Population-based screening for colorectal cancer: Australian research and implementation.
Australia is one of the first countries in the world to implement an organized whole-of-population screening program for colorectal cancer (CRC). Australians have made broad contributions to CRC in general ranging from primary prevention through genetics, secondary prevention and treatment, to palliation. This overview focuses on some of the contributions of direct relevance to population-based screening, stretching from technology development to population-based controlled studies and health services research. In terms of simple screening tests in a two-step screening strategy, the evidence is overwhelming that fecal immunochemical tests for hemoglobin (FITs) improve detection and are more acceptable. FIT-based screening is clearly acceptable to Australians and it has been demonstrated that a national organized screening program is feasible. In terms of benefit for Australians, with full roll out and high uptake by the population we could see the number of cases dying from CRC halved by this strategy. To this will be added the extra-screening benefits of improved diagnosis, improved treatment and improved public awareness, all benefits of other screening programs. CRC screening has progressed from a matter of irrelevance and distaste, to commonwealth government policy in the context of an organized program for all Australians.
Flinders University Centre for Cancer Prevention and Control, Adelaide, South Australia, Australia. graeme.young@flinders.edu.au
Graeme P
GP
Young
D001315:Australia / Q000453:epidemiology; D023881:Colonography, Computed Tomographic; D015179:Colorectal Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control; D003362:Cost-Benefit Analysis; D055088:Early Detection of Cancer; D019317:Evidence-Based Medicine; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006801:Humans; D008403:Mass Screening / Q000191:economics / Q000379:methods; D009313:National Health Programs; D009780:Occult Blood; D018579:Patient Selection; D011159:Population Surveillance; D011237:Predictive Value of Tests; D016730:Program Development; D012812:Sigmoidoscopy