Screening for colorectal cancer in the general population

Screening for colorectal cancer in the general population

Bowel Health Service
Surveillance for colorectal cancer
Development and evaluation of screening
Research Group Members

Factors associated with participation in screening for colorectal cancer

Population based screening programs are most effective when a large proportion of the target population participates. Several projects from 2002 to the present have investigated demographic, screening tests and program factors associated with initial uptake and maintenance of screening behaviours. Currently the research group is analysing results from a four year study aimed at monitoring longitudinal screening participation trends and identifying demographic and psychosocial factors associated with participation in re-screening, with a view to improving participation through more targeted approaches.

One of our studies was included in the NH&MRC publication ‘Ten of the Best 2006’ showcasing outstanding research achievements.

Research findings have been translated into practice in Australia’s National Bowel Cancer Screening Program and in programs in other countries.

Investigators: Steve Cole, Carlene Wilson, Deborah Turnbull (University of Adelaide), Adrian Esterman (UniSA), Graeme Young, Ingrid Flight (CSIRO).
Current project researchers: Jo Osborne, Amy Duncan.

Impact of colorectal cancer screening on participants and on health services capacity

People with a personal or strong family history of colorectal cancer have an increased risk of developing colorectal neoplasia (colorectal cancers and colorectal adenomas). The number of people at increased risk grows as additional people are identified through population screening. This project explores the psychological effect of screening on participants, especially on people who test positive and experience further diagnostic evaluation, and the impact of an expanding patient population at higher risk on health service capacity and performance.

Investigators: Peter Bampton, Graeme Young, Steve Cole, Deborah Turnbull (University of Adelaide), Rhys Williams.
Project researcher: Amanda Bobridge

Development of web-based delivery of colorectal cancer screening

Developments in electronic decision-support tools provide the capability to deliver sophisticated, personalised and tailored messages appropriate to a recipient’s current frame of reference, to achieve informed behaviour change.

In this study, tailored health information is provided within an investigator-developed web-based decision aid to facilitate decision-making and screening use appropriate to the user’s risk level and screening preferences. A unique multidisciplinary team has been assembled to undertake a randomised controlled trial of the efficacy of the decision aid combined with a screening delivery portal, plus an evaluation of factors associated with accessing web-based information about, and delivery, of screening.

Investigators: Steve Cole, Carlene Wilson, Deborah Turnbull (University of Adelaide), Graeme Young, Ingrid Flight (CSIRO
Project researcher: Ian Zajac (CSIRO)

Evaluation of bowel cancer screening programs

Randomised controlled trials have shown that screening is associated with reduced mortality from colorectal cancer. Australia’s National Bowel Cancer Screening Program (NBCSP) began as a Pilot Program in 2003 but as yet there is no evidence that this population-based program has had an impact on mortality.

Our investigators have obtained and linked data from the NBCSP register to South Australian Cancer Registry data to compare the stage profile of CRC found through screening to the stage profile of CRC diagnosed through other pathways. Analyses showed that screen detected CRC were diagnosed at a significantly earlier stage where cure is more likely, suggesting that screening should ultimately reduce mortality from colorectal cancer in Australia.

Investigators: Graeme Young, Steve Cole, Jo Osborne, Graeme Tucker (Epidemiology SA Health)

Equity of colorectal cancer screening

This study explores the association between various socio-demographic factors and participation in the National Bowel Cancer Screening Program (NBCSP) in SA, and barriers to and facilitators of participation in the NBCSP among selected ethnic groups, Indigenous and Anglo-Australian people.

Findings to date suggest that rates of participation vary depending on gender, age, geographical location, socio-economic status, ethnicity and Indigenous status, and indicate that inequity exists in outcomes from the NBCSP.

Investigators: Paul Ward, Steve Cole, Graeme Young
Project researcher: Sara Javanparast