Screening for colorectal cancer in remote, rural and metropolitan South Australia: analysis of the National Bowel Cancer Screening Program data

Abstract

The early detection of colorectal cancer (CRC) is a major clinical and public health concern. CRC is now the second most commonly diagnosed cancer in Australia and has the second highest cancer mortality rate. Around 1 in 19 men and 1 in 28 Australian women will develop the disease before 75 years of age. In 2005 there were 4165 deaths from CRC in Australia, accounting for almost 11% of all cancer deaths. Cancer mortality rates vary according to the remoteness of a person’s place of residence. The average annual death rate for CRC during 1998–2001 in Australia was highest in inner and outer regional areas (13.4% and 13.3%), followed by major cities (12.8%), remote areas (12.4%) and very remote areas (7.7%). Survival is inversely related to the degree of cancer progression, and up to 90% of all deaths from CRC may be preventable with early detection. This study aimed to explore the association between screening participation and different sociodemographic indicators in SA. This was part of a broader study that included a qualitative exploration of the barriers to and facilitators of NBCSP participation among selected ethnic groups, Indigenous Australians and people who speak English at home. This paper also draws on these qualitative findings in discussing the uptake of screening in rural, remote and metropolitan areas of SA.