Uptake of bowel cancer screening gradually improving

Since the introduction of the National Bowel Cancer Screening Program (NBCSP) in August 2006, it has been responsible for the detection of 17,378 bowel cancers in Australians.
 
As the program’s 20th anniversary approaches, it would appear to have made a significant impact, according to a monitoring report released on Thursday by the Australian Institute of Health and Welfare (AIHW).
 
The report reveals that, since 2006, bowel cancer mortality rates have fallen by almost half in people aged 50–74, with an estimated 23 deaths per 100,000 people in 2025, compared to 44 deaths per 100,000 people in 2006.
 
Associate Professor Joel Rhee, RACGP Specific Interests Cancer and Palliative Care Chair, said it is ‘encouraging’ to see this decline in mortality rates.
 
‘The drivers are not entirely clear, but likely include the screening program, increased awareness, and improvements in diagnosis and treatment,’ he told newsGP.
 
In other good news, the AIHW report shows that four out of five people who take part in the screening program return to it, with 83.5% of those 2.7 million people screened between January 2023 and December 2024 participating again when reinvited.
 
However, an enduringly stubborn issue remains overall participation. Over the same period, 6.4 million eligible people were invited to screen, with just 42% taking up the offer.
 
In its first year of operation, the NBCSP had 41% of 475,198 eligible people participate in the program, with an overall 7% of those testing positive.
 
Between January 2023 and December 2024, positive screening results had fallen to 5.8%, or one in 29 participants.
 
While rates of bowel cancer in people aged over 50 have stabilised or are declining, the incidence of early onset bowel cancer is increasing, with one in nine new cases now occurring in people aged under 50.
 
In July 2024, eligibility to access free screening kits was lowered from 50 to 45 years of age, with people aged 45–49 able to request a free kit.
 
The lowering of the age has proven potentially lifesaving. Of the 236,421 screening kits requested by people aged 45–49, 56.2% completed their test, and 4.7% returned positive results requiring further assessment. 
 
Despite the increase in early onset bowel cancer, Associate Professor Rhee says potentially lowering the eligibility age even further is a ‘complex question’.
 
‘There are clear benefits, but also potential harms, so any change should be guided by robust evidence,’ he said.
 
Mortality rates are also declining in younger people ‘including those aged below 45 years’, says Associate Professor Rhee.
 
‘As screening only recently expanded to include those aged 45, this suggests the reduction in mortality rate is not due to screening alone,’ he said.
 
He said the ‘more immediate issue’ was increasing participation in the NBCSP.
 
‘There is substantial room to improve engagement,’ he said.
 
‘GPs play a key role in recommending and normalising screening.’
 
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