous, 1997-2010
Table 28 Two-year participation in breast screening, age-specific and age-standard rates1, by remoteness category, NT Indigenous, 1997-2010
Table 29 Two-year participation in breast screening, age-specific and age-standard rates1, by remoteness category, NT non-Indigenous, 1997-2010
Table 30 Two-year participation in breast screening, age-standard rate1, by Indigenous status, region and remoteness category, aged 50-69 years, NT, 1997-2010
Table 31 Two-year participation in breast screening, age-standard rate1, by health service area, aged 50-69 years, NT Indigenous, 1997-2010
Table 32 Two-year participation in breast screening, age-standard rate1, by health service area, aged 50-69 years, NT non-Indigenous, 1997-2010
Table 33 Three-year participation in breast screening, age-specific and age-standard rates1, by Indigenous status, NT, 1996-2010
Table 34 Three-year participation in breast screening, age-standard rates1, by Indigenous status and region, aged 50-69 years, NT, 1996-2010
Table 35 Three-year participation in breast screening, age-standard rates1, by Indigenous status and remoteness category, aged 50-69 years, NT, 1996-2010
Table 36 Invasive breast cancer detection, by screening round and period, aged 50-69 years, 1996-2008
Table 37 Small (<15mm) invasive breast cancer, all screening rounds, by period, aged 50-69 years, 1996-2008
Table 38 DCIS detection, by screening round, aged 50-69 years, 1996-2008
Table 39 Two-year participation in cervical screening, number of women screened, by residency, 1997-2010
Table 40 Two-year participation in cervical screening, number of women screened, by age-group, NT, 1997-2010
Table 41 Two-year participation in cervical screening, age-specific and age-standardised rates1, NT, 1997-2010
Table 42 Two-year participation in cervical screening, number of women screened, by region and age-group, NT, 1997-2010
Table 43 Two-year participation in cervical screening, age-specific and age-standardised rates1, by region and age-group, NT, 1997-2010
Table 44 Two-year participation in cervical screening, number of women screened, by remoteness category and age-group, NT, 1997-2010
Table 45 Two-year participation in cervical screening, age-specific and age-standardised rates1, by remoteness category, NT, 1997-2010
Table 46 Two-year participation in cervical screening, age-standardised rate1, by region and remoteness category, aged 20-69 years, NT, 1997-2010
Table 47 Two-year participation in cervical screening, age-standardised rate1, by health service delivery area group, aged 20-69 years, NT, 1997-2010
Table 48 Estimated Indigenous two-year participation in cervical screening, age-standardised rate1, by region, aged 20-69 years, NT, 1997-2010
Table 49 Estimated Indigenous two-year participation in cervical screening, age-standardised rate1, by health service delivery area group, aged 20-69 years, NT, 1997-2010
Table 50 Three-year participation in cervical screening, age-specific and age-standardised rates1, NT, 1996-2010
Table 51 Three-year participation in cervical screening, age-specific and age-standardised rates1, by region, NT, 1996-2010
Table 52 Three-year participation in cervical screening, age-specific and age-standardised rates1, by remoteness category, NT, 1996-2010
Table 53 Three-year participation in cervical screening, age-standardised rate1, by region and remoteness category, aged 20-69 years, NT, 1996-2010
Table 54 Three-year participation in cervical screening, age-standardised rate1, by health service delivery area group, aged 20-69 years, NT, 1997-2010
Table 55 Estimated Indigenous three-year participation in cervical screening, age-standardised rate1, by region, aged 20-69 years, NT, 1996-2010
Table 56 Estimated Indigenous three-year participation in cervical screening, age-standardised rate1, by health service delivery area group, aged 20-69 years, NT, 1996-2010
Table 57 Five-year participation in cervical screening, age-specific and age-standardised rates1, NT, 1996-2010
Table 58 Five-year participation in cervical screening, age-specific and age-standardised rates1, by region, NT, 1996-2010
Table 59 Five-year participation in cervical screening, age-specific and age-standardised rates1, by remoteness category, NT, 1996-2010
Table 60 Five-year participation in cervical screening, age-standardised rate1, by region and remoteness category, aged 20-69 years, NT, 1997-2010
Table 61 Five-year participation in cervical screening, age-standardised rate1, by health service delivery area group, aged 20-69 years, NT, 1997-2010
Table 62 Estimated Indigenous five-year participation in cervical screening, age-standardised rate1, by region, aged 20-69 years, NT, 1996-2010
Table 63 Estimated Indigenous five-year participation in cervical screening, age-standardised rate1, by health service delivery area group, aged 20-69 years, NT, 1996-2010
Table 64 Proportion (%) of women rescreening early, by number of repeats and two-year period, aged 20-69 years, NT, 1997-2008
Table 65 Proportion (%) of women rescreening early, by region and two-year period, aged 20-69 years, NT, 1997-2008
Table 66 Proportion (%) of women rescreening early, by remoteness category and two-year period, aged 20-69 years, NT, 1997-2008
Table 67 Proportion (%) of women rescreening early, by community population characteristics1, remoteness category and two-year period, aged 20-69 years, NT, 1997-2008
Table 68 Proportion (%) of women rescreening early, by health service delivery area group and two-year period, aged 20-69 years, NT, 1997-2008
Table 69 Age-standardised rate1 of cytology result category, by two-year period, aged 20-69 years, NT, 1997-2010
Table 70 Age-standardised rate1 of squamous cell cytology result category, by two-year period, aged 20-69 years, NT, 1996-2010
Table 71 Age-specific rate1 of abnormality detection in cytology tests, by two-year period, NT, 1997-2010
Table 72 Age-standardised rate1 of endocervical cytology result category, by two-year period, aged 20-69 years, NT, 1996-2010
Table 73 Age-standardised rate1 of cytology result category, by remoteness category and five-year period, aged 20-69 years, NT, 1996-2010
Table 74 Age-standardised rate1 of cytology result category, by remoteness category and region, aged 20-69 years, NT, 2006-2010
Table 75 Age-standardised rate1 of cytology result category, by remoteness category and community population characteristics2, aged 20-69 years, NT, 2006-2010
Table 76 Age-standardised rate1 of cytology result category, by health service delivery area group, aged 20-69 years, NT, 2006-2010
Table 77 Histology test as proportion (%) of cytology test, by age-group and two-year period, NT, 1997-2010
Table 78 Age-standardised rate1 of histology result category, by two-year period, aged 20-69 years, NT, 1997-2010
Table 79 Age-standardised rate1 of squamous cell histology result category, by two-year period, aged 20-69 years, NT, 1996-2010
Table 80 Age-standardised rate1 of endocervical histology result category, by two-year period, aged 20-69 years, NT, 1996-2010
Table 81 Age-standardised rate1 of histology result category, by remoteness category and five-year period, aged 20-69 years, NT
Table 82 Age-standardised rate1 of histology result category, by remoteness category and region, aged 20-69 years, NT, 2006-2010
Table 83 High-grade abnormality detection, number and age-standardised rate, by two-year period, aged 20-69 years, NT
Table 84 High-grade abnormality detection, age-specific and age-standardised rate1, by 10-year age-group and two-year period, NT
Table 85 High-grade abnormality detection, age-standardised rate1, by remoteness category and five-year period, aged 20-69 years, NT
Table 86 High-grade abnormality detection, age-standardised rate1, by remoteness category, region and five-year period, aged 20-69 years, NT
Table 87 High-grade abnormality detection, age-standardised rate1, by remoteness category, community population characteristics2 and five-year period, aged 20-69 years, NT
Table 88 High-grade abnormality detection, age-standardised rate1, by region, community population characteristics2 and five-year period, aged 20-69 years, NT
Table 89 Correlation between squamous cytology and squamous histology, by five-year period, aged 20-69 years, NT
Table 90 Correlation between endocervical cytology and endocervical histology, by five-year period, aged 20-69 years, NT
Table 91 Sensitivity and positive predictive value (PPV) of squamous and endocervical abnormalities, aged 20-69 years, NT
Table 92 Counts for calculating sensitivity and positive predictive value (PPV) of squamous and endocervical abnormalities, aged 20-69 years, NT

List of figures
Figure 1 Map of Health Service Delivery Areas
Figure 2 Ten most common cancers, incidence and mortality, by Indigenous status, NT, 2001-2008
Figure 3 Cancer of the breast, incidence and mortality, by Indigenous status and period, NT
Figure 4 Cancer of the breast, survival rate, by Indigenous status and period, NT
Figure 5 Cancer of the cervix, incidence and mortality, by Indigenous status and period, NT
Figure 6 Cancer of the cervix, survival rate, by Indigenous status and period, NT
Figure 7 Cancer of the uterus, incidence, mortality and survival rate, by Indigenous status, NT, 1991-2008
Figure 8 Cancer of the ovary, incidence, mortality and survival rate, by Indigenous status, NT, 1991-2008
Figure 9 Cancer of the vulva, incidence, mortality and survival rate, by Indigenous status, NT, 1991-2008
Figure 10 Two-year participation in breast screening, age-standardised rates1, by Indigenous status, NT, aged 50-69 years
Figure 11 Two-year participation in breast screening, age-standard rates1, by Indigenous status and remoteness category, aged 50-69 years, NT, 2009-2010
Figure 12 Three-year participation in breast screening, age-standard rates1, by Indigenous status and remoteness category, aged 50-69 years, NT, 2008-2010
Figure 13 Two-year participation in cervical screening, age-standard rate1, by region, aged 20-69 years, NT, 1997-2010
Figure 14 Two-year participation in cervical screening, age-standard rate1, by remoteness category, aged 20-69 years, NT, 1997-2010
Figure 15 Two-year participation in cervical screening, age-standard rates1, by region and remoteness category, aged 20-69 years, NT, 2009-2010
Figure 16 Estimated Indigenous two-year participation in cervical screening, age-standard rates1, by region, NT, 1997-2010
Figure 17 Two-, three- and five-year participations in cervical screening, age-standard rate1, aged 20-69 years, total NT and estimated Indigenous (remote areas only), most recent period
Figure 18 Proportion (%) of women rescreening early, by remoteness category and two-year period, aged 20-69 years, NT, 1997-2008
Figure 19 Age-standardised rate1 of cytology result category, by two-year period, aged 20-69 years, NT, 1997-2010
Figure 20 Age-specific rate1 of low-grade abnormality detection in cytology tests, by two-year period, NT, 1997-2010
Figure 21 Age-specific rate1 of high-grade abnormality detection in cytology tests, by two-year period, NT, 1997-2010
Figure 22 Histology tests as proportion (%) of cytology tests, by age-group and two-year period, NT, 1997-2010
Figure 23 High-grade abnormality detection, age-standardised rate1, by remoteness category and five-year period, aged 20-69 years, NT
NT Cancer Registry publications
Departmental publications
Kinmonth TJN. Cancer in the Northern Territory. NT Department of Health, 1981.
Kinmonth TJN. Cancer in the Northern Territory. NT Department of Health, 1982,
Kinmonth TJN. Cancer in the Northern Territory 1981-83. NT Department of Health, 1985.
Honari M, Saint-Ives I. The Northern Territory Cancer Report 1981-1985, An analysis of ethnic, age & sex-specific rates. Epidemiology and Assessment Branch, Northern Territory Department of Health, Darwin, 1987.
d’Espaignet ET, Measey ML, Condon JR, Jelfs P, Dempsey KE. Cancer in the Northern Territory 1987–1993, Epidemiology Branch, Territory Health Services, 1996.
Condon JR, Zhao Y, Northern Territory Cancer Registry, Northern Territory Cancer Registry data collection, analysis and reporting procedures. Department of Health and Families, Darwin, 2004.
Condon JR, Zhao Y, Armstrong BK, Barnes A.  Northern Territory cancer register data quality 1981–2001. Department of Health and Families, Darwin, 2004.
Zhao Y, Condon JR, Garling LS. Cancer incidence and mortality Northern Territory 1991–2001. NT Cancer Registry, Department of Health and Families, Darwin, 2004.
Condon JR, Lee H, Garling LS. Cancer survival, Northern Territory 1991-2001. NT Cancer Registry, Department of Health and Families, Darwin 2006.
Condon JR, Zhang X, Li SQ, Garling LS. Northern Territory cancer incidence and mortality by region, 1991–2001. NT Cancer Registry, Department of Health and Families, Darwin, 2007.
Zhang X, Condon J, Dempsey K & Garling L. Cancer incidence and mortality, Northern Territory 1991–2005. Department of Health and Families, Darwin, 2008.
NT Cancer Registry journal articles
Condon JR, Armstrong BK, Barnes A, Zhao Y. Cancer incidence and survival for Indigenous Australians in the Northern Territory. Aust NZ J Public Health. 2005; 29:123-8
Cunningham J, Rumbold AR, Zhang X, Condon JR. Incidence, aetiology, and outcomes of cancer in Indigenous peoples in Australia. Lancet Oncol, 2008; 9(6):585-95.