australias national bowel cancer screening program does it work for indigenous australians澳大利亚的国家肠癌筛查程序是否为土著澳大利亚人工作.pdfVIP

Christou et al. BMC Public Health 2010, 10:373 /1471-2458/10/373 RESEARCH ARTICLE Open Access Australia’s National Bowel Cancer Screening Program: does it work for Indigenous Australians? 1*† 1 1,2† Aliki Christou , Judith M Katzenellenbogen , Sandra C Thompson Abstract Background: Despite a lower incidence of bowel cancer overall, Indigenous Australians are more likely to be diagnosed at an advanced stage when prognosis is poor. Bowel cancer screening is an effective means of reducing incidence and mortality from bowel cancer through early identification and prompt treatment. In 2006, Australia began rolling out a population-based National Bowel Cancer Screening Program (NBCSP) using the Faecal Occult Blood Test. Initial evaluation of the program revealed substantial disparities in bowel cancer screening uptake with Indigenous Australians significantly less likely to participate in screening than the non-Indigenous population. This paper critically reviews characteristics of the program which may contribute to the discrepancy in screening uptake, and includes an analysis of organisational, structural, and socio-cultural barriers that play a part in the poorer participation of Indigenous and other disadvantaged and minority groups. Methods: A search was undertaken of peer-reviewed journal articles, government reports, and other grey literature using electronic databases and citation snowballing. Articles were critically evaluated for relevance to themes that addressed the research questions. Results: The NBCSP is not reaching many Indigenous Australians in the target group, with factors contributing to sub-optimal participation including how participants are selected, the way the screening kit is distributed, the nature of the te