The National Bowel Cancer Screening Program (NBCSP) began in 2006. It aims to reduce the morbidity and mortality from bowel cancer by actively recruiting and screening the eligible target population, aged 50–74, for early detection or prevention of the disease. This monitoring report is the fifth to examine the NBCSP using the current key performance indicators. In 2020, it is estimated that about 7,227 people aged 50–74 will be diagnosed with bowel cancer (around 47% of all bowel cancers diagnosed) and 1,905 people in this age group will die from the disease (around 36% of all bowel cancer deaths).
Of the 5 million people invited between January 2017 and December 2018, 42% participated in the program. The national participation rate was similar to that for the previous rolling 2-year period (2016–2017) (41%). The re-participation rate for those who took part in their previous invitation round and were receiving a subsequent screening invitation was 80%. Screening results In 2018, 78,600 Australians returned a positive screening test, giving a 7% screening positivity rate. Of those who received a positive screening test, 66% reported a follow-up diagnostic assessment. The median time from positive screening test result to diagnostic assessment was 51 days.
Cancers and adenomas detected
As form return is not mandatory, diagnostic assessment data were not considered complete enough to allow formal performance indicator reporting. However, of the data available for participants who had a diagnostic assessment in 2018, 1 in 30 were diagnosed with a confirmed or suspected cancer (251 and 1,432, respectively) and adenomas were diagnosed in a further 6,149 (1 in 8 participants assessed). Adenomas are benign growths with potential to become cancerous; their removal lowers the risk of future bowel cancers developing.
Participants who identified as being of Aboriginal or Torres Strait Islander origin, as well as those who lived in Very remote areas and those who lived in low socioeconomic areas all had higher rates of positive screens (warranting further assessment), but lower rates of follow-up diagnostic assessment, and a longer median time between a positive screen and assessment.
Since the NBCSP began
Since the program began in August 2006, about 6.8 million NBCSP screening tests have been completed, with almost 3.8 million people participating at least once, and about 337,000 participants having a diagnostic assessment to follow up a positive screening result. From the data available for participants who have had diagnostic assessment, 1 in 30 have been diagnosed with a confirmed or suspected cancer and 1 in 7 have had an adenoma detected. Previous data linkage studies by the Australian Institute of Health and Welfare found that the NBCSP is contributing to reducing morbidity and mortality from bowel cancer in Australia (AIHW 2014a, 2018a, 2018b).