Uptake for bowel cancer screening remains low

For the third consecutive year, national bowel cancer screening targets are falling short, new figures from the Australian Institute of Health and Welfare (AIHW) confirm.
 
The AIHW’s 2025 monitoring report on the National Bowel Cancer Screening Program (NBCSP) reveals that just 42% of the 6.3 million people invited to participate in the program in 2022–23 undertook screening.
 
Of those who carried out the screening that year, 73% has previously participated in the NBCSP.
 
Six per cent of those who participated in 2023 returned a positive result warranting further assessment, and of those who underwent a follow-up diagnostic assessment, one in 26 was diagnosed with a confirmed or suspected cancer.
 
University of Melbourne Professor of Primary Care Cancer Research Jon Emery told newsGP while uptake is slow, it remains steady.
 
‘The first point to make is that 42% represents a small increase from the previous report for 2020–21 when it had dropped to 40.9%, from a high of 43.9% in 2019–20,’ he said.
 
‘At least it has not fallen any further.’
 
The target participation rate for Australia’s NBCSP is 56.6%, which applies to eligible people aged 50–74.
 
From 1 July 2024, eligibility expanded to include people aged 45–49, following rates of bowel cancer increasing among younger age cohorts.
 
The AIHW report notes that this age cohort was outside the 1 January 2022 – 31 December 2023 reporting period of the latest monitoring report. However, initial data shows 77,551 home kits were requested between July–December 2024 for eligible people aged 45–49.
 
Professor Emery believes there are several reasons for low participation rates, but GPs’ role in preventive health remains central to raising these.
 
‘[These include] a lack of awareness of the benefits of early detection of bowel cancer, fear of a cancer diagnosis, simply forgetting about the kit after it arrives in the post, concerns about hygiene and perceived challenges of completing the kit itself,’ he said.
 
‘GPs’ simple endorsement of the program and reminding a patient they are due to do the test can increase participation rates. 
 
‘Checking their screening status when someone consults is easy now with the integration of the National Cancer Screening Register in the medical record. 
 
‘The alternative access pathway now allows practices to provide the screening kit directly to patients, which is a great way to further increase participation.’ 
 
Under the alternative access pathway, healthcare providers can bulk order kits to give to eligible patients during consults.
 
The AIHW estimates there were 7265 new cases of bowel cancer diagnosed in people aged 50–74 (around 47% of all bowel cancer diagnoses) in 2024. Bowel cancer was the fourth most commonly diagnosed cancer in Australians of all ages after prostate cancer, breast cancer, and melanoma in 2023.
 
Noting the all-ages bowel cancer mortality rate is lower than that of the target age group due to it containing people aged younger than 50, deaths from bowel cancer are estimated at 1793 for people aged 50–74 in 2024, with it being the second leading cause of cancer death in Australians of all ages after lung cancer in 2023.
 
Since the NBCSP began in 2006, around 16,809 bowel cancers have been diagnosed from 12.8 million completed tests, with about 5.1 million people participating at least once.
 
As well as providing advice on the benefits of screening, Professor Emery says there are practical ways GPs and practices can encourage patients to use the NBCSP home kits.
 
‘GPs can help people plan to do the kit such as keeping the kit in the bathroom, setting a date to do the kit when they aren’t in a rush, and demonstrating how simple the kit is to do,’ he said. 
 
‘If the practice has not done it already, I recommend getting the National Cancer Screening Register integrated with their electronic medical record.
 
‘This will help flag patients who are not screened. It will also help them prepare for the National Lung Cancer Screening Program that starts next month.’
 
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bowel cancer cancer screening National Bowel Cancer Screening Program preventive health