ACPCC Annual Report 2024

Leading experts in cervical cancer prevention

ANNUAL REPORT 2024

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ACPCC ABN 35 430 554 780

GLOBAL ELIMINATION

In May 2018, the WHO Director-General announced a global call for action to eliminate cervical cancer as a public health problem.

Subsequently, a global elimination strategy was developed and endorsed at the World Health Assembly in 2020.

AS A RESULT OF THESE HIGHLY SUCCESSFUL PROGRAMS, MODELLING SUGGESTS THAT AUSTRALIA COULD BE THE FIRST COUNTRY TO ACHIEVE ELIMINATION, BY 2035.

ACPCC ABN 35 430 554 780

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AUSTRALIA HAS ANSWERED THE CALL TO ACTION BY DEVELOPING ITS OWN NATIONAL ELIMINATION STRATEGY. Australia is a world leader in cervical cancer prevention and already has existing organised cervical screening and HPV vaccination programs.

As a result of these highly successful programs, modelling suggests that Australia could be the first country to achieve elimination by 2035.

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WHO Cervical Cancer Elimination Day of Action On the 17th of November 2023, coinciding with the WHO Cervical Cancer Elimination Day of Action, ACPCC were thrilled to launch

THE NATIONAL STRATEGY FOR THE ELIMINATION OF CERVICAL CANCER IN AUSTRALIA On this day of action, the Australian Government launched this landmark strategy, which was developed through an ACPCC led co-design process and an exhaustive technical review.

The strategy outlines Australia’s commitment to achieving equitable elimination of cervical cancer as a public health problem by 2035, and the objectives and actions needed to achieve this goal.

ACPCC LTD. ABN 35 430 554 780

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THE ELIMINATION IN THE INDO PACIFIC FOR CERVICAL CANCER (EPICC) The Australian Government committed $12.5 million to the Elimination Partnership in the Indo-Pacific for Cervical Cancer (EPICC) as part of the Partnerships for a Healthy Region initiative. EPICC is leveraging Australian, international and in-country partner expertise to promote the World Health Organization’s strategy for the elimination of cervical cancer.

The EPICC consortium comprises of the Daffodil Centre (a joint venture between the University of Sydney and Cancer Council NSW), the Kirby Institute, Family Planning Australia and the Australian Centre for the Prevention of Cervical Cancer, together with Unitaid and the National Centre for Immunisation Research and Surveillance.

This investment will connect Australia’s world-leading cervical cancer expertise with governments across the region to support HPV vaccine programs, expand screening and treatment and build health workforce capacity.

Minister for Foreign Affairs, the Hon Penny Wong

Dr Lucas de Toca – Australia’s Ambassador for Global Health, launching EPICC

“A QUARTER OF GLOBAL CERVICAL CANCER CASES OCCUR IN OUR REGION, THE INDO-PACIFIC. TRAGICALLY, IN THE PACIFIC, WOMEN ARE DYING AT UP TO 13 TIMES THE RATE OF WOMEN IN AUSTRALIA.” – Minister for Foreign Affairs, the Hon Penny Wong

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CONTENTS

Contents WHAT WE DO

2

OUR VISION

2

VALUES

2

PARTNERSHIPS

4

CHAIRMAN & EXECUTIVE DIRECTOR REPORT

5

FINANCIAL SNAPSHOT 2023/24

6

Financial Position

6

Core Business Performance

6

Summary of ACPCC Consolidated Financial Results

7

OUR IMPACT AND ACHIEVEMENTS – 2023/2024

8

OUR IMPACTS ACROSS THE GLOBE

10

ACPCC GLOBAL

12

STRATEGIC PLAN

14

1

Support Victoria’s efforts to eliminate cervical cancer as a public health problem, in accordance with the Victorian Cancer Plan 2020-2024

16

2

Support Australia’s efforts to eliminate cervical cancer as a public health problem by 2035

20

3

Support countries in the Indo-Pacific region to scale up to meet the 2030 targets in support of the WHO Strategy to Eliminate Cervical Cancer as a Public Health Problem

24

4

Lead and promote the increased uptake of self-sampling

28

5

Support the National Bowel Cancer Screening Program in Victoria

30

6

Deliver and disseminate the research outcomes of the Compass Trial, C4 and other policy relevant research

32

7

Diversify the range of VCS Pathology laboratory tests by leveraging our existing expertise and capital investment

40

8

Leverage the value of the canSCREEN® and canVAX platforms for cost effective support of low to middle income countries (lmics) and for commercially advantageous opportunities

46

9

Reshape the business model to adapt to our new commercial environment and global opportunities

48

ACPCC ABN 35 430 554 780

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LEADERSHIP TEAM

50

OUR PEOPLE

52

OCCUPATIONAL HEALTH AND SAFETY

54

FREEDOM OF INFORMATION

54

PRIVACY

54

WHISTLEBLOWERS PROTECTION

55

RISK MANAGEMENT

55

2023/24 RISK ATTESTATION STATEMENT

55

AUDITOR’S INDEPENDENCE DECLARATION

55

FINANCIAL SUMMARY

56

DIRECTORS’ REPORT

57

FINANCIAL STATEMENTS

64

ACRONYMS

89

CONGRATULATIONS TO PROFESSOR KAREN CANFELL AC

90

APPENDICES

92

ACKNOWLEDGEMENT OF COUNTRY ACPCC acknowledges the people and the Elders of the Aboriginal and Torres Strait Islander Nations who are the Traditional Owners of the land and seas of Australia in which we work and live.

We pay our respect to Elders past, present and emerging.

Artwork: Madison Connors | Yorta Yorta, Dja Dja Wurrung and Gamilaroi | 2022

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WHAT WE DO

What We Do

Australia is a world leader in achieving cervical cancer control in our population and we are extending our leadership for global elimination, particularly in the Indo-Pacific region.

OUR VISION To prevent cancer and infectious diseases through excellence in the provision of public health services supporting screening, populationbased testing and vaccination.

VALUES Fairness Integrity Respect Excellence

ACPCC is a not-for-profit, multi-disciplinary team that has led cervical cancer prevention efforts in Australia for six decades. We employ that experience to strategically recommend to government those changes in the National Cervical Screening Program that are required to keep it effective and cost-effective, including renewal and self-collection.

We house and operate Australia’s HPV Reference Laboratory. We enable Australia’s aspiration to be the first country globally to eliminate cervical cancer, to meet the WHO elimination targets, and to support countries in the Indo-Pacific to reduce the incidence and mortality rates of cervical cancer.

Everything that we do is informed by the best available evidence and the interests of communities first and foremost.

We are evolving our services and projects as we move towards the target of cervical cancer elimination.

EVERYTHING THAT WE DO IS INFORMED BY THE BEST AVAILABLE EVIDENCE AND THE INTERESTS OF COMMUNITIES FIRST AND FOREMOST.

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The ACPCC acknowledges the support provided by the Victorian and Commonwealth Governments which has been invaluable in enabling the ACPCC to deliver outstanding service to participants in public health programs through its laboratory and registry services.

VCS Foundation Ltd, trading as the Australian Centre for the Prevention of Cervical Cancer (ACPCC), is a Company Limited

by Guarantee that operates under and complies with the: • Corporations Act 2001 (Cth) • Australian Charities and Not-for-profits Commission Act 2012 (Cth) • Improving Cancer Outcomes Act 2014 (Vic).

VCS Pathology is a specialist laboratory and medical education service committed to gynaecological health including HPV testing, histopathology, cytology and related molecular microbiology, clinical support and advice. We are Australia’s HPV and cervical screening reference laboratory.

Our laboratory’s agility was showcased when SARS-CoV-2 testing was introduced at a large scale in 2020 to support the Victorian Government's response during the pandemic.

Launched in November 2021, the laboratory assists a range of stakeholders in the National Cervical Screening Program (NCSP) to adapt to the changing landscape of HPV-based cervical screening.

As the Australian HPV Reference Laboratory, we provide a wide range of services from supporting national and international Quality Assurance Programs to providing specialist testing and review.

The laboratory works with a range of stakeholders including quality control and HPV assay manufacturers, other laboratories, clinicians, and researchers within Australia and abroad. Together, we strive to monitor and improve the HPV testing process (including laboratory procedures and technologies), to assist in the reduction of HPV-related disease.

Our Population Health team provide a combination of experience in delivering and managing population health services through epidemiology, surveillance, research and evaluation, reporting and enhancing screening pathways which allows us to find the best solutions to improve health outcomes for everyone.

This unique skill mix is key to our success and international reputation for high-quality, policyrelevant research focused on preventing cancer and infectious disease. Our team of experts work collaboratively and invest in strategic relationships with clients, governments, program partners and stakeholders. We are committed to being strong and effective advocates for population health programs and have extensive experience as advisors and experts in population screening and vaccination.

Our Digital Health team are market leaders in innovative, integrated digital healthcare solutions and services that deliver improved health outcomes.

Our core capabilities include population health management platforms and a broad range of IT service management expertise.

With a 25-year track record in building, integrating, deploying and supporting advanced eHealth solutions, our products and services are used by governments and researchers around the world.

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PARTNERSHIPS

Partnerships

Government and Strategic Partners The ACPCC strongly values its working relationships with our partners, which include Government Departments both State and Commonwealth, Cancer Councils, medical colleges, universities, major teaching hospitals, sexual and reproductive health services, primary care and community organisations, and technology and device manufacturers.

The ACPCC is a key contributor to state, national and international cervical cancer control policy and initiatives and is a trusted partner to UN bodies including the WHO and Unitaid.

ACPCC staff continue to serve in-kind on expert advisory committees and participate in working groups and forums that support both the Commonwealth and Victorian Governments in relation to cancer reporting and prevention, cancer screening and immunisation.

See Appendices 1 and 2 for access to a full list of our Partnerships and Committee involvement in 2023/24.

Peak Bodies Through partnerships and collaborations, the ACPCC encourages and supports improvements in health and health equity. We are proud to be a member of the Australian Global Health Alliance, BioMelbourne Network, The Public Health Association of Australia, Public Pathology Australia and the Union for International Cancer Control.

ACPCC ABN 35 430 554 780

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Chairman & Executive Director Report As the incoming Chairman and on behalf of Prof Saville, I would like to begin by thanking my predecessor, Mr Tim Humphries who has led the Board and organisation as Chairman of the Audit and Finance Committee from 2012 and then taking up the role of Chairman of the Board in 2020. Mr Humphries was a highly valued member of the Board, and his insights and advice will be greatly missed.

I am proud to be working with Prof Saville in expanding the reach of the expertise that ACPCC can bring, particularly in regional areas of Australia and low- and middle-income countries in our Region.

With a 60-year history in cervical screening and 30-year history in registry services, the Australian Centre for the Prevention of Cervical Cancer has evolved into a multidisciplinary team who together are leaders in cervical cancer control.

As pioneers in implementing self-collected HPV tests in Australia, ACPCC is supporting the wider rollout of this approach by providing accredited education to healthcare professionals and technical advice to laboratories as they also begin testing with this new modality. The continued promotion and education around self-collection will be a key driver in reaching under-screened individuals, particularly in remote and regional areas in Australia and in our neighbouring countries.

Casper David Wrede

Professor Marion Saville AM

This is an exciting time for the organisation as we share our skills to enable Australia’s aspiration to lead the world in achieving cervical cancer elimination, and to support countries in the Indo-Pacific as they progress towards cervical cancer elimination. Our participation in the DFAT funded Elimination Partnership in the Indo-Pacific for Cervical Cancer (EPICC) has enabled us to collaborate with consortium partners and partner governments. This collaborative work is highlighted in the annual report.

We gratefully recognise the Board of Directors who have been a continuing source of sound advice. We recognise the need for the organisation to continue to educate, develop and diversify so we can continue to progress towards the WHO cervical cancer elimination targets in Australia and in our region.

On behalf of myself and Prof Saville, I invite you to read this most recent impressive chapter of the organisation’s achievements.

Casper David Wrede, Chairman Marion Saville, Executive Director

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FINANCIAL SNAPSHOT 2022/23

Financial Snapshot 2023/24 Financial Position

OPERATING RESULT

TOTAL REVENUE

($4,147,513)

$22,048,334

UP FROM $– ($4,769,149) IN 2022/23

UP FROM $20,105,553 IN 2022/23

TOTAL EXPENSES

$26,195,847

UP FROM $24,874,969 IN 2022/23

Core Business Performance Total Revenue

2023/24

2022/23

2021/22

2020/21

$22,048,334

$20,105,553

$43,673,410

31,392,822

Total Expenses

$26,195,847

$24,874,969

$33,328,085

26,448,958

NET RESULT Surplus/(Deficit)

($4,147,513)

($4,769,149)

$10,345,325

5,107,489

Total Assets

$31,585,199

$35,670,655

$40,014,710

31,061,811

Total Liabilities

$6,382,738

$6,320,681

$5,895,320

7,287,746

NET ASSETS Total Equity

$25,202,461

$29,349,974

$34,119,390

23,774,065

ACPCC has valued the financial support from both the Commonwealth and Victorian Governments. This has enabled ACPCC to excel across its screening, vaccination and specialist laboratory services, consistent with our purpose as a not-for-profit organisation.

ACPCC ABN 35 430 554 780

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Summary of ACPCC Consolidated Financial Results The ACPCC’s consolidated net result for the financial year ended 30 June 2024 was a deficit of ($4.2M) after accounting for depreciation and amortisation. This was a minor variation from the budgeted deficit of ($4.0M).

The overall financial result highlights the dependency on Medicare bulk billing by VCS Pathology as the APCPCC’s new financial operating environment continues to feel the financial pressures since the National Partnership Agreement funding ended in 30 June 2021.

Annual Income by Source 2023/24

Annual Income by Source $M 2019/20 2020/21 2021/22 2022/23 2023/24

Government Grants Patient Fees Other Operating Income 2022/23 comparison

Non Operating Income Other Operating Income Patient Fees Government Grants 0

Operating Expenditure 2023/24 Salaries and Wages Operating and Administration Laboratory Consumables Depreciation

5

10

15

20

25

30

35

Annual Operating Expenditure $M 2019/20 2020/21 2021/22 2022/23 2023/24 Depreciation Laboratory Consumables Operating & Administration Salaries & Wages 0

2

4

6

8

10

12

14

16

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OUR IMPACT AND ACHIEVEMENTS 2022/2023

Our Impacts and Achievements 2023/2024 ACPCC has had considerable success in state, federal and international contexts this year. Refer to the snapshots below and find out more about these highlights inside.

NATIONAL STRATEGY FOR THE ELIMINATION OF CERVICAL CANCER IN AUSTRALIA A pathway to achieve equitable elimination of cervical cancer as a public health problem by 2035 November 2023

Launch of the National Strategy for the Elimination of Cervical Cancer in Australia in November 2023 coinciding with the Cervical Cancer Elimination Day of Action.

Launch of the Elimination Partnership in the Indo-Pacific for Cervical Cancer (EPICC).

Launch of the Inaugural Victorian Cancer Screening Annual Statistical Report – a rich level of cancer screening data now publicly available in a visual and accessible format.

The ACPCC Team set up shop in the Victorian Parliament House library for the world’s first cervical screening self-collection testing event in a parliament house. An overwhelmingly bipartisan show of support from MP’s turning up for testing or getting the word out to under-screened people across Victoria.

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The Australian Government Department of Health and Aged Care has funded ACPCC to undertake an education campaign to help healthcare providers get up to date and ready for expected patient demand for HPV self-collection.

Sharing the great news about the option of HPV self-collection at the National Closing the Health Gap Conference, with patient advocate Kerrie Castor, ACPCC’s Director of Communications, A/Prof Misha Coleman and Clinical Education Manager Hannah Saunders.

Together with the C4 Partners, ACPCC hosted the inaugural ECC2023 conference. It concentrated on advancements in cervical screening within Australia, New Zealand, and low- and middleincome countries (LMICs).

VCS Pathology processed 138,695 self-collected cervical screening samples during this financial year (compared to 58,757 in the previous year) making up nearly 50% of all screening tests reported by the laboratory.

Spreading the word about the option of HPV self-collection to all women and people with a cervix participating in cervical screening.

New location for our Population and Digital Health teams! Thanks to Jill Butty from the Victorian Department of Health for the ribbon-cutting.

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OUR IMPACT ACROSS THE GLOBE

Our Impact Across the Globe

ACPCC ABN 35 430 554 780

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GLOBAL PROJECTS

ACPCC Global CANADA

INDOPACIFIC

PAPUA NEW GUINEA

Ontario

ACPCC is part of a consortium called EPICC that has been awarded a four-year program of work funded by the Australian Department of Foreign Affairs and Trade (DFAT) in PNG, Solomon Isands, Tuvalu, Vanuatu, Timor-Leste, Malaysia, Nauru and Fiji (see pages 24-26).

canSCREEN® and laboratory support.

ITALY

ACPCC provided technical support to the YouScreen trial conducted by King’s College London, which is a research study that offered women and people with a cervix in north and east London the opportunity to take a self-sample for cervical screening.

Prof Saville provided Expert Advice to Cancer Care Ontario as a consultant for HPV Testing Implementation for the Ontario Cervical Screening Program.

COOK ISLANDS VCS Pathology provides HPV testing, refex cytology and histology support to the laboratory in the Cook Islands.

In 2023/24 we reported over 2,000 cases.

FIJI ACPCC is supplying technical advice and assistance to a private pathology laboratory in Fiji as part of our role as the Australian HPV Reference laboratory. (See page 26) Minderoo funded Screen and Treat model pilot using canSCREEN® and laboratory support.

Support to PICCSI project in Fiji through scientific advice, testing, research and biopsy interpretation.

INDIA Mizoram and Tamil Nadu The SHE-CAN study (see page 39).

ACPCC has undertaken studies of the stabilitity of the Copan FLOQSwab on behalf of Copan.

KENYA canSCREEN®.

MALAYSIA Program ROSE VCS Pathology provides technical assistance to the ROSE Laboratory.

This support covers review of results prior to reporting, internal quality control (IQC), and external quality assurance (EQA) as well as assistance with laboratory documentation. The Digital Health team also supports the ROSE team with our canSCREEN® platform.

NEW ZEALAND Te Ara Waiora and He Tapu Te Whare Tangata studies. canSCREEN® and laboratory support. (see page 38) Empowering study in the Tairawhiti region, laboratory support.

TONGA ACPCC continues to support the Tonga Family Health Association in conventional Pap smear screening.

UNITED KINGDOM

USA ACPCC is undertaking analytical validation of a new commercial self-collection device.

VANUATU ECCWP (see page 25).

HPV vaccination has now started! canSCREEN® and laboratory support (See page 25).

YAP canSCREEN® (see page46-47).

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ACPCC STRATEGIC PLAN 2020-2025

Strategic Plan

The ACPCC Strategic Plan 2020-2025 was developed by the Board of Directors in consultation with the Executive Team.

Over the five years of the plan, we commit to assisting the Victorian Government, the Commonwealth and countries in the Indo-Pacific region to eliminate cervical cancer as a public health issue.

We continue to support the National Bowel Cancer Screening Program and Victorian Immunisation Program through the delivery of our funded services.

We will build on laboratory service excellence by diversifying the range of VCS Pathology test capabilities and our unique position as the Australian HPV Reference Laboratory.

We continue to support a range of implementation projects and research activities using our canSCREEN® platform as a service.

This Annual Report showcases the activities of the ACPCC against the Strategic Plan.

ACPCC ABN 35 430 554 780

1. Support Victoria’s efforts to eliminate cervical cancer as a public health problem by a target date agreed with the Department of Health, in accordance with the Victorian Cancer Plan 2020-24.

Pages 16-19

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2. Support Australia’s efforts to eliminate cervical cancer as a public health problem by 2035. Pages 20-23

3. Support countries in the Indo-Pacific region to scale up to meet the 2030 targets in support of the WHO strategy to eliminate cervical cancer as a public health problem. Pages 25-27

4. Lead and promote the increased uptake of self-sampling. Pages 28-29

5. Support the National Bowel Cancer Screening Program in Victoria.

Page 30

6. Deliver and disseminate the research outcomes of the Compass trial, C4 and other policy relevant research.

Pages 32-39

7. Diversify the range of VCS Pathology laboratory tests by leveraging our existing expertise and capital investment. Pages 40-45

8. Leverage the value of the canSCREEN® and canVAX platforms for cost effective support of Low to Middle Income Countries (LMICs) and for commercially advantageous opportunities. Pages 46-47

9. Reshape the business model to adapt to our new commercial environment and global opportunities. Pages 48-49

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STRATEGIC PLAN OUTCOMES

One Support Victoria’s efforts to Eliminate Cervical Cancer as a Public Health Problem, in accordance with the Victorian Cancer Plan 2020-2024

Data and reporting tools for cervical, breast and bowel screening programs, in partnership with Victorian screening partners LAUNCH OF THE INAUGURAL VICTORIAN CANCER SCREENING ANNUAL STATISTICAL REPORT We are thrilled to announce the launch of the Inaugural Victorian Cancer Screening Annual Statistical Report.

The Victorian Cancer Screening Annual Statistical Report integrates key cancer screening data up to 2022 from: • the National Cervical Screening Program • the National Bowel Cancer Screening Program • the BreastScreen Victoria dataset.

The ACPCC is funded by the Victorian Department of Health to deliver this report under the Victorian Cancer Screening Framework (VCSF). The report is unique in Australia, and the first time that such a rich level of cancer screening data has been publicly available in a visual and accessible format.

The report presents key screening numbers and participation rates for Cervical, Bowel and Breast cancers across Victoria under the workplan of the Victorian Cancer Screening Framework (VCSF).

VCSF is a governance and funding model that guides Victoria’s delivery of and investment in cancer screening programs. The VCSF aims to increase equitable cancer screening participation, enhance primary care and workforce education and monitor screening participation, follow-up and outcomes across the screening pathway.

THE VICTORIAN CANCER SCREENING STATISTICAL REPORT DATA SUPPORTS THE WORK OF A RANGE OF ORGANISATIONS DELIVERING INITIATIVES OR UNDERTAKING RESEARCH IN CANCER SCREENING IN VICTORIA, INCLUDING LOCAL GOVERNMENTS, WOMEN'S HEALTH ORGANISATIONS, AND UNIVERSITIES.

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The authors have relied extensively upon data held by BreastScreen Victoria and the Australian Government's National Cancer Screening Register.

Sharing the data and findings publicly is an important component of a collaborative and transparent process required to improve cancer outcomes for all Victorians.

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Explore the interactive report Annual Statistical Report - ACPCC This report was made possible due to support from the Victorian government and working with key partners under the VCSF.

The ACPCC Population Health team at the launch of the Victorian Cancer Screening Annual Statistical Report

The VCSF is a funding and governance model established to support population cancer screening in Victoria and comprises of:

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STRATEGIC PLAN OUTCOMES

One Upskill healthcare service providers with a focus on underserved groups The Victorian Cancer Screening Framework aims to increase equitable cancer screening participation, enhance primary care and workforce education.

With support from the Victorian Government, the ACPCC team hit the road again this year and delivered self-collection clinical education sessions to 24 services across Victoria, including GP clinics and Bush Nursing Centres.

The ACPCC continues to demonstrate commitment to high quality clinical education for healthcare practitioners in Victoria.

24 dedicated practice education sessions were delivered in 2023/24 by ACPCC staff with a focus on regional Western Victoria and Northwest Melbourne.

CLINICAL EDUCATION

"APPRECIATE THIS QUALITY EDUCATION BEING DELIVERED ONSITE IN OUR RURAL SETTING." – RN, Bush Nursing Centre

ACPCC conducted clinical education sessions across regional areas of Victoria in 2023-24, seen here with members of the Dargo Bush Nursing Centre nursing team

"[THE SESSION WAS] RELEVANT, INTERESTING AND PRESENTED WELL. MADE ME FEEL THAT I COULD MAKE A DIFFERENCE AND PARTICIPATE IN THIS SCREENING PROCESS. I NOW FEEL MORE CONFIDENT TO PROMOTE THIS SCREENING [SELF-COLLECTION]."

– Remote Area Nurse, Bush Nursing Centre

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ACPCC and industry sponsors with the Premier of Victoria, The Hon. Jacinta Allen and the Minister for Health, The Hon. Mary-Anne Thomas, at the worldfirst ‘Cervical Screening: It’s in your hands’ event at the Parliament of Victoria

Aboriginal designed self-collection kits; Aboriginal designed towels for clinician-collected CSTs

A WORLD FIRST EVENT AT THE PARLIAMENT OF VICTORIA

CLINICAL RESOURCES FOR ABORIGINAL AND TORRES STRAIT ISLANDER PEOPLE IN VICTORIA

In a world-first, ACPCC conducted an HPV cervical screening event at the Victorian Parliament House in December 2023. This all-day event was supported by the Victorian Health Minister Mary-Anne Thomas, Pathology Awareness Australia and Pathology Technology Australia. MPs who attended shared the news about the self-collection option for screening with their electorates, and eligible MP’s and parliamentary staff were given the opportunity to have a GP consultation on-site and take a self-collected test, with same-day results provided.

14 MPs and parliamentary staff took up this offer!

The ACPCC has partnered with Primary Health Networks, Cancer Council Victoria, and the Victorian Aboriginal Community Controlled Health Organisation to provide dedicated self-collection education sessions and webinars. VACCHO’s and the ACPCC’s collaborative efforts are key to increasing rates of culturally safe and empowering cervical screening and improving cervical cancer outcomes amongst Victorian Aboriginal and Torres Strait Islander communities.

This year we distributed over 2000 clinical towels and almost 3000 self-collection kits to over 40 health services around Victoria.

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STRATEGIC PLAN OUTCOMES

Two Support Australia’s efforts to eliminate cervical cancer as a public health problem by 2035

LAUNCHING THE NATIONAL STRATEGY FOR THE ELIMINATION OF CERVICAL CANCER IN AUSTRALIA

With equity at its core, the Strategy identifies several priority populations to concentrate our efforts on, and identifies specific actions which are tailored to each population:

On the 17th of November 2023, coinciding with the Cervical Cancer Elimination Day of Action, the Australian Government launched this landmark strategy, which was developed by the ACPCC through an exhaustive co-design process.

• Aboriginal and Torres Strait Islander people

The strategy outlines Australia’s commitment to achieving equitable elimination of cervical cancer as a public health problem by 2035, and the objectives and actions needed to achieve this goal.

• Culturally and linguistically diverse people • People who are LGBTQ+ and people who are intersex • People with disability • People living in rural and remote areas.

Thank you to all our partners, stakeholders, and subject matter experts for their contribution and guidance in the development of the National Strategy.

VISION:

‘An Australia where preventable cervical cancer is a disease of the past, in which Australia’s diverse communities have equitable access to information and to culturally safe and inclusive vaccination, screening and treatment services.’

Assistant Minister for Health and Aged Care and Assistant Minister for Indigenous Health the Hon Ged Kearney MP officially launches the National Strategy, a major achievement of the ACPCC in 2023

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STRATEGIC PLAN OUTCOMES

Two

"[I WILL NOW] BE READY TO DISCUSS THE PROS AND CONS OF THIS [SELF-COLLECTION] OPTION AND EMBRACE THE CHANGE THAT IS AVAILABLE. I FEEL QUITE OPTIMISTIC ABOUT THE UPTAKE OF THIS SELF-COLLECTION OPTION." – GP, webinar attendee

A NEW NATIONAL CAMPAIGN In support of Australia’s elimination efforts, the ACPCC launched a new nationwide cervical screening and self-collection education and awareness campaign for healthcare providers in May 2024, funded by the Australian Government.

This campaign has involved delivering webinars and eLearning modules, speaking at conferences, contributing to podcasts, and having numerous articles published in healthcare professional newsletters and journals.

We have reached thousands of GPs, nurses, midwives and other healthcare professionals with evidenced-based messages and education about self-collection and the role it can play in the elimination of cervical cancer in Australia, particularly in engaging Aboriginal and Torres Strait Islander people and those from culturally and linguistically diverse backgrounds in cervical screening.

Developed in partnership with the Australian Multicultural Health Collaborative and the National Aboriginal Community Controlled Health Organisation, the healthcare provider campaign was designed to support a community facing campaign, to ensure that healthcare providers are ready to support the choice and meet demand for self-collection in their practice.

Professor Deborah Bateson AM, delivering a session to 2000 healthcare professionals at the HealthEd Annual Women’s and Children’s Update in Melbourne, supported by the ACPCC education booth

VCS PATHOLOGY CERVICAL SCREENING AUDIT In 2024, ACPCC was proud to launch the VCS Pathology Cervical Screening Audit, which is available to all our valued referring practitioners.

We partnered with GPEx to develop and deliver a Cervical Screening Audit program to enable VCS Pathology referring practitioners to participate in a comparative audit and review of their own practice findings to target areas for quality and performance improvement.

Completion of the activity contributes a total of 23 hours to Continuing Professional Development for GPs.

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“ACCORDING TO OUR REPORT, AUSTRALIA HAS MET THE WHO 2030 ELIMINATION SCALE-UP TARGET FOR SCREENING COVERAGE OF 70%, WHICH IS AN EXCELLENT ACHIEVEMENT FOLLOWING OUR EARLY SWITCH TO FIVE-YEARLY HPV BASED SCREENING IN 2017."

– Professor Marion Saville AM

AUSTRALIA REACHES CERVICAL SCREENING TARGETS ACPCC MAKING A POSITIVE DIFFERENCE IN PARTNERSHIP WITH THE C4 GROUP A 2023/24 report finds that Australia has met the WHO and Australian 2030 cervical cancer elimination scale-up target for screening For the first time Australia has met the WHO and Australian 2030 elimination scale-up target for screening. Now that the first 5-year screening interval in the HPV-based program has elapsed, nationally we have reached the screening target of 70%.

“While the national figures are encouraging, HPV screening remains inequitable. Those living in very remote areas are just below the target, reflecting a need for increased outreach from health services. There are also challenges in engaging young women to initiate screening in a timely way, with just over half up to date with recommended screening,” says Associate Professor Megan Smith from The Daffodil Centre.

Other WHO targets include 90% vaccination coverage by age 15 in females and 90% of people with pre-cancers and cancers receiving treatment. According to the report, Australia is sitting just below these targets, although there is currently no national data available for cervical cancer treatment rates.

Inequity remains, however, with those living in very remote areas just below the target, and data still unavailable for Aboriginal and Torres Strait Islander women. Findings show that just over half of those aged 25-29 years are up to date with screening and, in conjunction with other data, suggests that initiation of screening is not occurring in a timely way at the age of 25. Coverage among those aged 70-74 has improved strongly over time but still remains below 70%.

We are optimistic that Australia can address the ongoing challenges identified in this report by effectively implementing the National Strategy for the elimination of cervical cancer as a public health problem, noting its important emphasis on improving data quality and completeness, and focus on equity.

90%

of girls to be fully vaccinated with the HPV vaccine by 15 years of age

70%

First Nations women are almost twice as likely to be diagnosed with cervical cancer and face significant barriers to participating in cervical screening compared to non‑Indigenous women.

of women to be screened by 35 and again by 45 years of age using a high precision test

90%

of women identified with cervical disease receive treatment for pre-cancerous lesions or management of invasive cancer

Access the report Machalek D, Smith M, Brotherton J. et al., 2023 Cervical Cancer Elimination Progress Report: Australia’s progress towards the elimination of cervical cancer as a public health problem. Published online 12/04/2024, Melbourne, Australia, at https://report.cervicalcancercontrol.org.au/ Partners

This is a multi-institutional agreement in partnership with:

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STRATEGIC PLAN OUTCOMES

Three Support countries in the Indo-Pacific region to scale up to meet the 2030 targets in support of the WHO strategy to eliminate cervical cancer as a public health problem

While ACPCC has supported Australia to lead the world in its progress towards elimination, our expertise has increasingly been recognised by donors who are keen for us to support countries where the burden of cervical cancer remains far too high.

The key areas of expertise we are being recognised for globally include: • the design and implementation of screening and treatment models of care; • the provision of our canSCREEN® digital health solution; • regional policy and guideline development; and • Quality Assurance and Quality Control, support and advice to pathologists and laboratories for both point-of-care and lab-based testing.

POINT OF CARE HPV SCREEN AND TREAT MODEL

Self-collect

Test

Treat

Register

ELIMINATING CERVICAL CANCER IN THE INDO-PACIFIC ACPCC is part of a consortium of trusted partners that has been awarded a four-year program of work by the Australian Department of Foreign Affairs and Trade (DFAT) in PNG, Solomon Islands, Tuvalu, Vanuatu, Timor Leste, Malaysia, Nauru and Fiji. This award is based on the highly successful screen and treat model that has been implemented in the Western Highlands of PNG and Vanuatu under the ECCWP program.

EPICC has been made possible by a $12.5 million regional aid grant from the Australian Government. It will leverage long standing local, regional and international partnerships to accelerate the elimination of cervical cancer in the Indo-Pacific region, coordinated with other Australian Government-funded and international efforts.

The new EPICC program will focus on the three pillars (Immunisation, Screening, Treatment) of the WHO Global Strategy for the Elimination of Cervical Cancer. EPICC is currently Australian Government funded as a four-year program of work. Country plans are now being codesigned with partner governments to undertake a range of cervical cancer control activities, with a focus on capacity building, sustainability and equity.

Dr Lucas de Toca – Australia’s Ambassador for Global Health, launching EPICC

ACPCC ABN 35 430 554 780

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"AS A SINGLE MOTHER, I AM VERY GRATEFUL THAT I GET TO FIND OUT EARLIER SO THAT I CAN GET TREATMENT IN TIME AND I CAN SPEND TIME WITH KIDS; SEE THEM GROW IN THE FUTURE AS SOME OF THEM ARE STILL REALLY SMALL." – Floriana, Port Villa, Vanuatu Photo credit, Kirby Institute, UNSW, Oct 2023

Western Pacific EPICC will build on the successes of the Eliminating Cervical Cancer in the Western Pacific (ECCWP) project, funded by the Minderoo Foundation, which has supported the introduction of sustainable elimination policy and practice in Vanuatu and the Western Highlands region of Papua New Guinea. As of 30 June 2024, 36,000 women have been screened and their data entered into canSCREEN® in this region. A number of other provinces in PNG are also moving forward with their plans in establishing an HPV-based cervical cancer screening program with 22,334 women screened in PNG to date.

Timor Leste Building on the previous work of the C4 Centre of Research Excellence in Cervical Cancer Control in the region, Timor-Leste is one of the countries that is being supported by DFAT under the EPICC program.

To better understand the needs and opportunities for cervical cancer elimination in the country, and to strengthen inter-country relationships, members of the C4 consortium, the Daffodil Centre and ACPCC, conducted a scoping visit in August 2023.

the National Institute of Public Health, the National Health Laboratory, and the Australian Embassy (DFAT, in Timor-Leste).

Members of the C4 group, the Minderoo Foundation and guests from Timor-Leste then came to Sydney in October 2023 to begin the co-design planning process.

Vanuatu In October 2023 the Vanuatu Government declared that it would be the first nation in the Pacific to commit to a national strategy for the elimination of cervical cancer.

ACPCC has been thrilled to be part of the ECCWP program – alongside other partners in Vanuatu and Australia – to support this marvellous initiative as women in Vanuatu are seven times more likely to die from cervical cancer than those in Australia. Vaccine delivery has now commenced in all provinces at schools and communities.

As of 30 June 2024, 10,039 women have been screened and their data entered into canSCREEN® to ensure follow-up at the appropriate interval.

Vanuatu is now one of the new EPICC countries.

During the visit, we were able to meet and discuss cervical cancer control in Timor-Leste across the 3 pillars with many relevant national stakeholders including: the Ministry of Health, WHO-Timor-Leste, the NITAG, the National Hospital Guido Valadares,

The C4 Consortium, Minderoo and Cephied members in Vanuatu

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STRATEGIC PLAN OUTCOMES

Three Fiji

Project PICCSI

• ACPCC reported a backlog of close to 1500 cervical screening cases for the Ministry of Health in Fiji and provided insights into HPV prevalence. The results of these cases will inform considerations about changes to the cervical screening pathway in Fiji.

ACPCC partners with PICCSI to provide a point-of care testing instrument. PICCSI works with the Fiji National University, Department of Obstetrics and Gynaecology at Lautoka Hospital and addresses critical gaps in cervical cancer prevention and treatment.

• Members of the EPICC consortium have been supporting the Fijian government's plan to deliver HPV based cervical screening.

PICCSI aims to address several key challenges faced

by Fijian women in accessing the healthcare they need, such as travel and financial considerations, healthcare workforce capacity, and infrastructure.

• PICCSI provides on-the-spot HPV testing for women at rural community health centres across Fiji.

• Samples are self-collected & results are received in 45 minutes.

• Immediate pre-cancerous cell removal treatment is then offered to those with a positive result.

• Australian volunteers set up and run PICCSI to assist with the cervical screening public health need in the Pacific region.

This year’s PICCSI program took place in five different rural centres across Fiji, with a total of 300 Fijian women being screened for cervical cancer. The testing resulted in a positive HPV rate of 16.9%, and 30-40% of those women received treatment for pre-cancerous cells.

By offering immediate results, follow-up rates have significantly improved compared to delayed result models.

"PICCSI SHOWCASES THE COLLABORATIVE SPIRIT OF HEALTHCARE PROFESSIONALS ACROSS BORDERS. BY PROVIDING ACCESSIBLE, IMMEDIATE, AND SUSTAINED CARE, WE ARE CONTRIBUTING TO THE LARGER GOAL OF CERVICAL CANCER PREVENTION IN THE PACIFIC." – Dr. Nicola Fitzgerald

ACPCC ABN 35 430 554 780

Malaysia: Program ROSE Empowering women to screen through the use of self-collection Program ROSE (Removing Obstacles to Cervical ScrEening), developed by the ACPCC and the University of Malaya, is a pioneer and revolutionary HPV PCR self-sampling cervical screening methodology with five (5) pillars inclusive of education and advocacy to provide an integrated screening service with linkage to care.

1. EDUCATION & ADVOCACY Education of the public and healthcare professionals and advocacy for cervical cancer elimination

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1,555,485K Reached 30,360 Women Screened 372 Community Locations 13 States 2 Federal Territories

2. SELF-SAMPLING Self-sampling by women themselves instead of pap smear screening by healthcare professionals

3. VALIDATED PCR TESTING Clinically validated HPV PCR assay and a validated protocol for the testing of self-collected specimens for HPV-based cervical screening

4. DIGITAL HEALTH PLATFORM

5. LINKAGE TO CARE

A secure digital health platform that enables registration & follow-up communicated via mobile phone

ROSE Contact Centre refers positive cases for treatment and follow-up care

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STRATEGIC PLAN OUTCOMES

Four Lead and promote the increased uptake of self-sampling

SELF-COLLECTION IS A GAME CHANGER IN THE ELIMINATION OF CERVICAL CANCER SUPPORTING HEALTHCARE PROVIDERS

eLEARNING MODULES

The ACPCC continues to lead the way in providing high quality resources and educational sessions to support healthcare providers to incorporate self-collection into routine practice.

Our Cervical Screening, HPV and Self-Collection Clinical Education Course continues to be a popular Continuing Professional Development (CPD) option for GPs and nurses. Updated and revised to include additional CPD hours this year, this course has now had over 850 completions and continues to enjoy excellent feedback from participants.

RESOURCES The ACPCC team develops resources to meet the learning needs of healthcare providers. A highlight was the release of our online ‘Cervical screening and self-collection resource hub’, funded by the Australian Government, housing downloadable resources, videos, recorded webinars and podcasts to support selfcollection in clinical practice.

The webinars discuss what you need to know about self-collection and cervical screening, including case studies and practical information to ensure practices are on track to contribute to the elimination of cervical cancer in Australia. https://acpcc.org.au/get-the-facts-webinar/

NATIONAL CERVICAL SCREENING PROGRAM GUIDELINES

NATIONAL CERVICAL SCREENING PROGRAM GUIDELINES

HOW TO TAKE YOUR OWN CERVICAL SCREENING TEST

CERVICAL SCREENING PATHWAY QUICK REFERENCE GUIDE

CERVICAL SCREENING: Supporting your patients to make the choice Clinician-collected cervical sample Is it accurate?

Yes

Yes

Is liquid-based cytology (LBC) and co-testing possible?

Yes

No

• Test of Cure after HSIL treatment • People who have had a total hysterectomy with history of HSIL

STEP ONE

STEP TWO

STEP THREE

STEP FOUR

• Get in a comfortable position. You can stand, sit or lie down

• Rotate the swab gently for at least 10 seconds

• Place swab back in the tube

• Twist the swab cap and pull the swab out of the tube • Look at the swab and note the red mark closest to the soft tip

• Insert the swab into your vagina, aiming to insert up to the small red mark (this is about the same length as your index finger)

• Then remove the swab

• Return the tube to your healthcare provider

• People who have postcoital, unexplained intermenstrual or post-menopausal bleeding, or unexplained persistent unusual vaginal discharge3 • People undergoing surveillance after completely excised AIS • People who were exposed to DES in utero.

Management of participants in whom HPV is not detected

>90% of CSTs

Yes

Yes

No

25-29 years

17% Return 50-54 years in 5 years

4%

Routine 5-yearly screening

HPV detected (16/18)

LBC (reflex or collect at colposcopy)

Unsatisfactory LBC

The clinical guidelines are available via the Cancer Council Australia website https://cancer.org.au/clinicalguidelines/cervical-cancer/ cervical-cancer-screening

30-34 10% 55-59 years 4%to inform the Returnyears for clinician-collected cervical sample for LBC

~6% of CSTs

Reflex LBC is performed on the original sample, no need to return for a further sample to be taken

40-44 years yearsyears 4% 4% 25-29 years 6% 17% 65-6950-54 30-34 years 5% 10% 70-7455-59 45-49 years yearsyears 3% 3%

35-39 years 6% 60-64 years 3% 3 40-44 years 5% 65-69 years AIHW data 3% 45-49 years 4% Note: at the 12-month follow up HPV test after an Intermediate Risk result the incidence of HPV (not 16/18) is ~60%4 Patients aged 70 to 74 with HPV (not 16/18) detected are referred to colposcopy.

Management of participants in whom HPV (16/18) is detected

RED MARK

~2% of CSTs

Refer for colposcopy Repeat as soon as practical, ideally within 6 weeks

HPV: Human papillomavirus; LBC: Liquid based cytology; HSIL: High-grade squamous intraepithelial lesion; AIS: Adenocarcinoma in situ; DES: Diethylstilbesterol Adapted from ‘Self-collection: equity in reaching cervical cancer elimination, Aug 2022, InSight+, AMPCo.

Images reproduced with permission from: Cancer Council Victoria

Yes (following expected guideline changes in 2024/25*)

HPV test with partial genotyping (ages 25-69) HPV detected (not 16/18)

LBC (reflex or collect cervical sample if self-collection was used)

HPV not detected

Negative

www.acpcc.org.au

Refer for colposcopy

Scan to access the guidelines

pLSIL/LSIL

HPV detected (not 16/18)

Unsatisfactory LBC

LBC negative/pLSIL/ LSIL

Repeat LBC test in 6 weeks

Follow-up HPV test in 12 months

HPV detected (16/18)

Unsatisfactory HPV test

LBC (reflex or collect at colposcopy)

Repeat as soon as practical, ideally within 6 weeks

Any LBC result or unsatisfactory

LBC pHSIL or worse*

www.acpcc.org.au

LEGEND Test result Recommendation Woman’s risk of developing cervical cancer precursors within the next five years Low

Flowchart adapted from National Cervical Screening Program Guidelines, Cancer Council Australia

Intermediate Higher

Repeat as soon as practical, ideally within 6 weeks *Guideline changes regarding Test of Cure surveillance are expected in 2024/2025 – please check the National Cervical Screening Program Guidelines on the Cancer Council Australia website for up-to-date information.

1 Arbyn et al, Detecting cervical precancer and reaching underscreened women by using HPV testing on self samples: updated meta-analyses BMJ 2018; 363 :k4823 2 Saville et al, Analytical performance of HPV assays on vaginal self-collected vs practitioner-collected cervical samples: the SCoPE study, Journal of Clinical Virology (2020), doi: https://doi.org/10.1016/j.jcv.2020.104375 3 Co-testing is not required for breakthrough or irregular bleeding due to hormonal contraception or a sexually transmitted infection, heavy menstrual bleeding, or contact bleeding at time of obtaining a routine cervical screening test sample 4 Smith et al, National experience in the first two years of primary human papillomavirus (HPV) cervical screening in an HPV vaccinated population in Australia: observational study BMJ 2022; 376 :e068582

Repeat as soon as practical, ideally within 6 weeks

Refer for colposcopic assessment

Direct referral to colposcopy is recommended for screening participants who are: • aged 50+ years • Aboriginal and/or Torres Strait Islander • overdue for screening by at least 2 years at initial screen

LBC (reflex or collect cervical sample if self-collection was used)

Routine 5-yearly screening

Unsatisfactory HPV test

Any LBC result or unsatisfactory

LBC pHSIL or worse*

Follow-up HPV test in 12 months

Repeat LBC test in 6 weeks

HPV not detected

The incidence of HPV (not 16/18) is highly age dependent (NCSR data4)

Management of Unsatisfactory HPV test

Copyright Notice © 2024 Australian Centre for the Prevention of Cervical Cancer (ACN 609 597 408) These materials are subject to copyright and are protected by the Copyright Laws of Australia.

All rights are reserved. Any copying or distribution of these materials without the written permission of the copyright owner is not authorised.

No (current)

rating as 7% soon as practical, ideally within4% 6 weeks.

35-39 risk years 60-64 years

Management of participants in whom HPV (not 16/18) is detected

SOFT TIP

Yes

Yes Return in 5 years

• It should not hurt

RED MARK

For queries about clinical guidelines and management of patients please contact the VCS Pathology’s Clinical Advisory Service.

Tel: (03) 9250 0309

Your healthcare provider will give you the swab. If you have any questions, ask your healthcare provider.

SOFT TIP

MORE INFORMATION:

Both methods have equivalent sensitivity for the detection of HPV and CIN2+/AIS1,2

Identifies HPV infection?

Indicated for • People who are eligible and due or overdue for cervical screening, including during pregnancy • Other points in the pathway where only an HPV test is required, including the 12- and 24-month follow-up test after an intermediate risk result

• Lower your underwear

ROUTINE CERVICAL SCREENING (AGES 25-69 YEARS) ROUTINE CERVICAL SCREENING (AGES 25-69*)

Self-collected vaginal sample

HPV not detected

www.acpcc.org.au Copyright Notice © 2024, Australian Centre for the Prevention of Cervical Cancer (ACN 609 597 408) These materials are subject to copyright and are protected by the Copyright Laws of Australia. All rights are reserved.

Any copying or distribution of these materials without the written permission of the copyright owner is not authorised.

HPV detected any

LBC (reflex or collect at colposcopy)

Refer for colposcopic assessment

Routine 5-yearly screening

*See overleaf for information regarding the 70-74 age group

DES: diethylstilboestrol LSIL: low-grade squamous intraepithelial lesion HSIL: high-grade squamous intraepithelial lesion pLSIL: possible low-grade squamous intraepithelial lesion pHSIL: possible high-grade squamous intraepithelial lesion *Includes pHSIL, HSIL, cancer or glandular abnormality.

Suggested citation: Cancer Council Australia Cervical Cancer Screening Working Party. Clinical pathway: Cervical screening pathway. National Cervical Screening Program: Guidelines for the management of screen detected abnormalities, screening in specific populations and investigation of abnormal vaginal bleeding. CCA 2016. Accessible from http://wiki.cancer.org.au/australia/Guidelines:Cervical_cancer/Screening.

Updated Dec 2020.

Corp-Mkt-Pub-117 V10

How to take your own HPV test – English Version

Cervical Screening: Supporting your patients to make the choice

Screening Program Quick Reference Guide

An information sheet for clinicians and patients, with step-by-step, illustrated instructions.

An information sheet for clinicians comparing screening options (clinician-collected sample compared to self-collected)

2-page, clinician-facing resource with the illustrated National Cervical Screening Program pathway and supporting information.

ACPCC ABN 35 430 554 780

PAGE 29

"[THIS COURSE] GIVES COMPREHENSIVE EDUCATIONAL INFORMATION ABOUT CST SELF-COLLECTION AND INCREASES AWARENESS TO ENCOURAGE GPs TO HELP PATIENTS UNDERSTAND IT MORE, SO THAT THERE IS INCREASED CHANCE OF CST UPTAKE, PARTICULARLY IN PRIORITY COMMUNITIES." – GP

PARTNERSHIPS

Suitable for GPs, nurses, and other healthcare professionals interested in cervical screening.

Accredited with ACRRM and RACGP. Funding for these webinars is provided by the Australian Government Department of Health and Aged Care 99% of participants indicated that they would recommend this course to a colleague .

"VERY ENGAGING, EVIDENCEBASED, AND LOTS OF USEFUL INFORMATION"

We continue to build strong partnerships with health organisations to deliver self-collection education for healthcare providers. This year we have partnered with Primary Health Networks, Cancer Council Victoria, the Victorian Aboriginal Community Controlled Health Organisation and the National Aboriginal Controlled Health Organisation to provide dedicated self-collection education sessions and webinars.

– Practice Nurse

NATIONAL CERVICAL SCREENING PROGRAM GUIDELINES

NATIONAL CERVICAL SCREENING PROGRAM GUIDELINES

HPV AND CERVICAL SCREENING

CERVICAL SCREENING IS SAFE AT ALL STAGES OF PREGNANCY

90% of people will have HPV in their lifetime

All Cervical Screening Tests, including self-collected tests, look for the Human Papillomavirus (HPV).

HPV is so common that most people will be infected at some stage, as genital HPV is spread through skin to skin contact during sex.

Cervical screening during pregnancy is safe and should not be delayed if the patient is due or overdue.

For some women, pregnancy may be one of the few points of contact with the health system.

HPV usually has no symptoms and is cleared from the body naturally.

90% of people infected with HPV will clear the virus naturally within 2 years Occasionally HPV remains inactive in the cells and can be re-activated in later life. This is why it is important to continue to have tests even if you’ve been with the same partner or haven’t been sexually active for many years.

Age eligibility: 25-74 years Patients under 25?

• Cervical screening is not recommended for women (including pregnant women) under the age of 25 • Medicare does not fund routine Cervical Screening Tests (CST) for women under 25 • However, women with signs and symptoms suggestive of cervical cancer at any age, should be investigated using a co-test (HPV and LBC)4

Pregnant women should be given a choice of testing options1

Occasionally, HPV can cause serious disease. In fact, almost all cervical cancers are caused by HPV infections.

If a woman, or person with a cervix, has persistent infection with one of the HPV types

1. Clinician-collected cervical sample

2. Self-collected vaginal sample

that have the potential to cause cancer, cell changes may occur in the cervix.

• A cervical sampler broom is recommended for use during pregnancy1

• HPV self-collection is as sensitive for the detection of HPV and CIN2+/AIS as a clinician-collected test2

So, if HPV is found on your Cervical Screening Test, the cells of the cervix need to be

ü

examined to see if HPV infection is also causing any cell changes.

Depending on the type of HPV and the cell changes found, you might need immediate further investigation or a repeat test in 12 months.

There are 14 HPV types that cause 93% of cervical cancers and all of these types are detected by the Cervical Screening Test

Routine antenatal and postpartum care should include a review of the woman’s cervical screening history.

Women who are due or overdue for screening should be screened.1

Cervical cancer is one of the most preventable cancers. If you are a woman or person with a cervix aged 25 – 74, a Cervical Screening Test every five years can reduce your risk of getting cancer.

• The endocervical brush and Cervex-Brush® Combi are not recommended for use during pregnancy, due to the risk of associated bleeding which may cause unnecessary distress for the patient1

X

Endocervical brush Cervex-Brush® Combi

• HPV self-collection is suitable for use at all stages of pregnancy and may be a more acceptable option for some women

• Women testing positive for HPV (not 16/18) on a self-collected sample should be advised to return so that a cervical sample for Liquid Based Cytology (LBC) can be collected. The incidence of HPV (not 16/18) is highly age dependent. NCSR data3

• Women should be informed of the small risk of bleeding with this test during pregnancy • You may assist your patient to collect a vaginal sample if required

25-29 years 30-34 years 35-39 years 40-44 years 45-49 years

17% 10% 6% 5% 4%

1 Cancer Council Australia. (2022). National Cervical Screening Program: Guidelines for the management of screen-detected abnormalities, screening in specific populations and investigation of abnormal vaginal bleeding: 14 Screening in pregnancy. https://www.cancer.org.au/clinical-guidelines/cervical-cancer/cervical-cancer-screening/screening-in-pregnancy 2 Arbyn et al. Detecting cervical precancer and reaching underscreened women using HPV testing on self samples: updated meta-analyses BMJ 2018; 363 :k482.

Cervical screening means that HPV can be found, and any cell changes can be treated, BEFORE cancer has a chance to develop.

Copyright Notice © 2024 Australian Centre for the Prevention of Cervical Cancer (ACN 609 597 408) These materials are subject to copyright and are protected by the Copyright Laws of Australia.

All rights are reserved. Any copying or distribution of these materials without the written permission of the copyright owner is not authorised.

Cervical sampler broom

3 Smith et al. National experience in the first two years of primary human papillomavirus (HPV) cervical screening in an HPV vaccinated population in Australia: observational study BMJ 2022; 376 :e068582 4 Human papillomavirus and liquid-based cytology

www.acpcc.org.au

Copyright Notice © 2024 Australian Centre for the Prevention of Cervical Cancer (ACN 609 597 408) These materials are subject to copyright and are protected by the Copyright Laws of Australia.

All rights are reserved. Any copying or distribution of these materials without the written permission of the copyright owner is not authorised.

Corp-Mkt-Pub-187 V1 Images supplied by Hologic (Australia) Pty Ltd

www.acpcc.org.au

HPV and cervical screening

Cervical Screening in Pregnancy

A 2-page resource to aid discussion with patients about the nature of HPV and its link to cervical cancer.

A 2-page resource outlining considerations for screening women during pregnancy

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STRATEGIC PLAN OUTCOMES

Five Support the National Bowel Cancer Screening Program in Victoria

PARTICIPANT FOLLOW-UP FUNCTION An important component of the National Bowel Cancer Screening Program (NBCSP) is the follow-up of participants with a positive Faecal Occult Blood Test (FOBT) result.

The ACPCC is now into its 11th year of delivery of the Participation Follow up Function (PFUF) as part of the National Bowel Cancer Screening Program on behalf of the Victorian Department of Health. The service is expected to continue until at least 2028 after the Commonwealth Government announced in May 2024 further PFUF funding for all states and territories.

The PFUF service supports Victorian participants who have returned a positive test result to progress through the screening pathway in a timely manner. The team have supported participants to minimise undue delays in bowel cancer diagnoses, to reduce uncertainty, and to ultimately contribute to better cancer outcomes. In the past year, the team followed up 17,530 participants, successfully contacting 15,474 of these participants. Of those successfully contacted, 8,815 participants had either progressed to colonoscopy or had a colonoscopy booked.

It is estimated that 353 of these participants would have been diagnosed with a confirmed or suspected cancer.

Over 90% of bowel cancer cases can be successfully treated if detected early.

Since the commencement of PFUF, the service has successfully followed up over 118,000 Victorian participants who returned a positive FOBT.

If you are aged 45 to 74, ask your health worker or doctor about getting the free bowel screening test.

ALMOST 18,000 PARTICIPANTS WITH A POSITIVE FOBT TEST WERE FOLLOWED UP BY THE VICTORIA PFUF TEAM IN 2023/24

ACPCC ABN 35 430 554 780

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STRATEGIC PLAN OUTCOMES

Six Deliver and disseminate the research outcomes of the Compass Trial, C4 and other policy relevant research CENTRE OF RESEARCH EXCELLENCE IN CERVICAL CANCER CONTROL The ACPCC is a key partner of Australia’s National Health and Medical Research Council (NHMRC) funded Centre for Research Excellence in Cervical Cancer Control, known as C4. It was established in late 2017, to bring together cervical cancer control experts undertaking research and evaluation of HPV vaccination, screening programs and treatment.

The work of C4 will ensure that the future of cervical cancer control is underpinned by world-class research with the potential to inform substantial reductions in the global impact of cervical cancer. The core group consists of researchers from the Daffodil Centre, the ACPCC, the University of Melbourne, the Kirby Institute and the Australian National University with combined expertise in epidemiology, public health, laboratory testing, clinical trial implementation, predictive modelling, and economic evaluation. Our Associate Investigators bring additional expertise and perspectives from a range of organisations.

Research undertaken by C4 is driven by the World Health Organization’s Global strategy to accelerate the elimination of cervical cancer as a public health problem. This strategy comprises three pillars: HPV vaccination; cervical screening; and treatment.

C4 researchers are examining equity within the HPV vaccination program, with particular focus on underserved groups in the Australian population. They are looking at how community level-communications can help maintain vaccination levels, considering the potentially detrimental effects of public opinion of the COVID-19 vaccine. Improving equity in vaccine delivery will lead to equity in longer term health outcomes, and more rapid elimination for all groups in the Australian population. Other C4 vaccination-focused research is looking at the effectiveness of the one-dose HPV vaccine in Australia, South Africa and PNG. The C4 team work in a range of ways to support Australian and WHO guidelines development, and assess the real-word performance of the renewed NCSP in Australia. Self-collection is a major focus in this work.

Other key research includes new pathways for HPVbased screening and supporting the WHO screening guidelines in low-and-middle-income countries.

Additionally, there will be a focus on informing access to cancer treatment and care for people with cervical cancer.

ACPCC ABN 35 430 554 780

C4 AND SELF-COLLECTION The Centre for Research Excellence in Cervical Cancer Control (C4) is keenly focused on self-collection as a key strategy towards the achievement of the WHO screening target (70% participation in twice-lifetime cervical screening with a high precision approach such as HPV testing).

In current projects, the C4 team are examining implementation of universal self-collection in primary care in Victoria, as well as co-designing and piloting new models for HPV self-collection with Aboriginal and Torres Strait Islander women, with the support of the National Aboriginal Community Controlled Health Organisation (NACCHO).

C4 researchers are working on innovative solutions to support providers, women and people with a cervix to scale-up self-collection and to create an enabling environment for the implementation of innovative, co-designed models of care.

This is a multi-institutional agreement in partnership with:

PAGE 33

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STRATEGIC PLAN OUTCOMES

Six ELIMINATING CERVICAL CANCER (ECC) 2023 VIRTUAL CONFERENCE In 2023, the C4 partners hosted the inaugural ECC2023 conference, previously known as the Preventing Cervical Cancer Conference (PCC). Themed "From Prevention to Elimination," the conference concentrated on advancements in cervical screening within Australia, New Zealand, and low- and middle-income countries (LMICs).

The conference attracted approximately 130 participants and was conducted in two distinct afternoon sessions.

The first session addressed the topic of equity in cervical screening within Australia and New Zealand, whilst the second session focused on the implementation of HPV screening in LMICs.

The ECC2023 conference successfully fostered valuable discussions on advancing cervical cancer elimination across both Australian and global contexts.

The ECC2023 Recording is available online so you can view the entire conference on our website at https://acpcc.org.au/ecc/.

ACPCC ABN 35 430 554 780

PAGE 35

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STRATEGIC PLAN OUTCOMES

Six THE COMPASS TRIAL

THE COMPASS REGISTER

Compass is Australia’s largest clinical trial with over 76,000 participants, jointly led by the ACPCC and the Daffodil Centre (a joint venture of Cancer Council NSW and The University of Sydney).

The ACPCC continues to operate the Compass Register, supporting the participants and healthcare providers in the Compass Trial through to the conclusion of the trial at the end of 2026.

This trial is important, as it is the first large-scale randomised controlled trial internationally that will assess primary HPV screening in a population that is vaccinated against HPV.

Once participants have reached the endpoint of their participation in the trial, the Compass Register transfers participant data to the National Cancer Screening Register (NCSR), for their ongoing follow up in the National Cervical Screening Program. At the end of the 23/24 financial year, more than 71,000 participants had completed their involvement in the trial and had been successfully migrated to the NCSR, with 9,494 participants remaining under trial management.

The Compass trial is also assessing new next-generation technologies for triage testing, which are expected to improve the overall performance of HPV testing at a program level.

The outcomes and recommendations of the Compass Trial will help to inform the future direction of Australia’s NCSP. Publication: Correlates of intention-to-attend and confirmed cervical screening attendance during the COVID-19 pandemic in Australia: Findings from Compass-PLUS, a prospective cohort study.

Preventive Medicine Reports, Volume 45, 2024, https://doi.org/10.1016/j.pmedr.2024.102849.

THE COMPASS TRIAL IS A RANDOMISED CONTROLLED TRIAL WHICH AIMS TO COMPARE 2.5 YEAR CYTOLOGY SCREENING (PAP SMEAR) WITH THE 5 YEARLY HPV SCREENING. COMPASS PROVIDES INITIAL EVIDENCE TO SUPPORT THE INCREASED EFFICACY OF HPV VS. CYTOLOGY SCREENING IN HPV-VACCINATED POPULATIONS.

ACPCC ABN 35 430 554 780

SCoPE2 HPV Self-Collection or Practitioner-Collected Evaluation 2 Following the National Cervical Screening Program’s announcement that all people eligible for cervical screening would have the choice to use self-collection for routine screening from July 2022, more people were expected to access self-collection. However, many laboratories were not ready to process these samples. The SCoPE2 project was designed to address this problem. It looked at different ways to process self-collected samples, including new lab equipment, different collection devices, and a different media (MSwab) for testing.

The objectives of the study were to determine if selfcollected vaginal samples are as accurate in detecting cervical disease as samples collected by healthcare practitioners from the cervix using the new method, and to validate a different liquid for testing (MSwab) to determine if there were better ways to handle more tests.

400 participants took part in the study, 58 had cervical disease (CIN2+), and 342 participants did not have cervical disease.

The study demonstrated that self-collected samples were as sensitive for cervical disease as the practitioner-collected samples. Moreover, the liquid (MSwab) is easier to transport and use (because it's not flammable or toxic), making the laboratory safer for staff. Following approval by NATA (the Australian laboratory accreditation body), self-collection using the method developed in SCoPE2 began as part of the NCSP at the ACPCC in October 2023.

PAGE 37

The study, followed by NATA accreditation allowed us to adopt a more efficient process for handling selfcollected specimens, speeding the time from receipt of the sample to making results available. This is crucial, given the significant increase in self-collected samples.

Over 100,000 self-collection tests have now been reported with this method.

This study has also helped laboratories in New Zealand use this method for self-collection as part of their cervical screening program.

Te Ara Waiora Study – New Zealand Te Tātai Hauora o Hine, National Centre for Women’s Health Research Aotearoa, and Mahitahi Hauora Primary Health Entity undertook a trial implementing HPV selftesting in Te Tai Tokerau (Northland). The trial aimed to test whether cervical screening coverage utilising the universal offer of HPV self-test programme approach was non-inferior to cervical screening coverage in the then cytology cervical screening programme.

Data collection for this study is complete. Publications are anticipated late 2024.

The study played a critical part in informing the transition of New Zealand’s NCSP from cytology-based screening to HPV-based screening, including the option of self-test.

The ACPCC’s canSCREEN® platform was customised for this study to facilitate appropriate follow up and measurement of outcomes.

THE SCoPE2 STUDY DEMONSTRATED THAT SELF-COLLECTED SAMPLES WERE AS SENSITIVE FOR CERVICAL DISEASE AS THE HEALTHCARE PRACTITIONER-COLLECTED SAMPLES.

PAGE 38

STRATEGIC PLAN OUTCOMES

Six He Tapu Te Whare Tangata: Empowering Rural Solutions Study – New Zealand The He tapu Whare Tangata study explored a new clinical pathway for colposcopy using HPV self-taken vaginal swabs, point-of-care testing, and direct referral to secondary services. The research center Te Tātai Hauora O Hine partnered with the Iwi (tribal) group Ngāti Pāhauwera Development Trust, and Māori health provider Ngāti Porou Oranga for this important project.

The ACPCC has provided training and technical support throughout the process.

This study aimed to address inequities in the clinical care pathway to colposcopy for wāhine Māori in rural Aotearoa, by combining HPV self-testing with pointof-care technology in a community-controlled cervical cancer prevention pathway.

Data collection for this study is complete. Publications are anticipated in late 2024.

Both studies informed changes to the New Zealand National Cervical Screening Programme, and in September 2023 New Zealand became the first highincome country to switch straight to HPV self-testing as the primary screening method for their cervical cancer prevention programme.

The program of work (He Tapu Te Whare Tangata) led

by Prof Bev Lawton, is being published as a chapter in the first comprehensive publication bringing together current global data about Indigenous and Tribal peoples’ experience with cancer. ‘Indigenous and Tribal Peoples and Cancer’ is an open access book, due to be published in late 2024. https://www.youtube.com/ watch?v=qdKivcgfh3o Through public crowdfunding, a documentary was filmed at “Shear-4-a-Cause”, a rural farming community sheep shearing fundraiser where a mobile cervical screening unit - including the use of HPV selftest - was piloted. In the film, shearers, wool-handlers, families, health practitioners, and researchers highlighted the continuing barrier of cost and the unique cervical screening challenges faced by wāhine (women) who live rurally. The film “Cervical screening in rural Aotearoa: Preventing the preventable” was published by an online news website and shared widely through social media. Visit www.hpvselftest.nz to watch the documentary on YouTube

Supporting HPV self-testing as a primary screening method in rural communities in New Zealand

Research team A/Prof David Hawkes, Prof Marion Saville, Bev Prof Lawton, Francesca Storey, Dr Jane MacDonald with Gene-Xpert users (Ngāti Porou Oranga nurses Gina ChaffeyAupouri and Daisy Higgins) outside Ruatoria Health Centre, Ruatoria, East Coast, Aotearoa New Zealand

Research team A/Prof David Hawkes, Prof Marion Saville, Prof Bev Lawton, Dr Jane MacDonald) with staff member of Ngāti Porou Oranga at Tokomaru Health Centre, East Coast, Aotearoa New Zealand

ACPCC ABN 35 430 554 780

PAGE 39

The SHE-CAN project. Right to left, Dr Anu Oommen, A/Prof David Hawkes, Prof Julia Brotherton, Maleeha Ashfaq (Research Assistant at UniMelb, visiting the tribal region in Tamil Nadu where self-collection will be offered as part of the project

The SHE-CAN study Project partners in India include not-for-profit health care organisations (Christian Medical College Vellore, and Tribal Heath Initiative Sittilingi), in collaboration with the Directorate of Public Health and Preventive Medicine for the state of Tamil Nadu, and the Population Based Cancer Registry in Mizoram. Our partners include researchers from the University of Melbourne, Baker Heart and Diabetes Institute, and the International Agency for Research on Cancer.

Training in pre-cancer treatment for the Mamit and Vellore Sites has been completed.

Dr Lalropuii and Dr Lalruattluanga Chawngthu, attended a 2-day training program in Calcutta at Chittaranjan National Cancer Institute, Kolkata.

A 2-day training program was also held in CMC Vellore, with Dr Katayoun Taghavi, a post-doctoral fellow at the International Agency for Research on Cancer, acting as a resource person for the training.

A collection of educational materials has been developed. A flipchart consisting of a narrative that demonstrates the importance of early detection and prevention of cervical cancer was written and codesigned by a community of Tribal women from Jawadhi Hills, Tamil Nadu with the support of the team from the Community Health Dept, CMC Vellore.

A video demonstrating self-collection for HPV testing and instructional flyers and brochures that provide additional information on self-collection, HPV testing and cervical cancer were also developed. Feedback on these materials is currently being sought.

Our canSCREEN® registry platform, which will be used to document and organise screening and management for all SHE-CAN participants, has now been tailored for the trial by the team at ACPCC and is ready for implementation.

Procurement of testing equipment and consumables is currently underway with the support of A/Prof David Hawkes and Prasad Nekkadapu from ACPCC. The SHE-CAN project. The team was joined by Partha Basu from IARC (fifth from the right) who is a member of the international project team

STRATEGIC PLAN OUTCOMES

Seven Diversify the range of VCS Pathology laboratory tests by Leveraging our existing expertise and capital investment CORE ACTIVITIES

Cervical Screening: HPV tests and Liquid-Based Cytology tests

As Australia’s largest not-for-profit cervical screening laboratory, VCS Pathology continues to report almost half of Victoria’s cervical screening tests. This volume of cervical screening testing provides ACPCC with the expertise required to operate the Australian HPV Reference Laboratory which offers up to date technical information, advice, guidance and training on HPV laboratory practices.

Since the NCSP’s move from a two-year to a five-year cycle for cervical screening, annual testing volumes continue to fluctuate and have not yet stabilised.

When healthcare providers choose VCS Pathology they are, by extension, supporting our national and global work with under-screened populations, as we work towards the elimination of cervical cancer. Being a specialist laboratory, we are experts in cervical screening and can provide advice to our referrers on all aspects of the National Cervical Screening Program (NCSP) and associated test results. We provide all Medicare-eligible women and people with a cervix undergoing eligible tests with a bulk-billed service.

HPV & LIQUID BASED CYTOLOGY TESTING NUMBERS HPV

LBC

300,000

223,379 44,170

167,057 40,849

96,866

50,000

40,004

100,000

122,318

150,000

47,782

200,000

176,027

250,000

54,230

VCS Pathology has reported over 12 million cervical screening tests since commencing in 1965.*

VCS Pathology has reported 1,174,259 HPV and 332,324 LBC tests since the beginning of the renewed NCSP in December 2017, and 12 million1 cervical screening tests since commencing operations in 1964.

248,719

What makes us experts?

When HPV is detected in a clinician-collected Cervical Screening Test (CST), a reflex liquid-based cytology test is performed on the same specimen.

66,081

PAGE 40

0

1. Corrected from the 2022/2023 Annual Report.*

2018/2019 2019/2020 2020/2021 2021/2022 2022/2023 2023/2024

ACPCC ABN 35 430 554 780

PAGE 41

"VCS PATHOLOGY WAS READY FOR THE INCREASED UPTAKE IN SELF-COLLECTION, WITH ALMOST 50% OF THE HPV TESTS PERFORMED NOW COMING FROM A SELF-COLLECTED SAMPLE." – David Hawkes, Director – Molecular Microbiology

HISTOLOGY VOLUMES 5,000 4,500

4,720

4,000

2,706

2,500

Histology

2,000

Referrers and patients alike gain significant benefits from the specialist gynaecological histopathology service offered by VCS Pathology. Each case receives comprehensive analysis, with LBC tests taken prior to biopsy often immediately available for review and correlation.

3,002

3,000

3,021

3,500

3,769

Self-collection volumes have steadily increased since the change to universal availability for all screening participants in July 2022. In 2021/2022 VCS Pathology processed 3,432 samples compared to 138,695 in 2023/24.

This remarkable increase demonstrates the need in the population for an alternative to a speculum examination.

3,896

Self-collection for HPV-based Cervical Screening

1,500 1,000 500 0

2018/2019 2019/2020 2020/2021 2021/2022 2022/2023 2023/2024

Our team returns almost all histology results within 2 working days (and often within 24 hours). At the close of the 2023/24 financial year, 99.26% of histology cases were reported within 48 hours.

SELF COLLECTION TEST VOLUMES

16,000 14,000 12,000 10,000 8,000 6,000 4,000 2,000 0

Jun 2024

Apr 2024

May 2024

Feb 2024

Mar 2024

Jan 2024

Dec 2023

Nov 2023

Oct 2023

Sep 2023

Apr 2022

Aug 2023

Jul 2023

Jun 2023

May 2023

Apr 2023

Mar 2023

Jan 2023

Feb 2023

Dec 2022

Oct 2022

Nov 2022

Sep 2022

Aug 2022

Jun 2022

May 2022

Apr 2022

Feb 2022

Mar 2022

Jan 2022

PAGE 42

STRATEGIC PLAN OUTCOMES

Seven CHLAMYDIA AND GONORRHOEA TESTING VOLUMES Chlamydia

Gonorrhoea

2,000

5,657

5,443 3,952

3,171

3,000

3,275

4,000

3,669

5,629

5,000

3,312

6,000

6,353

7,000

7,335

8,000

1,000 0

2019/2020 2020/2021

2021/2022

2022/2023 2023/2024

Molecular Laboratory Technician Nikita Menta with the Roche Cobus 5800 System

NEW TECHNOLOGIES The ACPCC’s laboratory capabilities and turn-around times continued to benefit from our investment in technology and innovation. ACPCC undertook the world first clinical validation of the Roche cobas HPV test on the cobas 5800 system which has allowed it to be used as part of the National Cervical Screening Program, and in a range of other international HPV-based screening programs. ACPCC will introduce the cobas 5800 system as a replacement for the current cobas 4800 system in late 2024. The new machine requires less hands on time and will free up staff for other work in the laboratory.

Multi Disciplinary Scientist Anna Zhou operating the new Microtome

ACPCC ABN 35 430 554 780

PUBLIC HEALTH MEDICAL EQUIPMENT REPLACEMENT PROGRAM Thanks to the generosity of the Victorian Government, as part of the Public Health Reference Laboratory Medical Equipment Replacement Program (PHMERP), ACPCC was able to purchase 2 new Microtomes for Histology Cut Up. These assets will support ACPCC to deliver its funded activities to the Victorian Department of Health for histology services as part of the cervical screening program. The HistoCore Multicut has an additional feature of Fast Homing and Memory Position, where it can recall the optimal specimen position for sectioning to enable fast and effortless trimming. This will improve the efficiency of sectioning and increase productivity.

PAGE 43

ACCREDITATION VCS Pathology meets the NATA regulatory requirements for Australian Laboratories reporting under the NCSP. A NATA Assessment was conducted at VCS Pathology in April 2024, with a focus on Requirements for Information Communication and Reporting. The final report noted that VCS Pathology is operating at a standard that demonstrates it is competent to perform the activities for which accreditation is held.

VCS Pathology is committed to meeting all relevant industry standards including the various requirements of NATA, National Pathology Accreditation Advisory Council (NPAAC), the Royal College of Pathologists Australasia (RCPA) and ACPCC insurance agencies.

"WE ARE GRATEFUL TO RECEIVE FUNDING FROM THE VICTORIAN GOVERNMENT AS PART OF THE EQUIPMENT REPLACEMENT PROGRAM." – Grace Tan, Director – Cytology/Histology

PAGE 44

STRATEGIC PLAN OUTCOMES

Seven AUSTRALIAN HPV REFERENCE LABORATORY

Services provided by the Australian HPV Reference Laboratory include:

Launched in November 2021, the laboratory assists a range of stakeholders in the National Cervical Screening Program (NCSP) to adapt to the changing landscape of HPV-based cervical screening.

Up-to-date technical information, advice, guidance and training on HPV laboratory practices

As the Australian HPV Reference Laboratory, we provide a wide range of services from supporting national and international Quality Assurance Programs to providing specialist testing and review.

The laboratory works with a range of stakeholders including quality control and HPV assay manufacturers, other laboratories, clinicians, and researchers within Australia and abroad. Together, we strive to monitor and improve the HPV testing process (including laboratory procedures and technologies), to assist in the reduction of HPV-related disease.

Molecular Laboratory Technician Jaspreet Kaur with the BD COR System

Expertise in the development, evaluation and implementation of HPV assays for use in cervical screening and other pradigms for HPV detection Support for quality assurance programs in the Asia Pacific Region Specialist diagnostic and clinical advice for individual cases Expertise in the development of policy and programs for eliminating HPV-based cervical cancers Sample Biobank used to support the development of technologies and processes to reduce the incidence and impact of HPV-related disease

ACPCC ABN 35 430 554 780

PAGE 45

Key activities in 2023/24 include:

QUALITY ASSURANCE

• Assisted two laboratories in New Zealand to validate self-collection for use in their HPV-based National Cervical Screening Programme which launched in September 2023.

Since its establishment in 1964, the ACPCC has always regarded the provision of a quality service as the most important aspect of its operation. The Executive Director of the ACPCC and our staff remain fully committed to the organisation as a Centre of Excellence in cervical screening tests and registry services.

• Continued to assist Australian laboratories verifying the self-collection method used by the Roche cobas and cobas 4800 HPV assays.

• The Australian HPV Reference laboratory supported two commercial laboratories with validation of the dry swab self-collection method, which in turn has led to NATA accreditation.

• Developed a method to produce quality control self-collected FLOQSwabs, which have been used in several countries in the Pacific for quality assurance and validation.

• Undertook pre-release validation testing of HPV specimens for two leading External Quality Assurance manufacturers.

• Introduced a new self-collection processing method based on the SCoPE2 clinical study undertaken with the Royal Women’s Hospital Oncology and Dysplasia clinic. This was introduced in October 2023 and over 100,000 thousand self-collection tests have now been reported with this method, which is the same method introduced by the largest New Zealand cervical screening laboratory.

• Clinically validated the Roche cobas HPV test on both the cobas 5800 and 6800 systems.

• Undertook analytical validation studies for a new self-collection device on behalf of Teal Health which has now submitted to the FDA (USA) for regulatory approval.

Our quality system comprises the structure, objectives and policies of the ACPCC and the description of work practices and procedures that promote a high quality of operation in all aspects of our work. Thus, the quality system forms the basis on which the pathology laboratory and registries operate.

All staff embrace an ethos of quality improvement and a customer focus. We have a broad perspective of our customer base, which include the healthcare practitioners who send us pathology samples for reporting, community members from whom the samples are taken, the participants recorded on our registries, and our funding providers.

The ACPCC is committed to meeting all relevant industry standards, including AS ISO 15189:2012 and the various requirements of NATA, NPAAC, the RCPA and our insurers.

Quality system activities are coordinated by the Director of Cytology and Histology under the guidance of the Executive Director of the ACPCC. These activities are supported by the quality management software Q-Pulse, which is designed to support key elements of the Quality System.

PAGE 46

STRATEGIC PLAN OUTCOMES

Eight Leverage the value of the canSCREEN® and canVAX platforms for cost effective support of low to middle income countries (LMICS) and for commercially advantageous opportunities AT-A-GLANCE canSCREEN® supports a three-pronged approach to cervical cancer elimination.

Vaccination: can assist in managing the provision of the HPV vaccine, if needed.

Screening: supports in the provision of cervical screening to women aged 25-64 years.

Technology for improved health outcomes canSCREEN is a valuable example of how technology can be used to improve health outcomes in all countries, including those that are resource constrained. The application uses digital infrastructure to track vaccination and screening activities, and to provide real-time feedback to program managers. ®

Treatment: provides a registry for the treatment of women with precancerous changes in the cervix. Treatment can pevent these changes from developing into cancer.

This information helps to ensure that people with positive screening tests progress to assessment and, where indicated, treatment. The information is also used to assess the performance of the program, to highlight areas that would benefit from further work and thereby to inform continuous improvement in program performance.

canSCREEN® for point-of-care testing

Patient presents for screening

Test is processed on site using instrument such as GeneXpert

Nurse or clinician enters patient data into canSCREEN®, then receives test result directly from GeneXpert or a similar machine

Patient given result within hours of the original cosultation along with any further advice

Results automatically sent to canSCREEN®

Patient can be sent results and follow up info directly

canSCREEN® for off-site testing

Patient presents for screening

Test sent to lab

ACPCC ABN 35 430 554 780

PAGE 47

PNG cervical screening patient information being entered onto a tablet

PNG cervical screening information being captured on the mobile phone app where internet connectivity is intermittent or unavailable

canSCREEN ® IN 2024

As we look ahead, preparations are actively underway to introduce canSCREEN® into Timor-Leste, Tuvalu, and the Solomon Islands. These initiatives are part of our strategic collaboration with Elimination Partnership in the Indo-Pacific for Cervical Cancer (EPICC) partners, funded by the Department of Foreign Affairs and Trade (DFAT). The next financial year is set to be a pivotal period, with additional expansions planned and the introduction of canSCREEN® into India in support of the SHE-CAN study. (see p. 39)

This year, we have made significant strides in the global expansion of canSCREEN®, furthering our commitment to improving cervical cancer prevention worldwide.

New instances of canSCREEN® have been successfully established in the Cook Islands and several key regions of Papua New Guinea, including the provinces of Jiwaka, Southern Highlands, and the National Capital District.

Additionally, we have extended our reach into Fiji, broadening the scope of our impact in the Pacific region.

In Malaysia, the Rose program, which has already demonstrated considerable success, has been expanded to include the Sarawak region, reinforcing our efforts to provide comprehensive cervical cancer screening across diverse populations.

2024 Success Stories: • Program ROSE (see p. 27) • Te Ara Waiora Study – New Zealand (see p. 38) • ECCWP (Vanuatu & PNG) – (see p. 24-25)

PAGE 48

STRATEGIC PLAN OUTCOMES

Nine Reshape the business model to adapt to our new commercial environment and global opportunities

LABORATORY INFORMATION MANAGEMENT SYSTEM UPGRADE

NEW LOCATION IN PELHAM STREET CARLTON

The Australian Centre for the Prevention of Cervical Cancer (ACPCC) has selected Cirdan as its chosen partner to deploy Cirdan’s state-of-the-art Laboratory Information Management System (LIMS) ULTRA, to enhance, streamline, and future-proof our laboratory workflows and processes.

ACPCC secured a new office to accommodate our Digital Health and Population Health teams.

This additional Carlton office is located at Level 3, 15-31 Pelham Street and is in a strategic location for the ACPCC, being a 10-minute walk door-to-door to the Faraday Street premises. It is also co-located in the same building as BreastScreen and Melbourne University, providing a valuable opportunity for our staff to build stakeholder relationships.

ACPCC was attracted to Cirdan’s LIMS offering due to its ability to collect high volumes of data in a lean and expeditious way, to help reduce the time taken for patient diagnosis. The system will provide new insights into healthcare data through its ability to modernise and standardise ACPCC’s pathology workflows and processes.

The new system is scheduled to be operational by December 2024.

An official opening was held in February 2024 and we were honoured to have Jill Butty from the Victorian Department of Health cutting the ribbon.

ACPCC ABN 35 430 554 780

Our new laboratory management system will provide new insights into healthcare data

Celebrating with dignitaries and staff at the opening of our new location in Pelham Street Carlton

PAGE 49

PAGE 50

LEADERSHIP TEAM

Leadership Team

EXECUTIVE DIRECTOR Prof Marion Saville AM

DIRECTOR COMMUNICATIONS AND GOVERNMENT RELATIONS

DIRECTOR MOLECULAR MICROBIOLOGY

DIRECTOR DIGITAL HEALTH

Associate Professor (Hon) Misha Coleman

Associate Professor David Hawkes

Michael Lammardo

CLINICAL EDUCATION MANAGER

CLINICAL MICROBIOLOGISTS

Hannah Saunders

Dr Hiu Tat Mark Chan Dr Nomvuyo Mothobi

SENIOR BUSINESS ANALYSTS

MOLECULAR SENIOR SCIENTISTS Desuba Gurung Joanne Romano Marco Ho Ting Keung

Elizabeth Shao APPLICATIONS DELIVERY MANAGER Mark Bryant SENIOR ANALYST PROGRAMMER David Lamb SYSTEMS ADMINISTRATOR Simon Chapman

ACPCC ABN 35 430 554 780

DIRECTOR POPULATION HEALTH

DIRECTOR CYTOLOGY AND HISTOLOGY

DIRECTOR CORPORATE SERVICES

Alvin Lee

Grace Tan

Ricki Vinci

OPERATIONS MANAGER

PATHOLOGISTS

FINANCE MANAGER

Kerry Crooks

Dr Fong Koh Dr Reshma Pujari Dr Prudence Russell Dr Yi Sun

Prasad Nekkadapu

CYTOLOGY & HISTOLOGY SUPERVISOR Diana Stockman MULTI-DISCIPLINARY SENIOR SCIENTISTS Noni Christou Domenica Giacomantonio OPERATONS MANAGER Sheree Holt

HR AND PAYROLL ADVISOR Sujane Choong

PAGE 51

PAGE 52

OUR PEOPLE

Our People The ACPCC endeavors to attract, retain and develop talented, highly skilled and committed employees with the passion and vision to support the objectives of our Strategic Plan. As of 30 June 2024, the ACPCC employed 131 staff across a range of managerial, professional, technical and operational roles who are dedicated to the ACPCC vision. Our staffing model includes permanent, temporary and casual employees, comprising 80 full-time, 45 part-time and 6 casual appointments.

The resourcing needs of VCS Pathology have continued to be a major priority for the workforce planning.

We aim to recruit and retain the best people to deliver on the objectives of our Strategic Plan.

We employ, develop, and promote our employees based on the strengths of the individual and the needs of our operations. The ACPCC has a long-established history of an inclusive and strong female workforce. In 2023/24, ACPCC’s workforce comprised of 67% female employees.

ENTERPRISE AGREEMENT

ACPCC achieved the annual reporting requirements for the Workplace Gender Equality Agency and was compliant for the 2023/24 reporting period.

With a negotiation period of 16 months commencing in May 2022, the new ACPCC Enterprise Agreement was implemented by a majority vote. The agreement was lodged with the FairWork Commission on 19 September 2023 and approved to commence from 16 October 2023.

The nominal expiry date of the new ACPCC Enterprise Agreement is 9 October 2027.

The new Enterprise Agreement covers the wages and conditions of more than 88% of ACPCC employees.

DIVERSITY, INCLUSION AND GENDER EQUALITY ACPCC is an equal opportunity employer, consistent with our values of Fairness, Integrity, Respect and Excellence.

We acknowledge that a diverse workforce promotes engagement and wellbeing and underpins our position as an employer of choice. The financial year saw ACPCC become a member of the Diversity Council Australia.

Compliance training was delivered to all ACPCC employees via an online platform to support an inclusive culture and respectful workplace, ensuring legislative compliance.

The ACPCC commits to providing all employees with the same rewards, resources, opportunities for success and outcomes, regardless of background or gender.

WORKFORCE COMPLIANCE AND SAFETY TRAINING ACPCC continued to provide compliance training including Anti-bullying and Anti-Harassment, Discrimination, Cybersecurity, Equal Opportunity, Privacy, Social Media, Manual Handling, Respect@Work, Occupational Health & Safety and Whistleblower Protection to all new employees.

This year, ACPCC has relaunched the Manual Handling training to all employees. Additionally, a new Psychosocial Hazards training was deployed to all employees reflecting best practice training to support mental health in the workplace.

The financial year continued ACPCC’s reliance on the Fit2Work platform for pre-employment checks.

ACPCC has continued to utilise the reference check service from Fit2Work for most new employees.

The Employment Hero employee self-service system continued to track the status of annual confidentiality deeds and other certifications, ensuring continuous compliance.

ACPCC ABN 35 430 554 780

PERFORMANCE, LEARNING AND DEVELOPMENT ACPCC continued to support the career development of employees across the organisation. We recognise that training is critical to employee engagement and retention, providing the basis for succession planning and achieving our operational objectives.

Following on from previous years, efforts continued towards upskilling our multidisciplinary VCS Pathology team and introducing flexibility into our workforce across the molecular and cytology work areas.

PAGE 53

We continued our valued relationship with RMIT for laboratory student placements. These placements provide students with invaluable support in building their academic performance, as well as gaining technical and employment skills. It also demonstrates ACPCC’s commitment to continue developing a workforce for the future of the pathology industry.

WORKFORCE STATISTICS Total Workforce and Employment Types WORKFORCE AGE DEMOGRAPHICS Aged 30 and under (31%) Aged 31 - 40 (19%) Aged 41 - 50 (16%) Aged 50+ (34%)

EMPLOYMENT TYPES Full Time 160 140 120

Part Time

146

140

13

5

49

100

55

Casual 134

131

131

7

5

6

53

54

45

74

72

2021/22

2022/23

2023/24

31%

29%

33%

69%

70%

2021/22

2022/23

80 60 84 40

80

80

20 0

2019/20

WORKFORCE BREAKDOWN BY POSITION

WORKFORCE GENDER BALANCE Women

Executive (5%) Manager/Supervisors (8%)

2020/21

Men

Unstated

120 100

Medical Employees (6%) Professional (19%)

80

Scientists/ Laboratory (24%)

60

27%

27%

73%

73%

2019/20

2020/21

67%

40 20 0

2023/24

PAGE 54

OH&S, FREEDOM OF INFORMATION, PRIVACY

Occupational Health and Safety Outcomes for 2023/24 The ACPCC’s comprehensive health and safety approach directly supports the physical and mental wellbeing of all employees. Health and Safety initiatives conducted throughout the year included influenza vaccinations, warden training, and the promotion of employee mental health and wellbeing.

The Lost Time Injury Frequency Rate (LTIFR) rate was 0 for the financial year, consistent with the rate of 0 in 2022/23*. LTIFR is calculated by the number of lost time injuries per million hours worked in the quarter.

There were no incidents in the year which resulted in a WorkSafe claim.

The services of the Employee Assistance Program continued to be used with a total of three sessions provided to employees in the financial year. ACPCC staff are regularly encouraged to reach out to this service if they are experiencing mental health difficulties or challenges in the workplace. All EAP sessions are free to ACPCC employees, confidential and provided by an independent agency.

The Health and Safety Committee continued to meet in accordance with legislative requirements, consistent with our commitment to excellence in safety management and best practices. Health and Safety at the ACPCC is underpinned by genuine care for our employees, in alignment with our corporate values of Fairness, Integrity, Respect and Excellence. The ACPCC Health and Safety Policy was last reviewed and approved by the Board in July 2024. * Rate for 2022/23 was updated based on WorkSafe claim information received during the year

Freedom of Information The ACPCC is not directly subject to the Freedom of Information (FOI) Act 1982. While some of the organisation's government funded activities may be

the subject of FOI requests, these requests should be made to the relevant government department for assessment.

Privacy The ACPCC understands the importance of protecting the privacy and confidentiality of all personal and health information that is held by the organisation.

The ACPCC collects a range of personal and health information about individuals. The ACPCC may collect this information from the individual or from another person dealing with that individual, such as their healthcare practitioner. The type of information that the ACPCC collects and the way in which it may use and disclose that information varies according to the services, activities and programs the ACPCC provides or undertakes in relation to an individual.

by these. A Disciplinary Policy and Procedure is in place to ensure staff comply with these practices. All persons who may observe personal and health information held by the ACPCC are required to sign a confidentiality statement annually.

The ACPCC has strict privacy and confidentiality practices in place and all staff are required to abide

Our Privacy Policy was last updated in 2022 and is available at www.acpcc.org.au/acpcc-privacy-policy/

All personal and health information is stored on the premises of the ACPCC or in cloud-based storage.

Backup tapes of the information system and some slides are stored in a secure facility off-site. Where services are contracted out, contractors must comply with the ACPCC privacy and confidentiality requirements if any personal information is provided to them.

ACPCC ABN 35 430 554 780

PAGE 55

Whistleblowers Protection The ACPCC is committed to the highest standards of legal, ethical and moral behaviour. The organisation seeks to maintain an operating environment where legitimate misconduct concerns can be reported without fear of retaliatory actions or retribution, and are managed expeditiously, in confidence and according to internal policy.

The ACPCCs Whistleblower Policy and Procedure is compliant with the new whistleblower reforms under Part 9.4AAA of the Corporations Act 2001 (Cth). An updated version of the Policy and Procedure was approved by the Board in March 2024.

Compliance training in whistleblower protection is routinely scheduled for all members of the Executive and Corporate Services teams.

Risk Management The ACPCC records, monitors and reports on enterpriselevel risks using the software RiskWizard™ which is compliant with ISO 45001:2018 and ISO 31000:2018.

The Board of Directors are provided with Quarterly Risk Reports and are immediately notified if a risk is escalated to a High or Extreme rating. The Risk Management Policy and Risk Management Procedure was scheduled to be updated in June 2024 together with the introduction of the ACPCC Risk Appetite Statement, which is in progress.

The risk management framework supports the organisation in effectively managing risks by providing a systematic and documented process to identify, mitigate and manage the risks that may impact the achievement of the ACPCC’s business and strategic objectives, both positively and negatively. The Executive Director, Business Unit Directors and Managers are responsible for identifying, evaluating and treating Risks in their respective business areas.

There were no High/Extreme risks at the end of the 2023/24 reporting period.

Rating

2023/24 2022/23 2021/22 2020/21 2019/20

High/Extreme

0

0

0

0

1

Major

16

22

23

20

19

Significant

31

31

34

33

31

Moderate/Low

44

27

29

30

30

Total

91

80

86

83

81

2023/24 RISK ATTESTATION STATEMENT I, Marion Saville, certify that the ACPCC has appropriate risk management processes in place consistent with the Risk Management Standard AS ISO 31000:2018 and has an internal control system in place that enables the Executive Management team to understand, manage and satisfactorily control risk exposures. The Audit and Finance Committee verifies this assurance and that the risk profile of the ACPCC has been critically reviewed within the last 12 months.

Professor Marion Saville, AM ACPCC Executive Director Fiona Kelly Chair, ACPCC Audit & Finance Committee

PAGE 56

FINANCIAL SUMMARY

Financial Summary

Ms Fiona Kelly

Ms Ricki Vinci

AUDIT AND FINANCE COMMITTEE CHAIRMAN AND DIRECTOR OF CORPORATE SERVICES REPORT The ACPCC’s consolidated net result for the financial year ended 30 June 2024 was a deficit of ($4.2M) after accounting for depreciation and amortisation. This was a minor variation from the budgeted deficit of ($4.0M).

HPV test volumes were 26% higher than budget at year end. LBC volumes were 1% lower than budget at year end.

The overall financial result highlights the dependency on Medicare bulk billing by VCS Pathology as the ACPCC’s new financial operating environment continues to feel the financial pressures since the National Partnership Agreement funding ended in 30 June 2021.

Operating and administrative costs were higher than budgeted for 2023/24, driven by higher than budgeted printing and postage charges, repairs, professional fees and provision for bad debts. Laboratory consumables were also higher than budgeted for 2023/24 due to higher test numbers.

ACPCC achieved the contractual requirements of its Service Plans with the Victorian Government. VCS Pathology continued to exceed its target market share for primary screening in 2023/24, reporting over 55% of all HPV tests in Victoria. Capital investment in the previous year has competitively positioned the laboratory to effectively service the volume demands of self-collected HPV tests. ACPCC also continued the important follow-up activities for the Compass Trial, helping to inform the future pathways for the National Cervical Screening Program.

A major investment in the financial year has been the implementation of a new Laboratory Information Management System (LIMS). The LIMS project is under way with a go-live date of November 2024. This has been a significant change management project which will enable efficiencies and streamlined processes in the laboratory to positively impact business outcomes.

ACPCC has valued the financial support from both the Commonwealth and Victorian Governments. This has enabled ACPCC to excel across its screening, vaccination and specialist laboratory services, consistent with our purpose as a not-for-profit organisation.

We acknowledge the support of the Audit and Finance Committee and finance team in completion of the 2023-24 financial statements.

Ms Fiona Kelly Chairman – Audit & Finance Committee Ms Ricki Vinci Director of Corporate Services

VCS FOUNDATION LTD. ABN 35 430 554 780

PAGE 57

Directors' Report 30 June 2024 The directors present their report, together with the financial statements, on the company for the year ended 30 June 2024.

DIRECTORS The following persons were directors of the company during the whole of the financial year and up to the date of this report, unless otherwise stated: Anthony Abbenante Jane Collins Professor Helen Evans (appointed on 10 October 2023) Kirstie Bree Fotheringham (appointed 23 February 2024) Tim Humphries (resigned on 17 November 2023) Fiona Kelly Stephanie Reeves Angela Steele Genevieve Webb David Wrede

OBJECTIVES The short-term objective of the company is to ensure an Australia where preventable cervical cancer is a disease of the past, in which Australia’s diverse communities have equitable access to information and to culturally safe and inclusive vaccination, screening and treatment services.

The long-term objective is to lead the way in the global commitment to eliminate cervical cancer.

STRATEGY FOR ACHIEVING THE OBJECTIVES The ACPCC is committed to preventing cancer and infectious diseases through excellence in the provision of population health services that support screening and vaccination.

As part of our commitment, the ACPCC continues to work with Australian and international partners to achieve the World Health Organization’s goal of eliminating cervical cancer as a public health problem, primarily through vaccination.

Our team are committed to supporting the effective delivery of cervical cancer vaccination and cervical screening programs to ensure women and people with a cervix everywhere can be free from cervical cancer.

It’s anticipated that Australia will be the first country in the world to achieve this, by 2035.

PRINCIPAL ACTIVITIES During the financial year the principal continuing activities of the company were laboratory and educational services, cancer screening and vaccination registries, and the delivery of digital health solutions to continue to lead the way in cervical cancer prevention.

There were no significant changes in the nature of ACPCC’s principal activities during the financial year.

PERFORMANCE MEASURES ACPCC assesses its performance using both qualitative and quantitative measures aligned with implementation of the strategic plan. Key measures include cervical screening market share, turn around times, quality metrics, financial performance, client feedback and research delivered. These are monitored throughout the year with performance reported periodically to the Board.

PAGE 58

DIRECTORS' REPORT

Directors' Report 30 June 2024 Information on directors NAME: Casper David Wrede TITLE: Non-Executive Chairman QUALIFICATIONS: MA MB BChir (Cantab) MAIDH FRCS(Eng) FRCOG FRANZCOG SPECIAL RESPONSIBILITIES: Chairman and member of the Audit & Finance Committee EXPERIENCE AND EXPERTISE: Mr David Wrede was appointed to the Board in May 2010 as the Director with gynaecological expertise and was appointed Chairman in 2023. Mr Wrede studied medicine at Cambridge University and St. Thomas’ Hospital London. His postgraduate training was in General Surgery and Obstetrics & Gynaecology and included two years research into Cervical Cancer and HPV at the St. Mary’s branch of the

NAME: Antonio Abbenante TITLE: Non-Executive Director QUALIFICATIONS: BSci (Computer Science)

Ludwig Institute. Previous appointments in the UK’s National Health Service include Consultant posts with interests in Gynaecological Cancer, Minimal Access Surgery and Colposcopy in Scotland and England. Since moving to Australia, his main clinical focus has been in gynaecological cancer prevention at The Royal Women’s Hospital. He is the clinical lead for the Dysplasia (Colposcopy) services at the Womens’ and Box Hill Hospitals. His research profile includes being an investigator on a number of cervical cancer screening projects including COMPASS (led by Prof Marion Saville and Prof Karen Canfell), iPAP (led by A/Prof Dorota Gertig) & EXCISE (co-led with A/Prof Paul Cohen) and he is also an Associate Investigator with the NHMRC Centre of Research Excellence for Cervical Cancer Control.

He was an author of the current Australian National Cervical Cancer Screening guidelines, is a member of the Program's National Expert Panel and a past Secretary of the Management Committee of the Australian Society for Colposcopy & Cervical Pathology. Mr Wrede is an Honorary Consultant to the Familial Centre Clinic on the Parkville Precinct and Honorary Senior Lecturer to the Department of O&G at the University of Melbourne.

EXPERIENCE AND EXPERTISE: Mr Antonio Abbenante was appointed to the board in October 2018 as a director with wide expertise in Information Technology and Communications, he has specialist knowledge and experience in enterprise-wide digital health. Mr Abbenante holds a Bachelor of Applied Science in Computer Studies from the University of South Australia and is a fellow of the Australian Institute of Digital Health. He has broad experience in governing national and state-wide programs; this provides a wealth of experience and knowledge to the VCS. His career spans more than 27 years in senior digital health roles and he has extensive experience with government. Tony has deep knowledge and experience in sector delivery, governance and digital health outcomes that deliver value-based clinical and business outcomes to the health sector.

VCS FOUNDATION LTD. ABN 35 430 554 780

NAME: Jane Collins TITLE: Non-Executive Director QUALIFICATIONS: MB.BS, DRANZCOG, FRACGP SPECIAL RESPONSIBILITIES: Co Vice Chairman

NAME: Professor (Hon) Helen Evans TITLE: Non-Executive Director QUALIFICATIONS: Bachelor of Arts, Grad Degree Social Administration EXPERIENCE AND EXPERTISE: Helen Evans AO joined the ACPCC Board in October 2023 as a representative with expertise in Global Health. Helen is an expert in public health and development, and social policy with a particular focus on infectious diseases. She served as Deputy CEO at Gavi, the Vaccine Alliance based in Geneva from 2009 until her retirement in late 2014.

While working at Gavi she was instrumental in achieving

NAME: Kirstie Bree Fotheringham (appointed on 23 February 2024) TITLE: Non-Executive Director QUALIFICATIONS: B Accounting, CPA, Grad Dip Secondary Teaching (Accounting & Economics) SPECIAL RESPONSIBILITIES: Member of the Audit & Finance Committee

PAGE 59

EXPERIENCE AND EXPERTISE: Dr Jane Collins was Chairman in 2019/20, a position she also held from 2009-2013. Dr Collins was appointed to the Board in February 2008 to fill the role of a Director with expertise in General Practice. Dr Collins is an experienced General Practitioner, business owner and freelance medical writer. She has a special interest in women’s health as well as the provision and organisation of health care in the wider community. Dr Collins is a co-owner and the Clinical Director of the Clifton Hill Medical Group, an inner urban general practice comprising 10 GPs. the Gavi Board’s support for the HPV vaccines. Prior to joining Gavi, she served as Deputy Executive Director at the Global Fund to Fight AIDS, Tuberculosis and Malaria, also based in Geneva, between 2005 and 2009.

Now living in Melbourne Helen has an honorary appointment as Professor at The Nossal Institute for Global Health at the University of Melbourne. She serves as Co-Deputy Chair of the Board of The Fred Hollows Foundation, as a Director on the Board of the Burnet Institute, and as a Board member of the Australian Centre for the Prevention of Cervical Cancer. She is also a member of the Technical Reference Group for the Australian Government’s Partnerships for a Healthy Region, a member of the Evaluation Advisory Committee of the Board of Gavi, the Vaccines Alliance, a member of the Advisory Board of the Australian Global Health Alliance, and a fellow of the Australian Institute of International Affairs.

EXPERIENCE AND EXPERTISE: Kirstie Fotheringham was appointed to the ACPCC Board of Directors in April 2024 with expertise finance management, public health governance and accounting.

Kirstie holds a Bachelor of Accounting from Monash University and is CPA qualified. She also holds a Graduate Diploma in Secondary Teaching – Accounting and Economics, from Monash University. She is currently Director of Finance and Corporate Service and Chief Financial Officer at Mansfield District Hospital. Kirstie has previously been a Non-executive Board Director at Yea and District Memorial Hospital and a member of the Oesophageal Atresia Research Association.

Kirstie has specific interest in finance communication and strategic planning in the area of sustainable public sector healthcare.

PAGE 60

DIRECTORS' REPORT

Directors' Report 30 June 2024 Information on directors NAME: Tim Humphries (resigned on 17 November 2023) TITLE: Former Non-Executive Director QUALIFICATIONS: B Commerce, MBA ,CPA SPECIAL RESPONSIBILITIES: Former Chairman and Former Member of the Audit and Finance Committee

NAME: Fiona Kelly TITLE: Non-Executive Director QUALIFICATIONS: B Economics, MBA, CA SPECIAL RESPONSIBILITIES: Chair of the Audit and Finance Committee

EXPERIENCE AND EXPERTISE: Mr Humphries joined the Board in 2012 as a Director with expertise in Finance, Commerce or Corporate Management. Mr Humphries holds a Bachelor of Commerce from Flinders University, and Master of Business Administration (MBA) from Deakin University. He is a member of the Certified Practising Accountants (CPA) Australia and the Australian Institute of Company Directors (MAICD). Mr Humphries brings a wealth of experience with a career spanning more that 20 years in senior Accounting and Finance roles, and CEO, a position he currently holds. His broad finance experience is complemented with HR, IT, corporate governance, sales and project management skills developed in a wide range of industries including health, aged care, transport and logistics, materials handling, recruitment, and not-forprofit sectors in Australia.

EXPERIENCE AND EXPERTISE: Ms Fiona Kelly was appointed to the Board in March 2017 as a Director with expertise in Finance, Commerce and Corporate Management and was appointed Chairman of the Audit and Finance Committee at the 2020 AGM. She holds a Bachelor of Economics from Monash University and a Master of Business Administration from the University of Melbourne. Ms Kelly has broad experience in financial management, operations and governance as a Chartered Accountant, management consultant and through executive roles in the not-for-profit and social enterprises sectors. Ms Kelly is passionate about improving health outcomes for women and values ACPCC’s commitment to cancer prevention in Australia and globally. She is currently Chief Financial Officer at FVREE, a specialist family violence service and is also a Board member of Carey Baptist Grammar School.

VCS FOUNDATION LTD. ABN 35 430 554 780

NAME: Stephanie Reeves TITLE: Non-Executive Director QUALIFICATIONS: BCom LLB GDip Sports Law, GDip Applied Law (Wills and Estates), Dip Company Secretarial Practice, GAICD SPECIAL RESPONSIBILITIES: Co Vice Chairman

NAME: Angela Steele TITLE: Non-Executive Director QUALIFICATIONS: MPH, Grad Dip in Adolescent Health, RN, Midwife

NAME: Genevieve Webb TITLE: Non-Executive Director QUALIFICATIONS: B.A (Hons) Psychology, Swinburne. B.App.Sci (Computing), Monash.

FAICD SPECIAL RESPONSIBILITIES: Member of the Audit and Finance Committee

PAGE 61

EXPERIENCE AND EXPERTISE: Ms Stephanie Reeves joined the Board in February 2014 as a Director with expertise in Law. She served as Chairman from 2017 to 2019 and was a member of the Audit and Finance Subcommittee of the Board from 2015 – 2020. Ms Reeves has worked as an in-house legal counsel for both small and large ASX Listed companies for many years. She is now Co-Principal of a consultancy business assisting families navigate the ageing process. She is also a Non-Executive Director of the Royal Automobile Club of Victoria (RACV) Limited, serving on its Governance & Risk Management subcommittee, and its Club & Membership subcommittee. Stephanie has previously been on the Council of the Royal Melbourne Golf Club, a member of the Melbourne Cricket Ground Trust, on the Advisory Board of a start-up law firm, Lexvoco, and a Non-Executive Director and Chairman of Crime Stoppers Victoria. Stephanie has a particular interest in corporate governance in both the commercial and not-for-profit sectors.

EXPERIENCE AND EXPERTISE: Angela Steele joined the ACPCC Board of Directors in January 2022 as the nurse representative with relevant expertise in preventative health. Ange is a Nurse Practitioner, Registered Nurse, Registered Midwife and has a Post Graduate Diploma in Adolescent Health and a Master of Public Health. Ange has been a cervical screening nurse for 23 years which includes experience in rural and remote Australia. Ange is currently the Associate Nurse Unit Manager at the Royal Women’s Hospital, Gynae Oncology Dysplasia Unit, and is the first trained Nurse Colposcopist in Victoria.

Ange is also a nurse educator and is currently leading a team of health professionals to train nurses in colposcopy within Victoria , and is involved in research participation in cervical cancer prevention at The Royal Women’s Hospital.

EXPERIENCE AND EXPERTISE: Ms Genevieve Webb joined the Board in 2019, as a Director with a consumer perspective. Genevieve is a senior executive with extensive experience in health and human services. Her most recent position was Director Quality at BreastScreen Victoria, where she led the client centric care and consumer engagement program. Her previous roles include CEO of Queen Victoria Women’s Centre, GM Corporate Services at Mind, Executive Director of Relationships Australia (Vic) and Associate Director at KPMG. Genevieve has extensive experience in organisational governance, as Chair of the Audit Committee at the State Revenue Office (Vic) and as a board member of a community health service, a TAFE college and other community organisations. She has qualifications in Psychology and IT and is a Fellow of the Australian Institute of Company Directors.

PAGE 62

DIRECTORS' REPORT

Directors' Report 30 June 2024 COMPANY SECRETARY In accordance with the Constitution, the person appointed as Executive Director shall also be the Company Secretary. The Executive Director, Professor Marion Saville AM, has held the position of Company Secretary for the year. She has over 25 years of experience as Executive Director and is a graduate of the Australian Institute of Company Directors ('AICD').

MEETINGS OF DIRECTORS The number of meetings of the company's Board of Directors ('the Board') and of each Board committee held during the year ended 30 June 2024, and the number of meetings attended by each director were: Full Board Anthony Abbenante

Audit Committee

Attended

Held

Attended

Held

5

9

-

-

Jane Collins

8

9

-

-

Professor Helen Evans

5

6

-

-

Kirstie Bree Fotheringham

2

3

-

-

Tim Humphries

5

5

5

5

Fiona Kelly

7

9

4

5

Stephanie Reeves

6

9

-

-

Angela Steele

8

9

-

-

Genevieve Webb

7

9

4

5

David Wrede

8

9

4

5

Held: represents the number of meetings held during the time the director held office or was a member of the relevant committee.

VCS FOUNDATION LTD. ABN 35 430 554 780

CONTRIBUTIONS ON WINDING UP In the event of the company being wound up, ordinary members liability is limited to the amount of the guarantee, being $10, in accordance with the Constitution.

The total amount that members of the company are liable to contribute if the company is wound up is $90, based on 9 current ordinary members.

AUDITOR'S INDEPENDENCE DECLARATION A copy of the auditor's independence declaration as required under section 307C of the Corporations Act 2001 is set out immediately after this directors' report.

This report is made in accordance with a resolution of directors, pursuant to section 298(2)(a) of the Corporations Act 2001.

On behalf of the directors

David Wrede Director 25 October 2024 Melbourne

PAGE 63

PAGE 64

FINANCIAL SUMMARY

AUDITOR'S INDEPENDENCE DECLARATION

AUDITORS INDEPENDENCE DECLARATION UNDER SECTION 60 40 OF THE AUSTRALIAN CHARITIES AND NOT FOR PROFITS COMMISSION ACT 2012 As lead auditor for the audit of the financial report of VCS Foundation Limited for the year ended 30 June 2024, I declare that, to the best of my knowledge and belief, there have been no contraventions of: (i)

the auditor independence requirements of the Australian professional accounting bodies; and

(ii)

any applicable code of professional conduct in relation to the audit.

AUDITORS INDEPENDENCE DECLARATION UNDER SECTION 60 40 OF THE AUSTRALIAN CHARITIES AND NOT FOR PROFITS COMMISSION ACT 2012 RSM AUSTRALIA PARTNERS As lead auditor for the audit of the financial report of VCS Foundation Limited for the year ended 30 June 2024, I declare that, to the best of my knowledge and belief, there have been no contraventions of: (i) the auditor independence requirements of the Australian professional accounting bodies; and K J DUNDON Partner (ii) any applicable code of professional conduct in relation to the audit.

Melbourne, Victoria Dated: 28 October 2024 RSM AUSTRALIA PARTNERS

K J DUNDON Partner Melbourne, Victoria Dated: 28 October 2024

VCS FOUNDATION LTD. ABN 35 430 554 780

PAGE 65

Financial Statements For the Year Ended 30 June 2024 66 Statement of Profit or Loss and other Comprehensive Income 67 Statement of Financial Position 68 Statement of Changes in Equity 69 Statement of Cash Flows 70 Notes to the Financial Statements 86 Directors’ Declaration 87 Independent Auditor's Report

GENERAL INFORMATION The financial statements cover VCS Foundation Limited as an individual entity. The financial statements are presented in Australian dollars, which is VCS Foundation Limited's functional and presentation currency.

VCS Foundation Limited is a not-for-profit unlisted public company limited by guarantee, incorporated and domiciled in Australia. Its registered office and principal place of business is: VCS Foundation Limited 265 Faraday Street Carlton VIC 3053 A description of the nature of the Company's operations and its principal activities are included in the directors' report, which is not part of the financial statements.

The financial statements were authorised for issue, in accordance with a resolution of directors, on 25 October 2024.

The directors have the power to amend and reissue the financial statements.

PAGE 66

FINANCIAL STATEMENTS

VCS Foundation Limited Trading as The Australian Centre for the Prevention of Cervical Cancer

STATEMENT OF PROFIT OR LOSS AND OTHER COMPREHENSIVE INCOME for the year ended 30 June 2024 Note

2024

2023

$

$

3

20,986,812

19,252,317

4,5

1,061,522

853,236

Wages and salaries

5

(12,741,006)

(12,703,764)

Interest Expense

5

(43,550)

(12,365)

Operating and administration costs

(6,013,204)

(5,648,901)

Laboratory Consumables

(5,126,876)

(4,168,647)

(9,207)

(41,288)

(2,262,004)

(2,300,004)

(4,147,513)

(4,769,416)

-

-

(4,147,513)

(4,769,416)

Revenue from contracts with customers Other income Expenses

Rental Expenses Depreciation and amortisation Deficit for the year attributable to the members of VCS Foundation Limited Other comprehensive income for the year Total comprehensive income for the year attributable to the members of VCS Foundation Limited

17

The above statement of profit or loss and other comprehensive income should be read in conjunction with the accompanying notes.

VCS FOUNDATION LTD. ABN 35 430 554 780

PAGE 67

STATEMENT OF FINANCIAL POSITION as at 30 June 2024 Note ASSETS CURRENT ASSETS

2024

2023

$

$

Cash and cash equivalents

6

1,356,545

2,321,641

Trade and other receivables

7

2,674,734

2,557,610

Inventories

8

916,469

917,656

Other financial assets

9

21,803,729

25,053,729

Other assets

11

1,298,586

356,559

28,050,063

31,207,195

Total current assets NON-CURRENT ASSETS Property, plant and equipment

12

2,206,968

2,192,859

Right-of-use assets

10

450,390

574,863

Intangibles

13

868,891

1,686,851

Other assets

11

8,887

8,887

Total non-current assets

3,535,136

4,463,460

Total assets

31,585,199

35,670,655

LIABILITIES CURRENT LIABILITIES Trade and other payables

14

1,310,835

1,686,546

Contract liabilities

15

935,749

380,000

Lease liabilities

10

109,446

92,145

Employee benefits

16

3,158,374

3,159,182

5,514,404

5,317,873

Total current liabilities NON-CURRENT LIABILITIES Lease liabilities

10

382,814

483,931

Employee benefits

16

485,520

518,877

868,334

1,002,808

Total liabilities

6,382,738

6,320,681

Net assets

25,202,461

29,349,974

25,202,461

29,349,974

25,202,461

29,349,974

Total non-current liabilities

EQUITY Accumulated surplus Total Equity The above statement of financial position should be read in conjunction with the accompanying notes.

17

PAGE 68

FINANCIAL STATEMENTS

STATEMENT OF CHANGES IN EQUITY for the year ended 30 June 2024

Accumulated surplus $

Total equity

Balance at 1 July 2022

34,119,390

34,119,390

Deficit for the year

(4,769,416)

(4,769,416)

Other comprehensive income for the year

-

-

Total comprehensive income for the year

(4,769,416)

(4,769,416)

Balance at 30 June 2023

29,349,974

29,349,974

Balance at 1 July 2023

29,349,974

29,349,974

Deficit for the year

(4,147,513)

(4,147,513)

Other comprehensive income for the year

-

-

Total comprehensive income for the year

(4,147,513)

(4,147,513)

Balance at 30 June 2024

25,202,461

25,202,461

The above statement of changes in equity should be read in conjunction with the accompanying notes

$

VCS FOUNDATION LTD. ABN 35 430 554 780

PAGE 69

STATEMENT OF CASH FLOWS for the year ended 30 June 2024

Note

2024

2023

$

$

Receipts from government

17,901,604

16,391,234

Receipts from customers

2,850,039

2,570,695

Payments to suppliers

(11,646,045)

(8,966,478)

Payments for wages and salaries

(12,782,257)

(12,995,888)

(3,676,659)

(3,000,437)

Interest received

847,607

696,101

Interest paid

(43,550)

(12,365)

(2,872,602)

(2,316,701)

CASH FLOWS FROM OPERATING ACTIVITIES

Net cash from/ (used in) operating activities

CASH FLOWS FROM INVESTING ACTIVITIES Payments for property, plant and equipment

12

(885,723)

(719,947)

Payments for intangibles

13

(363,181)

(258,693)

Payments for term deposits

(21,803,729)

(17,403,696)

Proceeds from redemption of term deposits

25,053,729

6,002,892

Net cash provided by/(used in) investing activities

2,001,096

(12,379,444)

Repayment of lease liabilities

(93,590)

(544,248)

Net cash used in financing activities

(93,590)

(544,248)

Net decrease in cash and cash equivalents

(965,096)

(15,240,393)

Cash and cash equivalents at the beginning of the financial year

2,321,641

17,562,034

1,356,545

2,321,641

CASH FLOWS FROM FINANCING ACTIVITIES

Cash and cash equivalents at end of the financial year The above statement of cash flows should be read in conjunction with the accompanying notes.

6

PAGE 70

FINANCIAL STATEMENTS

NOTES TO THE FINANCIAL STATEMENTS for the year ended 30 June 2024 NOTE 1. MATERIAL ACCOUNTING POLICY INFORMATION The financial report covers VCS Foundation Limited, a Company registered on 3 December 2015 in Victoria under the Corporations Act 2001 (previously registered as Victorian Cytology Service Inc., an Association incorporated on 3 September 1991 in Victoria under the Associations Incorporation Reform Act, 2012 (Vic)). In accordance with section 601BM of the Corporations Act 2001, this change does not create a new legal entity.

Historical cost convention The financial statements have been prepared under the historical cost convention, except for, where applicable, the revaluation of financial assets and liabilities at fair value through profit or loss, financial assets at fair value through other comprehensive income, investment properties, certain classes of property, plant and equipment and derivative financial instruments.

The Company is registered with the Australian Charities and Not for profit Commission (ACNC) and is therefore also required to comply with the Australian Charities and Not for profits Commission Act 2012.

Critical accounting estimates The preparation of the financial statements requires the use of certain critical accounting estimates. It also requires management to exercise its judgement in the process of applying the Company's accounting policies. The areas involving a higher degree of judgement or complexity, or areas where assumptions and estimates are significant to the financial statements, are disclosed in note 2.

Comparatives are consistent with prior years, unless otherwise stated.

New or amended Accounting Standards and Interpretations adopted The Company has adopted all of the new or amended Accounting Standards and Interpretations issued by the Australian Accounting Standards Board ('AASB') that are mandatory for the current reporting period.

Any new or amended Accounting Standards or Interpretations that are not yet mandatory have not been early adopted.

Basis of preparation

Revenue recognition The Company recognises revenue as follows: The core principle of AASB 15 is that revenue is recognised on a basis that reflects the transfer of promised goods or services to customers at an amount that reflects the consideration the Company expects to receive in exchange for those goods or services. Revenue is recognised by applying a five step model as follows:

These general purpose financial statements have been prepared in accordance with the Australian Accounting Standards - Simplified Disclosures issued by the Australian Accounting Standards Board ('AASB'), the Australian Charities and Not-for-profits Commission Act 2012 and Victorian legislation the Fundraising Act 1998 and associated regulations and the Corporations Act 2001, as appropriate for not-for profit oriented entities.

(1) Identify the contract with the customer

The Company is a not-for-profit entity and therefore applies the additional paragraphs applicable to 'not for profit' organisations under the Australian Accounting Standards ('AAS').

Generally the timing of the payment for sale of goods and rendering of services corresponds closely to the timing of satisfaction of the performance obligations, however where there is a difference, it will result in the recognition of a receivable, contract asset or contract liability.

The financial statements, except for the cash flow information, have been prepared on an accruals basis and are based on historical costs modified, where applicable, by the measurement at fair value of selected non current assets, financial assets and financial liabilities.

The accounting policies that are material to the Company are set out below and are consistent with prior reporting periods, unless otherwise stated.

(2) Identify the performance obligations (3) Determine the transaction price (4) Allocate the transaction price to the performance obligations (5) Recognise revenue as and when control of the performance obligations is transferred

None of the revenue streams of the Company have any significant financing terms as there is less than 12 months between receipt of funds and satisfaction of performance obligations.

Specific revenue streams The revenue recognition policies for the principal revenue streams of the Company are:

VCS FOUNDATION LTD. ABN 35 430 554 780

PAGE 71

Rendering of services

Leases

Revenue from provision of services is recognised in the accounting period in which the services are rendered. For fixed price contracts, revenue is recognised based on the actual services provided to the end of the reporting period as a proportion of the total services to be provided as the customer receives and uses the benefit simultaneously.

At inception of a contract, the Company assesses whether a lease exists i.e. does the contract convey the right to control the use of an identified asset for a period of time in exchange for consideration.

This involves an assessment of whether: •

The contract involves the use of an identified asset – this may be explicitly or implicitly identified within the agreement. If the supplier has a substantive substitution right then there is no identified asset.

•

The Company has the right to obtain substantially all of the economic benefits from the use of the asset throughout the period of use.

•

The Company has the right to direct the use of the asset i.e. decision making rights in relation to changing how and for what purpose the asset is used.

Grant revenue Government grants are recognised at fair value where there is reasonable assurance that the grant will be received and all grant conditions will be met. Grants relating to expense items are recognised as income over the periods necessary to match the grant to the costs they are compensating.

Grants relating to assets are credited to deferred income at fair value and are credited to income over the expected useful life of the asset on a straight line basis.

Interest Interest revenue is recognised on a proportional basis taking into account the interest rates applicable to the financial assets, using the effective interest rate method.

Rent Rent revenue from investment properties is recognised on a straight-line basis over the lease term. Lease incentives granted are recognised as part of the rental revenue.

Contingent rentals are recognised as income in the period when earned.

Other revenue Other revenue is recognised when it is received or when the right to receive payment is established.

Statement of financial position balances relating to revenue recognition Contract assets and liabilities Where the amounts billed to customers are based on the achievement of various milestones established in the contract, the amounts recognised as revenue in a given period do not necessarily coincide with the amounts billed to or certified by the customer.

When a performance obligation is satisfied by transferring a promised good or service to the customer before the customer pays consideration or before payment is due, the Company presents the contract as a contract asset, unless the Company's rights to that amount of consideration are unconditional, in which case the Company recognises a receivable.

When an amount of consideration is received from a customer prior to the entity transferring a good or service to the customer, the Company presents the contract as a contract liability.

Lessee accounting The non lease components included in the lease agreement have been separated and are recognised as an expense as incurred.

Right-of-use asset At the lease commencement, the Company recognises a right-of-use asset and associated lease liability for the lease term. The lease term includes extension periods where the Company believes it is reasonably certain that the option will be exercised.

The right-of-use asset is measured using the cost model where cost on initial recognition comprises of the lease liability, initial direct costs, prepaid lease payments, estimated cost of removal and restoration less any lease incentives received.

The right-of-use asset is depreciated over the lease term on a straight line basis and assessed for impairment in accordance with the impairment of assets accounting policy.

Lease liability The lease liability is initially measured at the present value of the remaining lease payments at the commencement of the lease. The discount rate is the rate implicit in the lease, however where this cannot be readily determined then the Company's incremental borrowing rate is used.

Subsequent to initial recognition, the lease liability is measured at amortised cost using the effective interest rate method. The lease liability is remeasured whether there is a lease modification, change in estimate of the lease term or index upon which the lease payments are based (e.g. CPI) or a change in the Company's assessment of lease term.

Where the lease liability is remeasured, the right of use asset is adjusted to reflect the re-measurement or is recorded in profit or loss if the carrying amount of the right of use asset has been reduced to zero.

PAGE 72

FINANCIAL STATEMENTS

NOTES TO THE FINANCIAL STATEMENTS for the year ended 30 June 2024 Adoption of short-term leases or low-value asset exception Exceptions to lease accounting: The Company has elected to apply the exceptions to lease accounting for both short term leases (i.e. leases with a term of less than or equal to 12 months) and leases of low value assets. The Company recognises the payments associated with these leases as an expense on a straight line basis over the lease term.

Borrowing costs

On initial recognition, all financial instruments are measured at fair value plus transaction costs (except for instruments measured at fair value through profit or loss where transaction costs are expensed as incurred).

Financial assets All recognised financial assets are subsequently measured in their entirety at either amortised cost or fair value, depending on the classification of the financial assets.

Borrowing costs are recognised as an expense in the period in which they are incurred.

Classification On initial recognition, the Company classifies its financial assets into the following category, those measured at:

Income tax

•

As the Company is a charitable institution in terms of subsection 50-5 of the Income Tax Assessment Act 1997, as amended, it is exempt from paying income tax.

Financial assets are not reclassified subsequent to their initial recognition unless the Company changes its business model for managing financial assets.

Current and non-current classification

Amortised cost Assets measured at amortised cost are financial assets where:

Assets and liabilities are presented in the statement of financial position based on current and non-current classification.

An asset is classified as current when: it is either expected to be realised or intended to be sold or consumed in the Company's normal operating cycle; it is held primarily for the purpose of trading; it is expected to be realised within 12 months after the reporting period; or the asset is cash or cash equivalent unless restricted from being exchanged or used to settle a liability for at least 12 months after the reporting period. All other assets are classified as non-current.

A liability is classified as current when: it is either expected to be settled in the Company's normal operating cycle; it is held primarily for the purpose of trading; it is due to be settled within 12 months after the reporting period; or there is no unconditional right to defer the settlement of the liability for at least 12 months after the reporting period.

All other liabilities are classified as non-current.

Cash and cash equivalents Cash and cash equivalents includes cash on hand, deposits held at call with financial institutions, other short-term, highly liquid investments with original maturities of three months or less that are readily convertible to known amounts of cash and which are subject to an insignificant risk of changes in value.

Financial instruments Financial instruments are recognised initially on the date that the Company becomes party to the contractual provisions of the instrument.

amortised cost

•

the business model is to hold assets to collect contractual cash flows; and

•

the contractual terms give rise on specified dates to cash flows are solely payments of principal and interest on the principal amount outstanding.

The Company's financial assets measured at amortised cost comprise trade and other receivables, cash and cash equivalents and term deposits in the statement of financial position.

Subsequent to initial recognition, these assets are carried at amortised cost using the effective interest rate method less provision for impairment.

Interest income, foreign exchange gains or losses and impairment are recognised in profit or loss. Gain or loss on derecognition is recognised in profit or loss.

Impairment of financial assets Impairment of financial assets is recognised on an expected credit loss (ECL) basis for the following assets: •

financial assets measured at amortised cost.

When determining whether the credit risk of a financial asset has increased significantly since initial recognition and when estimating ECL, the Company considers reasonable and supportable information that is relevant and available without undue cost or effort. This includes both quantitative and qualitative information and analysis based on the Company's historical experience and informed credit assessment and including forward looking information.

The Company uses the presumption that an asset which is more than 30 days past due has seen a significant increase in credit risk.

VCS FOUNDATION LTD. ABN 35 430 554 780

The Company uses the presumption that a financial asset is in default when: •

the other party is unlikely to pay its credit obligations to the Company in full, without recourse to the Company to actions such as realising security (if any is held); or

•

the financial assets are more that 90 days past due.

Credit losses are measured as the present value of the difference between the cash flows due to the Company in accordance with the contract and the cash flows expected to be received. This is applied using a probability weighted approach.

Trade receivables Impairment of trade receivables have been determined using the simplified approach in AASB 9 which uses an estimation of lifetime expected credit losses. The Company has determined the probability of non payment of the receivable and multiplied this by the amount of the expected loss arising from default.

The amount of the impairment is recorded in a separate allowance account with the loss being recognised in finance expense. Once the receivable is determined to be uncollectable then the gross carrying amount is written off against the associated allowance.

Where the Company renegotiates the terms of trade receivables due from certain customers, the new expected cash flows are discounted at the original effective interest rate and any resulting difference to the carrying value is recognised in profit or loss.

Other financial assets measured at amortised cost Impairment of other financial assets measured at amortised cost are determined using the expected credit loss model in AASB 9. On initial recognition of the asset, an estimate of the expected credit losses for the next 12 months is recognised.

Where the asset has experienced significant increase in credit risk then the lifetime losses are estimated and recognised.

Trade and other receivables Other receivables are recognised at amortised cost, less any allowance for expected credit losses.

Financial liabilities The Company measures all financial liabilities initially at fair value less transaction costs, subsequently financial liabilities are measured at amortised cost using the effective interest rate method.

The financial liabilities of the Company comprise trade and other payables and finance lease liabilities.

PAGE 73

Inventories Finished goods are stated at the lower of cost and net realisable value on a 'first in first out' basis. Cost comprises of purchase and delivery costs, net of rebates and discounts received or receivable.

Net realisable value is the estimated selling price in the ordinary course of business less the estimated costs of completion and the estimated costs necessary to make the sale.

Property, plant and equipment Each class of property, plant and equipment is carried at cost less, where applicable, any accumulated depreciation and impairment. Assets are capitalised when in excess of $1,000.

Depreciation is calculated on a straight-line basis to write off the net cost of each item of property, plant and equipment (excluding land) over their expected useful lives as follows: Plant and Equipment

5 ‑ 50%

Leased Equipment

20%

Motor Vehicles

25%

Leasehold improvements

5 - 33%

The residual values, useful lives and depreciation methods are reviewed, and adjusted if appropriate, at each reporting date.

Leasehold improvements are depreciated over the unexpired period of the lease or the estimated useful life of the assets, whichever is shorter.

An item of property, plant and equipment is derecognised upon disposal or when there is no future economic benefit to the Company. Gains and losses between the carrying amount and the disposal proceeds are taken to profit or loss.

Intangible assets Intangible assets represent identifiable non monetary assets without physical substance such as patents, trademarks, and computer software and development costs (where applicable). Intangible assets are initially recognised at cost.

Subsequently, intangible assets with finite useful lives are carried at cost less accumulated amortisation and accumulated impairment losses. Costs incurred subsequent to initial acquisition are capitalised when it is expected that future economic benefits will flow to the Company.

Amortisation Amortisation is recognised in profit or loss on a straight line basis over the estimated useful lives of intangible assets, other than goodwill, from the date that they are available for use.

Amortisation methods, useful lives and residual values are reviewed at each reporting date and adjusted if appropriate.

PAGE 74

FINANCIAL STATEMENTS

NOTES TO THE FINANCIAL STATEMENTS for the year ended 30 June 2024 Software and licenses Software and licenses have a finite life and are carried at cost less any accumulated amortisation and impairment losses.

It has an estimated useful life of three years.

The recoverable amount of an asset or CGU is the higher of the fair value less costs of disposal and the value in use.

Value in use is the present value of the future cash flows expected to be derived from an asset or cash generating unit.

Intangible assets acquired as part of a business combination, other than goodwill, are initially measured at their fair value at the date of the acquisition. Intangible assets acquired separately are initially recognised at cost. Indefinite life intangible assets are not amortised and are subsequently measured at cost less any impairment. Finite life intangible assets are subsequently measured at cost less amortisation and any impairment. The gains or losses recognised in profit or loss arising from the derecognition of intangible assets are measured as the difference between net disposal proceeds and the carrying amount of the intangible asset. The method and useful lives of finite life intangible assets are reviewed annually. Changes in the expected pattern of consumption or useful life are accounted for prospectively by changing the amortisation method or period.

Where the recoverable amount is less than the carrying amount, an impairment loss is recognised in profit or loss.

Cloud Computing Arrangements The Company enters into service contracts which provide the right to access software held within the cloud over the contract period. In these arrangements, the Company does not recognise any software intangible asset at the contract commencement date because the Company does not have the power to obtain any future economic benefits flowing from the software or to restrict others’ access to those benefits.

Within Software as a Service (“SaaS”) arrangements, the Company recognises an operating expense over the term of the contract for use of the software application, and any related customisation and configuration performed by the software vendor which is not distinct from the software.

Other costs, including testing, training, and data management are expensed as incurred.

Impairment of non-financial assets At the end of each reporting period, the Company determines whether there is any evidence of impairment for its non financial assets.

Where an indicator exists and regardless for goodwill, indefinite life intangible assets and intangible assets not yet available for use, the recoverable amount of the asset is estimated.

Where assets do not operate independently of other assets, the recoverable amount of the relevant cash generating unit (CGU) is estimated.

Reversal indicators are considered in subsequent periods for all assets which have suffered an impairment loss, except for goodwill.

Trade and other payables These amounts consist predominantly of liabilities for goods and services. Payables are initially recognised at fair value and then subsequently carried at amortised cost and represent liabilities for goods and services provided to the Company prior to the end of the financial year that are unpaid, and arise when the Company becomes obliged to make future payments in respect of purchase of these goods and services.

The normal credit terms are usually Net 30 days.

Contract liabilities Contract liabilities represent the Company's obligation to transfer goods or services to a customer and are recognised when a customer pays consideration, or when the Company recognises a receivable to reflect its unconditional right to consideration (whichever is earlier) before the Company has transferred the goods or services to the customer.

Employee benefits Short-term employee benefits Provision is made for the Company’s obligation for short term employee benefits. Short term employee benefits are benefits (other than termination benefits) that are expected to be settled wholly before 12 months after the end of the annual reporting period in which the employees render the related service, including wages and salaries. Short term employee benefits are measured at the (undiscounted) amounts expected to be paid when the obligation is settled.

The Company’s obligations for short term employee benefits such as wages and salaries are recognised as a part of current trade and other payables in the statement of financial position.

VCS FOUNDATION LTD. ABN 35 430 554 780

Other long-term employee benefits Provision is made for employees’ long service leave and annual leave entitlements not expected to be settled wholly within 12 months after the end of the annual reporting period in which the employees render the related service. Other long term employee benefits are measured at the present value of the expected future payments to be made to employees.

Expected future payments incorporate anticipated future wage and salary levels, durations of service and employee departures and are discounted at rates determined by reference to market yields at the end of the reporting period on corporate bonds that have maturity dates that approximate the terms of the obligations. Upon the remeasurement of obligations for other long term employee benefits, the net change in the obligation is recognised in profit or loss as a part of employee benefits expenses.

The Company’s obligations for long term employee benefits are presented as non current provisions in its statement of financial position, except where the Company does not have an unconditional right to defer settlement for at least 12 months after the end of the reporting period, in which case the obligations are presented as current provisions.

Defined contribution superannuation expense Obligations for contributions to defined contribution superannuation plans are recognised as an employee benefit expense in profit or loss in the periods in which services are provided by employees.

Fair value measurement When an asset or liability, financial or non-financial, is measured at fair value for recognition or disclosure purposes, the fair value is based on the price that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants at the measurement date; and assumes that the transaction will take place either: in the principal market; or in the absence of a principal market, in the most advantageous market.

Fair value is measured using the assumptions that market participants would use when pricing the asset or liability, assuming they act in their economic best interests. For non-financial assets, the fair value measurement is based on its highest and best use. Valuation techniques that are appropriate in the circumstances and for which sufficient data are available to measure fair value, are used, maximising the use of relevant observable inputs and minimising the use of unobservable inputs.

PAGE 75

Goods and Services Tax ('GST') and other similar taxes Revenues, expenses and assets are recognised net of the amount of associated GST, unless the GST incurred is not recoverable from the tax authority. In this case it is recognised as part of the cost of the acquisition of the asset or as part of the expense.

Receivables and payables are stated inclusive of the amount of GST receivable or payable. The net amount of GST recoverable from, or payable to, the tax authority is included in other receivables or other payables in the statement of financial position.

Cash flows are presented on a gross basis. The GST components of cash flows arising from investing or financing activities which are recoverable from, or payable to the tax authority, are presented as operating cash flows.

PAGE 76

FINANCIAL STATEMENTS

NOTES TO THE FINANCIAL STATEMENTS for the year ended 30 June 2024 NOTE 2. CRITICAL ACCOUNTING JUDGEMENTS, ESTIMATES AND ASSUMPTIONS The preparation of the financial statements requires management to make judgements, estimates and assumptions that affect the reported amounts in the financial statements.

Management continually evaluates its judgements and estimates in relation to assets, liabilities, contingent liabilities, revenue and expenses. Management bases its judgements, estimates and assumptions on historical experience and on other various factors, including expectations of future events, management believes to be reasonable under the circumstances. The resulting accounting judgements and estimates will seldom equal the related actual results. The judgements, estimates and assumptions that have a significant risk of causing a material adjustment to the carrying amounts of assets and liabilities (refer to the respective notes) within the next financial year are discussed below.

Allowance for expected credit losses The allowance for expected credit losses assessment requires a degree of estimation and judgement. It is based on the lifetime expected credit loss, grouped based on days overdue, and makes assumptions to allocate an overall expected credit loss rate for each group. These assumptions include recent sales experience and historical collection rates.

Estimation of useful lives of assets The Company determines the estimated useful lives and related depreciation and amortisation charges for its property, plant and equipment and finite life intangible assets. The useful lives could change significantly as a result of technical innovations or some other event. The depreciation and amortisation charge will increase where the useful lives are less than previously estimated lives, or technically obsolete or non-strategic assets that have been abandoned or sold will be written off or written down.

Impairment of non-financial assets other than goodwill and other indefinite life intangible assets The Company assesses impairment of non-financial assets other than goodwill and other indefinite life intangible assets at each reporting date by evaluating conditions specific to the Company and to the particular asset that may lead to impairment. If an impairment trigger exists, the recoverable amount of the asset is determined. This involves fair value less costs of disposal or value-in-use calculations, which incorporate a number of key estimates and assumptions.

Lease term The lease term is a significant component in the measurement of both the right-of-use asset and lease liability. Judgement is exercised in determining whether there is reasonable certainty that an option to extend the lease or purchase the underlying asset will be exercised, or an option to terminate the lease will not be exercised, when ascertaining the periods to be included in the lease term. In determining the lease term, all facts and circumstances that create an economical incentive to exercise an extension option, or not to exercise a termination option, are considered at the lease commencement date. Factors considered may include the importance of the asset to the Company's operations; comparison of terms and conditions to prevailing market rates; incurrence of significant penalties; existence of significant leasehold improvements; and the costs and disruption to replace the asset. The Company reassesses whether it is reasonably certain to exercise an extension option, or not exercise a termination option, if there is a significant event or significant change in circumstances.

Incremental borrowing rate Where the interest rate implicit in a lease cannot be readily determined, an incremental borrowing rate is estimated to discount future lease payments to measure the present value of the lease liability at the lease commencement date. Such a rate is based on what the Company estimates it would have to pay a third party to borrow the funds necessary to obtain an asset of a similar value to the right-of-use asset, with similar terms, security and economic environment.

Employee benefits provision As discussed in note 1, the liability for employee benefits expected to be settled more than 12 months from the reporting date are recognised and measured at the present value of the estimated future cash flows to be made in respect of all employees at the reporting date. In determining the present value of the liability, estimates of attrition rates and pay increases through promotion and inflation have been taken into account.

VCS FOUNDATION LTD. ABN 35 430 554 780

NOTE 3. REVENUE

PAGE 77

2024 $

2023 $

Department of Health – Government Grants

5,686,469

6,469,528

Patient fees

12,333,545

9,846,555

Project income

2,310,427

2,744,502

656,371

191,732

20,986,812

19,252,317

2024

2023

$

$

Recognised at a point in time

12,989,916

10,038,287

Recognised over time

7,996,896

9,214,030

20,986,812

19,252,317

2024 $

2023 $

(7,086)

2,325

-

52,813

Bank interest

1,068,608

798,098

Other income

1,061,522

853,236

Revenue from contracts with customers:

Other revenue from operating activities Revenue Disaggregation of revenue The disaggregation of revenue from contracts with customers is as follows:

Timing of revenue recognition

NOTE 4. OTHER INCOME Foreign currency translation (losses)/gains Profit on sale of non-current assets

PAGE 78

FINANCIAL STATEMENTS

NOTES TO THE FINANCIAL STATEMENTS for the year ended 30 June 2024 NOTE 5. EXPENSES

2024 $

2023 $

Plant and equipment

745,867

638,096

Motor Vehicle

115,669

156,160

Leasehold improvements

85,079

64,465

1,181,141

1,140,967

Right-of-use asset - Building

100,724

203,800

Right-of-use asset - Equipment

33,524

96,516

2,262,004

2,300,004

43,550

12,365

7,086

(2,325)

-

(52,813)

Defined contribution superannuation expense

1,165,939

1,101,660

Employee benefits expense excluding superannuation

11,575,067

11,602,104

12,741,006

12,703,764

2024

2023

$

$

Cash at bank

706,494

67,945

Deposits at call

650,051

2,253,696

1,356,545

2,321,641

DEFICIT INCLUDES THE FOLLOWING SPECIFIC EXPENSES: Depreciation and amortisation

Computer Software

Total depreciation and amortisation Finance costs Interest and finance charges paid/payable on lease liabilities Net foreign exchange loss/(gain) Net foreign exchange loss/(gain) Net profit on disposal Profit on sale of non-current assets Employee benefits expense

NOTE 6. CASH AND CASH EQUIVALENTS Current

Total cash and cash equivalents The effective interest on short-term bank deposits was 1.35% (2023: 1.55%).

VCS FOUNDATION LTD. ABN 35 430 554 780

NOTE 7. TRADE AND OTHER RECEIVABLES

PAGE 79

2024

2023

$

$

Trade receivables

3,189,355

2,515,196

Less: impairment of receivables

(887,486)

(109,450)

2,301,869

2,405,746

372,865

151,864

2,674,734

2,557,610

Current

Interest receivable

The maximum exposure to credit risk at the reporting date is the fair value of each class of receivable in the financial statements.

Impairment of receivables The Company applies the simplified approach to providing for expected credit losses prescribed by AASB 9 Financial Instruments, which permits the use of the lifetime expected loss provision for all trade receivables. To measure the expected credit losses, trade receivables have been grouped based on shared credit risk characteristics and the days past due. The loss allowance provision as at 30 June 2024 is determined as follows, the expected credit losses incorporate forward looking information.

Current

Less than 30 days overdue

Less than 90 days overdue

Greater than 90 days overdue

Total

-

-

-

48.30

27.83

1,334,085

(156,721)

174,375

1,837,616

3,189,355

ECL provision

-

-

-

887,486

887,486

30 June 2023

Current

Less than 30 days overdue

Less than 90 days overdue

Greater than 90 days overdue

Total

-

-

-

8.10

4.36

1,035,394

61,262

67,933

1,350,607

2,515,196

-

-

-

109,450

109,450

2024 $

2023 $

Balance at beginning of the year

109,450

106,869

Additional provisions recognised

778,036

2,581

Balance at end of the year

887,486

109,450

30 June 2024 Expected loss rate (%) Gross carrying amount ($)

Expected loss rate (%) Gross carrying amount ($) ECL provision

RECONCILIATION OF CHANGES IN THE PROVISION FOR IMPAIRMENT OF RECEIVABLES IS AS FOLLOWS:

The Company measures the loss allowance for trade receivables at an amount equal to lifetime expected credit loss (ECL).

The ECL on trade receivables are estimated using a provision matrix by reference to past default experience of the debtor and an analysis of the debtor’s current financial position, adjusted for factors that are specific to the debtors, general economic conditions of the industry in which the debtors operate and an assessment of both the current as well as the forecast direction of conditions at the reporting date.

The Company writes off a trade receivable when there is information indicating that the debtor is in severe financial difficulty and there is no realistic prospect of recovery, e.g. when the debtor has been placed under liquidation or has entered into bankruptcy proceedings or when the trade receivables are over 150 days past due, whichever occurs first.

PAGE 80

FINANCIAL STATEMENTS

NOTES TO THE FINANCIAL STATEMENTS for the year ended 30 June 2024 NOTE 8. INVENTORIES

2024

2023

$

$

916,469

917,656

2024

2023

$

$

21,803,729

25,053,729

Current Medical and surgical supplies - at cost

NOTE 9. OTHER FINANCIAL ASSETS FINANCIAL ASSETS AT AMORTISED COST Current Term deposits

NOTE 10. LEASES The Company as a lessee The Company has leases over a range of assets including land and buildings, and plant and equipment. Information relating to the leases in place and associated balances and transactions are provided below.

Terms and conditions of leases The Company has entered into the following lease arrangements: • a premises located in Carlton for the term 1 May 2023 to 30 April 2028; and • plant and equipment, 1 x Cobas 6800 system and 2 x Cobas p 480 v2 instruments, from 1 December 2022 to 30 November 2025.

Neither of the above lease agreements contain options to extend the term of options to purchase the assets on expiry.

RIGHT-OF-USE ASSETS Buildings $

Plant and Equipment $

Total $

493,845

81,018

574,863

9,775

-

9,775

(100,724)

(33,524)

(134,248)

402,896

47,494

450,390

2024 $

2023 $

Current

109,446

92,145

Non current

382,814

483,931

492,260

576,076

Within one year

140,703

137,139

One to five years

451,668

592,371

592,371

729,510

Year ended 30 June 2024 Balance at beginning of year Additions to right-of-use assets Depreciation expense

LEASE LIABILITIES Lease liabilities included in the balance sheet:

Future lease payments: Future lease payments are due as follows:

VCS FOUNDATION LTD. ABN 35 430 554 780

NOTE 11. OTHER ASSETS

PAGE 81

2024

2023

$

$

Prepayments

643,641

356,559

Prepaid software cost

654,945

-

1,298,586

356,559

8,887

8,887

1,307,473

365,446

2024

2023

$

$

Leasehold improvements - at cost

1,537,962

1,387,993

Less: Accumulated depreciation

(994,247)

(909,168)

543,715

478,825

Plant and equipment - at cost

5,979,928

6,707,735

Less: Accumulated depreciation

(4,359,535)

(5,152,230)

1,620,393

1,555,505

Motor vehicles - at cost

442,791

442,791

Less: Accumulated depreciation

(399,931)

(284,262)

42,860

158,529

2,206,968

2,192,859

Current

Non-current Security deposit

NOTE 12. PROPERTY, PLANT AND EQUIPMENT

Non-current

RECONCILIATIONS Reconciliations of the written down values at the beginning and end of the current financial year are set out below: Plant and Equipment $

Motor Vehicles $

Leased Improvements $

Total $

1,555,505

158,529

478,825

2,192,859

Additions

810,755

-

149,969

960,724

Depreciation expense

(745,867)

(115,669)

(85,079)

(946,615)

Balance at 30 June 2024

1,620,393

42,860

543,715

2,206,968

Balance at 1 July 2023

PAGE 82

FINANCIAL STATEMENTS

NOTES TO THE FINANCIAL STATEMENTS for the year ended 30 June 2024 NOTE 13. INTANGIBLES

2024

2023

$

$

Computer software - at cost

3,992,243

10,235,259

Less: Accumulated amortisation

(3,123,352)

(8,548,408)

868,891

1,686,851

Non-current

RECONCILIATIONS Reconciliations of the written down values at the beginning and end of the current financial year are set out below: Computer software

Total

$

$

1,686,851

1,686,851

363,181

363,181

Amortisation expense

(1,181,141)

(1,181,141)

Balance at 30 June 2024

868,891

868,891

2024

2023

$

$

Trade payables

605,705

1,230,623

GST payable

171,581

28,227

Other payables

533,549

427,696

1,310,835

1,686,546

2024

2023

$

$

Government grants

881,772

380,000

Income received in advance

53,977

-

935,749

380,000

Balance at 1 July 2023 Additions

NOTE 14. TRADE AND OTHER PAYABLES Current

NOTE 15. CONTRACT LIABILITIES Current

VCS FOUNDATION LTD. ABN 35 430 554 780

NOTE 16. EMPLOYEE BENEFITS

PAGE 83

2024

2023

$

$

Long service leave

1,487,341

1,568,135

Annual leave

1,671,033

1,591,047

3,158,374

3,159,182

485,520

518,877

3,643,894

3,678,059

2024

2023

$

$

Accumulated surplus at the beginning of the financial year

29,349,974

34,119,390

Deficit for the year

(4,147,513)

(4,769,416)

Accumulated surplus at the end of the financial year

25,202,461

29,349,974

Current

Non-current Long service leave

NOTE 17. ACCUMULATED SURPLUS

NOTE 18. MEMBERS' GUARANTEE The Company is incorporated under the Australian Charities and Not‑for‑profits Commission Act 2012 and is a Company limited by guarantee. If the Company is wound up, the constitution states that each member is required to contribute a maximum of $10 each towards meeting any outstanding obligations of the Company. At 30 June 2024 the number of members was 9 (2023: 8).

PAGE 84

FINANCIAL STATEMENTS

NOTES TO THE FINANCIAL STATEMENTS for the year ended 30 June 2024

NOTE 19. FINANCIAL RISK MANAGEMENT The Company's principal financial instruments comprise of deposits with banks, receivables and payables.

The totals for each category of financial instruments, measured in accordance with AASB 9 Financial Instruments as detailed in the accounting policies to these financial statements, are as follows: Note

2024

2023

$

$

FINANCIAL ASSETS Held at amortised cost: Cash and cash equivalents

6

1,356,545

2,321,641

Trade and other receivables

7

2,674,734

2,557,610

Term deposits

9

21,803,729

25,053,729

25,835,008

29,932,980

FINANCIAL LIABILITIES Held at amortised cost: Trade and other payables

14

1,139,254

1,658,319

Lease liabilities

10

492,260

576,076

1,631,514

2,234,395

NOTE 20. KEY MANAGEMENT PERSONNEL DISCLOSURES The names of persons who were Board members at any time during the year are set out in the Directors' Report.

There were no transactions that require disclosure for the years ended 30 June 2024 and 30 June 2023. The Board did not receive any remuneration during the financial years ended 30 June 2024 and 30 June 2023.

COMPENSATION The aggregate compensation made to directors and other members of key management personnel of the Company is set out below: 2024

Aggregate compensation

2023

$

$

2,194,472

2,716,737

VCS FOUNDATION LTD. ABN 35 430 554 780

PAGE 85

NOTE 21. REMUNERATION OF AUDITORS During the financial year the following fees were paid or payable for services provided by RSM Australia, the auditor of the Company: 2024

2023

$

$

35,650

36,550

Preparation of the financial reports

4,000

4,000

Technical accounting advice

5,775

-

9,775

4,000

45,425

40,550

Audit Audit of the financial statements Other services

NOTE 22. CONTINGENCIES In the opinion of the Directors, the Company did not have any contingencies at 30 June 2024 (2023: Nil).

NOTE 23. RELATED PARTY TRANSACTIONS KEY MANAGEMENT PERSONNEL Disclosures relating to key management personnel are set out in note 20.

TRANSACTIONS WITH RELATED PARTIES There were no transactions with related parties during the current and previous financial year.

RECEIVABLE FROM AND PAYABLE TO RELATED PARTIES There were no trade receivables from or trade payables to related parties at the current and previous reporting date.

LOANS TO/FROM RELATED PARTIES There were no loans to or from related parties at the current and previous reporting date.

NOTE 24. ECONOMIC DEPENDENCY The Company is dependent on the Department of Health and Aged Care and Department of Health for a significant portion of its revenue used to operate the business. At the date of this report, the Board of Directors has no reason to believe the Departments will not continue to support the Company.

NOTE 25. EVENTS AFTER THE REPORTING PERIOD No matter or circumstance has arisen since 30 June 2024 that has significantly affected, or may significantly affect the Company's operations, the results of those operations, or the Company's state of affairs in future financial years.

PAGE 86

FINANCIAL STATEMENTS

265 Faraday Street Carlton VIC 3053 Phone: +61 3 9250 0300 Fax: +61 3 9349 1977 www.vcs.org.au VCS Foundation Limited ABN 35430554780

DIRECTORS' DECLARATION for the year ended 30 June 2024

265 Faraday 265 Street Faraday Carlton Street VICCarlton 3053 VIC 3053 Phone: +61Phone: 3 9250+61 0300 3 9250 Fax: +61 03003 Fax: 9349+61 1977 3 9349 1977 www.vcs.org.au www.vcs.org.au VCS FoundationVCS Limited Foundation ABN 35430554780 Limited ABN 35430554780

In the directors' opinion: •

the attached financial statements and notes comply with the Australian Accounting Standards – Simplified Disclosures, the Australian Charities and Not-for-profits Commission Act 2012 and Victorian legislation the Fundraising Act 1998 and associated regulations, and other mandatory professional reporting requirements;

•

the attached financial statements and notes give a true and fair view of the Company's financial position as at 30 June 2024 and of its performance for the financial year ended on that date; and

•

there are reasonable grounds to believe that the Company will be able to pay its debts as and when they become due and payable.

In addition: • We certify that VCS Foundation Limited has complied with the terms and conditions of their service agreement with the Commonwealth and Victorian Department(s).

• We certify that VCS Foundation Limited has used funding received from the Commonwealth and Victorian Department(s) for the year ended 30 June 2024 on the services specified in the service agreement.

Signed in accordance with a resolution of directors made pursuant to subs 60.15(2) of the Australian Australian Charities and Not-for-profits Commission Regulation 2022.

On behalf of the Directors

David Wrede Director 25 October 2024

VCS FOUNDATION LTD. ABN 35 430 554 780

INDEPENDENT AUDITOR’S REPORT

INDEPENDENT AUDITOR’S REPORT To the Members of VCS Foundation Limited Opinion We have audited the financial report of VCS Foundation Limited, which comprises the statement of financial position as at 30 June 2024, the statement of profit or loss and other comprehensive income, the statement of changes in equity and the statement of cash flows for the year then ended, and notes to the financial statements, including material accounting policy information, and the directors’ declaration.

In our opinion, the financial report of VCS Foundation Limited has been prepared in accordance with Division 60 of the Australian Charities and Not-for-profits Commission Act 2012, including: (a)

giving a true and fair view of the registered entity’s financial position as at 30 June 2024 and of its financial performance and cash flows for the year ended on that date; and

(b)

complying with Australian Accounting Standards – Simplified Disclosures under AASB 1060 General Purpose Financial Statements – Simplified Disclosures for For-Profit and Not-for-Profit Tier 2 Entities and Division 60 of the Australian Charities and Not-for-profits Commission Regulation 2022.

Basis for Opinion We conducted our audit in accordance with Australian Auditing Standards. Our responsibilities under those standards are further described in the Auditor's Responsibilities for the Audit of the Financial Report section of our report. We are independent of the VCS Foundation Limited in accordance with the ethical requirements of the Accounting Professional and Ethical Standards Board's APES 110 Code of Ethics for Professional Accountants (the Code) that are relevant to our audit of the financial report in Australia. We have also fulfilled our other ethical responsibilities in accordance with the Code.

We believe that the audit evidence we have obtained is sufficient and appropriate to provide a basis for our opinion.

Other Information Those charged with governance are responsible for the other information. The other information comprises the information included in VCS Foundation Limited's annual report for the year ended 30 June 2024, but does not include the financial report and the auditor's report thereon.

Our opinion on the financial report does not cover the other information and accordingly we do not express any form of assurance conclusion thereon.

In connection with our audit of the financial report, our responsibility is to read the other information and, in doing so, consider whether the other information is materially inconsistent with the financial report or our knowledge obtained in the audit or otherwise appears to be materially misstated.

If, based on the work we have performed, we conclude that there is a material misstatement of this other information, we are required to report that fact. We have nothing to report in this regard.

PAGE 87

PAGE 88

INDEPENDENT AUDITOR'S REPORT

Responsibilities of Management and Those Charged with Governance for the Financial Report The directors of the registered entity are responsible for the preparation of the financial report that gives a true and fair view in accordance with Australian Accounting Standards – Simplified Disclosures under AASB 1060 General Purpose Financial Statements – Simplified Disclosures for For-Profit and Not-for-Profit Tier 2 Entities and the Australian Charities and ACNC Act, and for such internal control as the directors determine is necessary INDEPENDENT AUDITOR’S REPORT to enable the preparation of the financial that gives a true and fair view and is free from material To the Members of VCS Foundation report Limited misstatement, whether due to fraud or error.

Opinion In preparing the financial report, the directors are responsible for assessing VCS Foundation Limited’s ability to continue a going as applicable, matters related going concern and usingofthe going We haveas audited theconcern, financialdisclosing, report of VCS Foundation Limited, whichtocomprises the statement financial concern management either intends liquidate VCS Foundation Limited or to cease position basis as at of 30accounting June 2024,unless the statement of profit or loss andtoother comprehensive income, the statement of operations, has and no realistic alternative but flows to do for so.the year then ended, and notes to the financial statements, changes in or equity the statement of cash including material accounting policy information, and the directors’ declaration.

The directors are responsible for overseeing the registered entity's financial reporting process.

In our opinion, the financial report of VCS Foundation Limited has been prepared in accordance with Division 60 of the Australian Charities and Act 2012, including: Auditor's Responsibilities for theNot-for-profits Audit of the Commission Financial Report Our are to obtain reasonable assurance aboutfinancial whetherposition the financial report a whole from (a) objectives giving a true and fair view of the registered entity’s as at 30 Juneas 2024 and ofisitsfree financial materialperformance misstatement, duefor to fraud or error, issue auditor's report that includes our opinion. andwhether cash flows the year endedand on to that date;anand Reasonable assurance is a high level of assurance, but is not a guarantee that an audit conducted in accordance with Australianwith Auditing Standards will always detect a–material misstatement it exists. (b) thecomplying Australian Accounting Standards Simplified Disclosureswhen under AASBMisstatements 1060 General can arise from Financial fraud or Statements error and are considered material for if, For-Profit individually or Not-for-Profit in the aggregate, they could Purpose – Simplified Disclosures and Tier 2 Entities and reasonably be expected influenceCharities the economic decisions of users taken onRegulation the basis of this financial report.

Division 60 of the to Australian and Not-for-profits Commission 2022.

ABasis further fordescription Opinion of our responsibilities for the audit of the financial report is located at the Auditing and Assurance Standards Board website at: http://www.auasb.gov.au/Home.aspx. This description forms part of our We conducted auditor's report. our audit in accordance with Australian Auditing Standards. Our responsibilities under those standards are further described in the Auditor's Responsibilities for the Audit of the Financial Report section of our report. We are independent of the VCS Foundation Limited in accordance with the ethical requirements of Independence the Accounting Professional and Ethical Standards Board's APES 110 Code of Ethics for Professional We confirm that independence declaration required the ACNC Act, which hasWe been to the Accountants (the the Code) that are relevant to our audit of thebyfinancial report in Australia. havegiven also fulfilled responsible entities of VCS Foundation Limited,with would in the same terms if given to the responsible entities our other ethical responsibilities in accordance thebe Code. as at the time of this auditor’s report.

We believe that the audit evidence we have obtained is sufficient and appropriate to provide a basis for our opinion.

Other Information Those charged with governance are responsible for the other information. The other information comprises the information included in VCS Foundation Limited's annual report for the year ended 30 June 2024, but does not RSM AUSTRALIA PARTNERS include the financial report and the auditor's report thereon.

Our opinion on the financial report does not cover the other information and accordingly we do not express any form of assurance conclusion thereon.

K J DUNDON

In connection with our audit of the financial report, our responsibility is to read the other information and, in doing Partner so, consider whether the other information is materially inconsistent with the financial report or our knowledge obtained in the audit or otherwise appears to be materially misstated.

Melbourne, Victoria If, based on the work Dated: 28 October 2024we have performed, we conclude that there is a material misstatement of this other information, we are required to report that fact. We have nothing to report in this regard.

ACPCC ABN 35 430 554 780

List of Acronyms ACPCC

Australian Centre for the Prevention of Cervical Cancer

CPD

Continuing Professional Development

CST

Cervical Screening Test

Cth

Commonwealth

ECHO

Extension For Community Healthcare Outcomes

ECCWP

Eliminating Cervical Cancer in the Western Pacific

EPICC

Elimination Partnership in the Indo-Pacific for Cervical Cancer

GP

General Practitioner

HPV

Human Papillomavirus

HR

Human Resources

ICT

Information Communication Technology

ISO

International Standards

NATA

National Association of Testing Authorities, Australia

NCSP

National Cervical Screening Program

NCSR

National Cancer Screening Register

NHMRC

National Health and Medical Research Council

NPAAC

National Pathology Accreditation Advisory Council

PCC

Preventing Cervical Cancer Conference

RACGP

Royal Australian College of General Practitioners

RCPA

Royal College of Pathologists Australasia

VCS

VCS Foundation Limited

WHO

World Health Organization

PAGE 89

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ACPCC ABN 35 430 554 780

Congratulations to Professor Karen Canfell AC

We were delighted to hear that Karen was appointed a Companion of the Order of Australia in the 2024 King’s Birthday Honours for “eminent service to medicine as an epidemiologist, particularly through cancer research, to tertiary education, and as a mentor and leader.”

L-R A/Prof Megan Smith, Prof Karen Canfell AC, Prof Marion Saville AM

This incredibly well deserved award reflects Karen’s commitment to research and as a research leader, generously collaborating and developing the careers of other researchers. Her leadership in the policy space has been nothing short of remarkable. Importantly the award also reflects her incredible commitment to working tirelessly to reduce the impact of cancer in people across the world.

“IT HAS BEEN AN ABSOLUTE PLEASURE TO WORK WITH SOMEONE OF KAREN’S INTELLECT AND CHARACTER. OUR COLLABORATION STARTED MORE THAN A DECADE AGO AS CO-PRINCIPAL INVESTIGATORS ON THE COMPASS TRIAL AND HAS CONTINUED INTO MANY PROJECTS THAT HAVE LED TO IMPROVEMENTS IN CERVICAL SCREENING IN AUSTRALIA AND AROUND THE WORLD." – Prof Marion Saville

ACPCC ABN 35 430 554 780

PAGE 91

L-R Prof Karen Canfell AC, Governor-General Sam Mostyn AC

Karen is an epidemiologist, modeller and translationallyfocused population health researcher, and her research program focuses on providing policy-makers with an evidence-base for decision making across the cancer control continuum.

Karen has received multiple awards including the 2020 Elizabeth Blackburn Investigator grant award from the National Health and Medical Research Council for leadership in Health Services Research, the 2021 Cancer Australia Senator Jeanne Ferris Award for Gynaecological Cancer Research, and the 2022 Public Health Association of Australia NSW Public Health Impact Award. In 2019 Karen was elected a Fellow of the Australian Academy of Health and Medical Sciences.

In 2015 she won the NHMRC National Award for Research Excellence and was also nominated that year as a Woman of Influence by Westpac and the Australian Financial Review.

In 2021 she was invited to give the prestigious Richard Doll Seminar at Oxford where she spoke as co-leader of the World Health Organization (WHO) Cervical Cancer Elimination Modelling Consortium on the topic of the WHO’s strategy for the elimination of cervical cancer (The road to cervical cancer elimination).

In 2024 Karen was appointed as a Companion of the Order of Australia for eminent service to medicine as an epidemiologist, particularly through cancer research, to tertiary education, and as a mentor and leader.

PAGE 92

ACPCC ABN 35 430 554 780

Appendices See our full list of 2023/24 committee engagements here: acpcc/committees-23-24

1. Committee Engagement

See our full list of 2023/24 strategic partnerships here: acpcc/partners-23-24

2. Strategic Partnerships

See our full list of 2023/24 publications here: acpcc/publications-23-24

3. 2023/24 Publications

Members of the ACPCC team are engaged with committees on a range of international, national and Victorian organisations.

Our team members support with: data monitoring and reporting, professional mentoring, program and policy development and guidance, as well as clinical and technical expertise.

The ACPCC partners with health organisations and academic institutions in Australia and the Indo-Pacific, contributing to a variety of research and implementation projects.

The ACPCC’s research team (in collaboration with our key partners) continues to undertake research and evaluation of public health activities supporting cervical cancer elimination in Australia and internationally, with outcomes published in peer-reviewed journals and healthcare focussed articles.

Australian Centre for the Prevention of Cervical Cancer ANNUAL REPORT 2023/24 Australian Centre for the Prevention of Cervical Cancer PO Box 178, Carlton South VIC 3053 265 Faraday Street, Carlton VIC 3053 Telephone: (03) 9250 0300 Website: www.acpcc.org.au

© Australian Centre for the Prevention of Cervical Cancer ACN: 609 597 408 Copies of this report are available online: www.acpcc.org.au Printed copies can be ordered from: Australian Centre for the Prevention of Cervical Cancer Telephone: (03) 9250 0322 Email: directorate@acpcc.org.au ISSN 2202-4441

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