Bowel cancer screening

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Bowel (colorectal) cancer causes the second highest number of cancer deaths in Australia (after lung cancer) yet can usually be treated successfully if detected early.

Bowel cancers typically begin as precancerous polyps, called adenomas, which can be detected and removed before becoming cancers. The cancer tumours themselves can also be removed with relative efficiency if detected before they spread beyond the bowel.

In 1997, the Australian Government published an analysis of the data on bowel cancer screening that clearly showed the benefits in mortality reduction on a population basis. The evidence shows these are highest in people aged 50 and over, screened every two years; evidence does not support mass screening of people aged below 50.

In 2002, the government conducted pilot studies that supported the clinical and cost-effectiveness of biennial population screening for bowel cancer in Australia using the faecal occult blood test.

In August 2006, the National Bowel Cancer Screening Program was introduced, with the first testing kits sent to Australians turning 55 and 65. People turning 50 were added in 2008; a plan for long-term full implementation, commencing with the addition of 60- and 70-year-olds, was announced in the 2012-13 federal budget. 

The Australian Government's National Bowel Cancer Screening Program now provides a free FOBT kit and pathology to Australians aged 50, 55, 60, 64, 65, 70, 72 and 74. Cancer Council urges all eligible Australians to participate. The program will be fully implemented by 2020, inviting all Australians aged 50 to 74 to screen every two years with a home FOBT.

Detailed analysis of the evidence on bowel cancer screening and recommendations on the roll-out of Australia's National Bowel Cancer Screening Program is available in the bowel cancer chapter of our National Cancer Prevention Policy. It also includes a summary of the evidence on primary prevention of bowel cancer.

Sources:

• Australian Health Technology Advisory Committee. Colorectal cancer screening. Canberra: Publications Production Unit, Commonwealth Department of Health and Family Services, 1997.
• Clinical practice guidelines for the prevention, early detection and management of colorectal cancer, 2^nd edition, Cancer Council Australia, National Health and Medical Research Council, 2005.