New analysis shows most Australians at increased risk of bowel cancer are under-screened

People who are at an increased risk of developing bowel cancer, because they have a family history of the disease, are failing to have adequate screening, a University of Melbourne study has found.

Medical guidelines recommend that where the family history is strong enough, family members should be having more intensive screening than the usual faecal occult blood test that is recommended for everyone over the age of 50. They should be having a colonoscopy every two to five years.

A new study by researchers at The University of Melbourne and the CSIRO published in Cancer Prevention Research shows that the vast majority of people in Australia who should be having regular colonoscopy because of their family history, are not.

This study found that 71% of people in high risk families were not having any screening for bowel cancer, 24% were having some screening but not frequently enough and only 4% were having appropriate screening.

Researchers led by PhD student, Mr Driss Ait Ouakrim and Associate Professor Mark Jenkins, at the University’s School of Population Health, analysed data from a survey of 1,627 people who, because of their family history of bowel cancer, should be having a colonoscopy every two to five years. All those surveyed were participants of the Australasian Colorectal Cancer Family Study and were recruited as part of a population-based cancer family study.

"Those who were most likely to be having appropriate screening were 40-49 years old, had university or TAFE education and had lived in Australia for at least 20 years" said Mr Ait Ouakrim.

"Screening for bowel cancer is important," Mr Ait Ouakrim said. "Because it detects pre-cancerous polyps before they develop into cancer. Screening also reduces the risk of dying from bowel cancer by finding cancers at an earlier stage when they are more treatable."

Associate Professor Jenkins said the amount of screening among this high risk group was unexpectedly low.

"Our research highlights a real need for further studies to determine why screening is so low in this risk group and how this might be turned around," he said.

Australia has one of the highest rates of bowel cancer in the world. It is recommended by the National Health and Medical Research Committee and the College of General Practitioners that all Australians, whether they have a family history of bowel cancer or not, have a faecal occult blood test for bowel cancer every two years from age 50.

The Federal Government’s National Bowel Cancer Screening Program provides a free screening test for all Australians when they turn 50, 55 and 65 years of age. Approximately 20% of people have a family history of bowel cancer and about 3% have a family history significant enough that they are recommended to have regular colonoscopies. People who have a family history of bowel cancer should discuss it with their doctor so that appropriate screening can be organised.