title: Colorectal cancer screening in rural and remote areas: analysis of the National Bowel Cancer Screening Program data for South Australia.
abstract: BACKGROUND
  In Australia, colorectal cancer is the second most commonly diagnosed cancer and cause of death from malignant diseases, and its incidence is rising. The aim of this article was to present an analysis of National Bowel Cancer Screening Program (NBCSP) data for rural and remote South Australia (SA), in order to identify geographical areas and population groups that may benefit from targeted approaches to increase participation rates in colorectal cancer screening.
  
  
  METHODS
  De-identified data from the NBCSP (February 2007 to July 2008) were provided by Medicare Australia. Mapping and analysis of the NBCSP data was performed using ESRI ArcGIS (http://www.esri.com/software/arcgis/index.html) and MapInfo (http://slp.pbinsight.com/info/mipro-sem-au). Data were aggregated to postcode and Accessibility/Remoteness Index of Australia (ARIA) and participation was then mapped according to overall participation rates, sex, age, Indigenous status and Socio-Economic Indexes for Areas (SEIFA)-Index of Relative Socio-Economic Disadvantage (IRSD). The participants were South Australians who turned 55 and 65 years between 2007 and 2008 who returned the completed NBCSP test sent to them by Medicare Australia.
  
  
  RESULTS
  The overall participation rate was 46.1% in rural and remote SA, although this was statistically significantly different (p<.001) according to sex (46.7% for males and 53.3% for females), age (45.2% for those 55 years, and 52% for those 65 years), socio-economic status (from 43% in 'most deprived' quintile to 50% in 'most affluent' quintile) and remoteness (45.6% for metropolitan, 46% for remote and 48.6% for rural areas). Indigenous participation was 0.5%.
  
  
  CONCLUSIONS
  The findings of this study suggest lower NBCSP participation rates for people from metropolitan and remote areas, compared with those from rural areas. The uptake of cancer screening is lower for older rural and remote residents, men, Indigenous people, lower socioeconomic groups and those living in the Far North subdivision of SA.
authors.affiliation: Discipline of Public Health, Flinders University, Adelaide, South Australia, Australia. Angelita.martini@flinders.edu.au
authors.forename: Angelita
authors.initials: A
authors.lastname: Martini
authors.forename: Sara
authors.initials: S
authors.lastname: Javanparast
authors.forename: Paul R
authors.initials: PR
authors.lastname: Ward
authors.forename: Genevieve
authors.initials: G
authors.lastname: Baratiny
authors.forename: Tiffany
authors.initials: T
authors.lastname: Gill
authors.forename: Stephen
authors.initials: S
authors.lastname: Cole
authors.forename: George
authors.initials: G
authors.lastname: Tsourtos
authors.forename: Paul
authors.initials: P
authors.lastname: Aylward
authors.forename: Moyez
authors.initials: M
authors.lastname: Jiwa
authors.forename: Gary
authors.initials: G
authors.lastname: Misan
authors.forename: Carlene
authors.initials: C
authors.lastname: Wilson
authors.forename: Graeme P
authors.initials: GP
authors.lastname: Young
mesh_terms: D000368:Aged; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D005243:Feces / Q000737:chemistry; D005260:Female; D005843:Geography; D054625:Healthcare Disparities; D006801:Humans; D016015:Logistic Models; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D009313:National Health Programs / Q000706:statistics & numerical data*; D019035:Rural Health Services / Q000706:statistics & numerical data*; D017678:Sex Distribution; D013021:South Australia