Centre for Epidemiology and Biostatistics, School of Population and Global Health, 85084The University of Melbourne, Parkville, VIC, Australia.
Department of Gastroenterology and Hepatology, 26066Amsterdam UMC, AZ Amsterdam, Netherlands.
Cancer Control. 2022 Jan-Dec;29:10732748221121383. doi: 10.1177/10732748221121383.
Colorectal cancer (CRC) is the second most diagnosed cancer in men and women and second most common cause of cancer death in Australia; Australia's CRC incidence and mortality are among the world's highest. The Australian National Bowel Cancer Screening Program began in 2006; however, only 33% of those approached for the first time by the Program between 2018 and 2019 returned the kit. Of the 5.7 million kits sent during this period, only 44% were returned. Our aim was to identify practices and features of national bowel cancer screening programs in countries with similar programs but higher screening participation, to identify potential interventions for optimising Australian CRC screening participation.
We searched published and grey literature for CRC screening programs reporting at least 50% screening participation using postal invitation and free return of iFOBT home kits. Interviews were conducted with cancer registry staff and academic researchers, focused on participant and practitioner engagement in screening.
National programs in Netherlands, Scotland, Denmark, and Finland reported over 50% screening participation rates for all invitation rounds. Shared characteristics include small populations within small geographic areas relative to Australia; relatively high literacy; a one-sample iFOBT kit; national registration systems for population cancer screening research; and screening program research including randomised trials of program features.
Apart from the one-sample kit, we identified no single solution to persistent Australian low uptake of screening. Research including randomised trials within the program promises to increase participation.
This screening program comparison suggests that within-program intervention trials will lead to increased Australian screening participation.
结直肠癌（CRC）是男性和女性中第二大常见的癌症，也是澳大利亚癌症死亡的第二大常见原因；澳大利亚的 CRC 发病率和死亡率均处于世界最高水平之列。澳大利亚国家结直肠癌筛查计划于 2006 年开始实施；然而，在 2018 年至 2019 年期间，首次被该计划接触的人群中，只有 33%的人返回了试剂盒。在这段时间内，寄出的 570 万套件中，只有 44%被返回。我们的目的是确定在具有类似计划但参与率更高的国家中，全国结直肠癌筛查计划的实践和特点，以确定优化澳大利亚 CRC 筛查参与率的潜在干预措施。
我们使用邮政邀请和免费返还 iFOBT 家用试剂盒，搜索了至少报告 50%筛查参与率的 CRC 筛查计划的已发表和灰色文献。我们对癌症登记处工作人员和学术研究人员进行了访谈，重点是参与者和从业者对筛查的参与。
荷兰、苏格兰、丹麦和芬兰的全国性计划报告了所有邀请轮次的筛查参与率均超过 50%。共同特点包括：相对于澳大利亚，人口和地理面积较小；相对较高的文化程度；单一样本 iFOBT 试剂盒；人口癌症筛查研究的国家登记系统；以及包括方案特征的随机试验的筛查方案研究。
除了单一样本试剂盒外，我们没有发现解决澳大利亚持续低筛查参与率的单一方法。包括在该计划内进行的随机试验的研究有望提高参与度。
这项筛查计划比较表明，计划内干预试验将提高澳大利亚的筛查参与度。
