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Screening practices of Australian men and women categorized as “at or slightly above average risk” of colorectal cancer

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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.

Conflicts of interest

The authors declare that there are no conflicts of interest.

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Authors and Affiliations

  1. Centre for Molecular, Environmental, Genetic & Analytic Epidemiology, School of Population Health, The University of Melbourne, Level 3, 207 Bouverie Street, Melbourne, VIC, 3010, Australia

    Driss Ait Ouakrim, Louisa B. Flander, John L. Hopper & Mark A. Jenkins

  2. Preventative Health National Research Flagship, CSIRO Food and Nutritional Sciences, North Ryde, NSW, 2113, Australia

    Trevor Lockett

  3. Peter MacCallum Cancer Centre, Melbourne, 3002, Australia

    Alex Boussioutas

  4. Centre for Women’s Health, Gender and Society, The University of Melbourne, Melbourne, VIC, 3010, Australia

    Louise Keogh

  5. Genetic Medicine, The University of Melbourne and The Royal Melbourne Hospital, Parkville, VIC, 3050, Australia

    Ingrid Winship

  6. Cancer Epidemiology Centre, Cancer Council Victoria, Carlton, VIC, 3053, Australia

    Graham G. Giles

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  1. Driss Ait Ouakrim
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  2. Trevor Lockett
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Correspondence to Driss Ait Ouakrim.

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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

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