Bowel cancer is one of the most treatable cancers – if it’s found early.

The National Bowel Cancer Screening Program (NBCSP) mails out a free bowel screening test to eligible Australians aged between 50 and 74. This test can help find changes in the bowel long before any symptoms occur.

Aboriginal and Torres Strait Islander people are less likely to screen through the national program than other Australians, and are more likely to be diagnosed with bowel cancer at an advanced stage, when treatment is less likely to be successful.

Menzies research has now shown that this bowel screening Gap can be overcome if screening kits are given out through primary health care centres, where a trusted health professional can explain why the test is important, and how to do it. As a result, an 'Alternative Pathway' for kit distribution and screening promotion is expected to be introduced as part of the NBCSP in early 2022.

The National Indigenous Bowel Screening Pilot
The Australian Government Department of Health contracted Menzies to research, consult about and develop a model that could increase participation in bowel screening by Aboriginal and Torres Strait Islander people. In 2018-19, the Alternative Pathway model was piloted nationally, with 47 Indigenous primary health care centres from across Australia.

The pilot was conducted as a cluster randomised controlled trial under the leadership of Professor Gail Garvey, with health centres randomly allocated to receive either intensive or low intensity support to take up the Alternative Pathway.

While not all health centres managed to implement the Alternative Pathway, mainly due to competing priorities, there was no significant difference between the performance of health centres who received either level of support. Overall, the rate of screening participation by Aboriginal and Torres Strait Islander people through the pilot was similar to that of non-Indigenous Australians through the NBCSP's usual mail out model. An evaluation of the pilot is available here.

Many health centres that took part in the pilot continue to give out kits to their patients, despite the interruptions of the Covid-19 pandemic.

Bowel screening promotional materials for use with Aboriginal and Torres Strait Islander people are available from www.health.gov.au - search for National Indigenous Bowel Screening Pilot.

A training module for health professionals can be found at www.indigenousbowelscreen.com.au and via the website above.

For information about the new Alternative Pathway for kit distribution, contact nbcsp@health.gov.au

Project dates: 2015-2020