Screening for bowel cancer among NSW adults with varying levels of risk: a community survey

Objective: To estimate the extent and modality of screening for colorectal cancer in NSW among community-dwelling adults aged over 40 with varying degrees of familial risk. Design: Cross-sectional telephone survey with participants randomly selected from the electronic NSW telephone directory. Main results: 5.7% of people at average risk aged 40-49 report having had at least one faecal occult blood test (FOBT) in the previous five years, compared with 18.4% of those at average risk aged 50 and over. Of those at above-average risk (by age and familial risk), 7.9% reported that they had had an FOBT in the previous five years. Around 5% of respondents aged 40-49 and 10% of those aged 50(+) reported having had a colonoscopy/sigmoidoscopy for screening within the previous five years, compared with 30% of those at above-average risk. People with medical insurance were more likely to have undergone a screening test (either FOBT or sigmoidoscopy/colonoscopy), than those without insurance (PR=1.30; 95% CI 1.02-1.67). Compared with those employed full time, those who were retired (PR=1.45 95% CI 1.01-2.09) and those who reported home duties (PR=1.54 95% CI 1.01-2.36) were slightly, but significantly more likely to report having had a test. As perception of personal risk for colorectal cancer increased, so did the likelihood of having had a screening test within the previous five years (PR=1.19; 95% CI 1.05-1.35). Conclusion: We have reported important baseline data with which to compare the progress of both pilot screening programs and more widespread implementation of colorectal screening in Australia. In particular, we have highlighted the need for greater participation in screening for those at increased familial risk.