title: Initial impact of Australia's National Bowel Cancer Screening Program.
abstract: OBJECTIVE
  To examine the initial impact of the National Bowel Cancer Screening Program (NBCSP), which was launched in May 2006 and offers faecal occult blood testing to Australians aged 55 or 65 years.
  
  
  METHODS
  Review of data on colorectal cancer (CRC) cases diagnosed between May 2006 and June 2008 from a prospective database used at 19 Australian hospitals, linked and analysed by BioGrid Australia.
  
  
  METHODS
  Number of CRC cases detected through the NBCSP or symptomatic presentation, and differences by sex, stage at diagnosis, tumour location and level of socioeconomic disadvantage.
  
  
  RESULTS
  1628 cases of CRC were identified; 1268 had information on the patients' test status as part of the NBCSP, and 40 of these (3.2%) were recorded as being detected by the NBCSP. Of 75 CRC cases in patients aged 55 or 65 at diagnosis, 22 were NBCSP-detected. Overall, there was no difference in NBCSP-detected cases by sex. The distribution of tumour locations was similar between NBCSP-detected cases and symptomatic cases, but NBCSP-detected cancers were diagnosed at an earlier stage than symptomatic cancers (stage I, 40% v 14%; stage IV, 3% v 15%, respectively). Of patients diagnosed through the NBCSP, 63% were from areas of least socioeconomic disadvantage (deciles 8-10) and 18% were from the most disadvantaged areas (deciles 1-4) (P=0.0375).
  
  
  CONCLUSIONS
  Initiation of the Australian NBCSP has had a measurable impact on CRC stage at diagnosis, and an improvement in survival would be anticipated. The lower uptake among people from disadvantaged areas is of concern.
authors.affiliation: Royal Melbourne Hospital, Melbourne, VIC, Australia. sumitra.ananda@mh.org.au
authors.forename: Sumitra S
authors.initials: SS
authors.lastname: Ananda
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: McLaughlin
authors.forename: Frank
authors.initials: F
authors.lastname: Chen
authors.forename: Ian P
authors.initials: IP
authors.lastname: Hayes
authors.forename: Andrew A
authors.initials: AA
authors.lastname: Hunter
authors.forename: Iain J
authors.initials: IJ
authors.lastname: Skinner
authors.forename: Malcolm C A
authors.initials: MC
authors.lastname: Steel
authors.forename: Ian T
authors.initials: IT
authors.lastname: Jones
authors.forename: Ian A
authors.initials: IA
authors.lastname: Hastie
authors.forename: Nicholas A
authors.initials: NA
authors.lastname: Rieger
authors.forename: Susan
authors.initials: S
authors.lastname: Shedda
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Compston
authors.forename: Peter
authors.initials: P
authors.lastname: Gibbs
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia / Q000453:epidemiology; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009780:Occult Blood; D012959:Socioeconomic Factors; D055815:Young Adult