title: Colorectal cancer screening in Australia: a community-level perspective.
abstract: OBJECTIVE
  To determine current colorectal cancer (CRC) screening rates and the level of adherence to screening guidelines @a community level.
  
  
  METHODS
  A cross-sectional cohort of at-risk people aged 56-88 years randomly selected from the Hunter Community Study (HCS), Australia.
  
  
  METHODS
  Proportion ever reporting undertaking any CRC testing; current screening rates for each CRC screening modality; level of screening in accordance with national screening guidelines.
  
  
  RESULTS
  Of the 1117 participants (70%) who returned a questionnaire, 777 were deemed asymptomatic and eligible for analysis. Overall, 63% of respondents had ever received any CRC testing. Forty-three per cent had ever had a faecal occult blood test (20% screened in the previous 2 years); 30% had ever had a colonoscopy (16% screened in the previous 5 years); and 7% had ever had a sigmoidoscopy (1% screened in the previous 5 years). Rates of adherence to screening guidelines were 21% for respondents who were @or slightly above average risk, and 45% for respondents who were @moderately increased or potentially high risk.
  
  
  CONCLUSIONS
  Rates of CRC screening remain low. The screening rate for colonoscopy was particularly high among people who were @or slightly above average risk, despite such screening not being endorsed in the guidelines. Effective strategies to improve rates of CRC screening and appropriate use of colonoscopy are required across the entire at-risk population.
authors.affiliation: School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia. ryan.courtney@newcastle.edu.au
authors.forename: Ryan J
authors.initials: RJ
authors.lastname: Courtney
authors.forename: Christine L
authors.initials: CL
authors.lastname: Paul
authors.forename: Robert W
authors.initials: RW
authors.lastname: Sanson-Fisher
authors.forename: Finlay A
authors.initials: FA
authors.lastname: Macrae
authors.forename: Mariko L
authors.initials: ML
authors.lastname: Carey
authors.forename: John R
authors.initials: JR
authors.lastname: Attia
authors.forename: Mark A
authors.initials: MA
authors.lastname: McEvoy
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D003113:Colonoscopy / Q000706:statistics & numerical data; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D003430:Cross-Sectional Studies; D055088:Early Detection of Cancer / Q000706:statistics & numerical data*; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009780:Occult Blood; D017410:Practice Guidelines as Topic; D012306:Risk; D011795:Surveys and Questionnaires