Article

Colorectal cancer screening in Australia: A community-level perspective

School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia.
The Medical journal of Australia (Impact Factor: 4.09). 05/2012; 196(8):516-20. DOI: 10.5694/mja11.10661
Source: PubMed

ABSTRACT

To determine current colorectal cancer (CRC) screening rates and the level of adherence to screening guidelines @a community level.
A cross-sectional cohort of at-risk people aged 56-88 years randomly selected from the Hunter Community Study (HCS), Australia.
Proportion ever reporting undertaking any CRC testing; current screening rates for each CRC screening modality; level of screening in accordance with national screening guidelines.
Of the 1117 participants (70%) who returned a questionnaire, 777 were deemed asymptomatic and eligible for analysis. Overall, 63% of respondents had ever received any CRC testing. Forty-three per cent had ever had a faecal occult blood test (20% screened in the previous 2 years); 30% had ever had a colonoscopy (16% screened in the previous 5 years); and 7% had ever had a sigmoidoscopy (1% screened in the previous 5 years). Rates of adherence to screening guidelines were 21% for respondents who were @or slightly above average risk, and 45% for respondents who were @moderately increased or potentially high risk.
Rates of CRC screening remain low. The screening rate for colonoscopy was particularly high among people who were @or slightly above average risk, despite such screening not being endorsed in the guidelines. Effective strategies to improve rates of CRC screening and appropriate use of colonoscopy are required across the entire at-risk population.

Full-text preview

Available from: mja.com.au
  • Source
    • "The most recent investigation of CRC screening participation among at-risk persons (i.e. those aged over 55 years) since the National Bowel Cancer Screening Program’s introduction in 2006 indicated that screening in accordance with guideline recommendation for persons “at or slightly above average risk” was 20 per cent [24]. Although community-based studies in the United States (US) have generally established rates of FOBT screening in accordance with guideline recommendations among FDRs of CRC patients of between 9% and 42%, [37-40] the studies with the highest screening rates had recruited participants through advertisements [38,39]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: BACKGROUND: The aim of this study was to determine the proportions and predictors of first-degree relatives (FDRs) of colorectal cancer (CRC) patients (i) ever receiving any CRC testing and (ii) receiving CRC screening in accordance with CRC screening guidelines. METHODS: Colorectal cancer patients and their FDRs were recruited through the population-based Victorian Cancer Registry, Victoria, Australia. Seven hundred and seven FDRs completed telephone interviews. Of these, 405 FDRs were deemed asymptomatic and eligible for analysis. RESULTS: Sixty-nine percent of FDRs had ever received any CRC testing. First-degree relatives of older age, those with private health insurance, siblings and FDRs who had ever been asked about family history of CRC by a doctor were significantly more likely than their counterparts to have ever received CRC testing. Twenty-five percent of FDRs "at or slightly above average risk" were adherent to CRC screening guidelines. For this group, adherence to guideline-recommended screening was significantly more likely to occur for male FDRs and those with a higher level of education. For persons at "moderately increased risk" and "potentially high risk", 47% and 49% respectively adhered to CRC screening guidelines. For this group, guideline-recommended screening was significantly more likely to occur for FDRs who were living in metropolitan areas, siblings, those married or partnered and those ever asked about family history of CRC. CONCLUSIONS: A significant level of non-compliance with screening guidelines was evident among FDRs. Improved CRC screening in accordance with guidelines and effective systematic interventions to increase screening rates among population groups experiencing inequality are needed.Australian and New Zealand Clinical Trial Registry: ACTRN12609000628246.
    Full-text · Article · Jan 2013 · BMC Cancer
  • [Show abstract] [Hide abstract]
    ABSTRACT: While the government's implementation of the National Bowel Cancer Screening Program remains stalled, Australians are dying unnecessarily.
    No preview · Article · May 2012 · The Medical journal of Australia
  • [Show abstract] [Hide abstract]
    ABSTRACT: Australia has one of the highest incidences of colorectal cancer (CRC) in the world. In 2006, the federal government introduced a screening program consisting of a one-off fecal occult blood test offered to people turning 50, 55, or 65 years. We conducted a population-based study to estimate CRC screening practices existing outside the current program. A total of 1887 unaffected subjects categorized "at or slightly above average risk" of CRC were selected from the Australasian Colorectal Cancer Family Registry. We calculated the proportions of participants that reported appropriate, under- and over-screening according to national guidelines. We performed a logistic regression analysis to evaluate associations between over-screening and a set of socio-demographic factors. Of 532 participants at average risk of CRC, eligible for screening, 4 (0.75 %) reported appropriate screening, 479 (90 %) reported never having been screened, 18 (3 %) reported some but less than appropriate screening, and 31 (6 %) reported over-screening. Of 412 participants aged 50 years or over, slightly above average risk of CRC, 1 participant (0.25 %) reported appropriate screening, 316 (77 %) reported no screening, and 11 (3 %) reported some but less than appropriate screening. Among participants under age 50 years, 2 % of those at average risk and 10 % of those slightly above average risk reported over-screening. Middle-aged people, those with a family history of CRC and those with a university degree, were more likely to be over-screened. Overall, the level of CRC screening participation was low and the vast majority of screening tests undertaken were inappropriate in terms of timing, modality, or frequency.
    No preview · Article · Sep 2012 · Cancer Causes and Control
Show more