Abstract
Purpose
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.
Methods
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.
Results
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.
Conclusion
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.
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Acknowledgments
The authors thank Kelly Aujard for her assistance with variable design and ascertainment. This study was supported by the NIH (National Cancer Institute grants RFA CA-95-011, UO1 CA097735). Driss Ait Ouakrim was supported by a Commonwealth Scientific and Industrial Research Organisation PhD scholarship (CSIRO, Preventative Heath Flagship). The study was conducted independently of funding agencies.
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The authors declare that there are no conflicts of interest.
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Ait Ouakrim, D., Lockett, T., Boussioutas, A. et al. Screening practices of Australian men and women categorized as “at or slightly above average risk” of colorectal cancer. Cancer Causes Control 23, 1853–1864 (2012). https://doi.org/10.1007/s10552-012-0067-y
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DOI: https://doi.org/10.1007/s10552-012-0067-y