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Table 2 Differences between CRC and CRC screening programs in selected industrialised countries with disadvantaged Indigenous populations

From: Australia's National Bowel Cancer Screening Program: does it work for Indigenous Australians?

Country Organised Screening Program CRC Incidence CRC Mortality Screening recommendations/characteristics Participation by Indigenous groups
   (per 100 000) (per 100 000)   
   Indigenous vs non-Indigenous population Indigenous vs non-Indigenous population   
Australia Yes 36.6 vs 52.4 [13] for females** 17.9 vs 19.8^^[115] Free once-off iFOBT For those aged 50, 55 & 65 yrs 17% compared to 39% in non-Indigenous [115, 10]
     Kit posted to all in these age groups  
   39.9 vs 76.4 [13] for males**   Currently only a once-off test  
New Zealand No 15.5 vs 24.1*[116] 8.8 vs 9.8*[116] No program in place yet No data available
   Once diagnosed with CRC, Maori are two thirds more likely to die Relative risk of mortality in Maori is 1.24 after adjusting for age, sex and stage [6] Opportunistic screening only  
   Mortality: Incidence ratio:    
57% Maori vs 41% in non-Maori      
Canada Yes 37.2 vs 34.8 for femalesc 16.1 vs 18.4 [118]b FOBT (guaiac) every 2 years 30% adherence in general population but no specific data on Indigenous participation [94]
  (in certain provinces only ie. Ontario and Alberta) 55.1 vs 67 for malesc [117]   For those aged 50-74 yrs.  
     Kit obtained free from health care provider.  
     Information sheet available in Inuit language.  
USA No 33.9 (AI/AN ranged from 17.1-106.2) vs 53.2 (non Hispanic whites) [119, 120]^ 17.9 (AI/AN) vs 21.0 (USA all races)a [121] Recommendation by professional organisation for either; Any CRC screening in last 2 years:
  (Recommendations in place but no organised or national program. Primarily opportunistic and some state programmes exist)   Mortality rate ratio: 1.15 vs 0.89 (10)a Annual FOBT or 38.1% AI/AN vs 58.5% non-Hispanic white [122]
     5 yearly flexible sigmoidoscopy or FOBT: 5.8% (AI/AN) vs 12.6% (white) [120]
     combination of the above two, or Sigmoidoscopy or colonoscopy:
     10 yearly colonoscopy 31.7 (AI/AN) vs 45.8 (white) [120]
     For everyone over 50 yrs [48] Endoscopy or FOBT: 34.4 vs 49.5 [120]
  1. All figures are per 100 000 and are age-standardised
  2. Abbreviations
  3. AI/AN- American Indian/Alaska Native
  4. iFOBT- immunochemical FOBT
  5. gFOBT- guiac FOBT
  6. ^ 1999-2004 Included only those that attended Indian Health Services and limited to Contract Health Service Delivery Area Counties. Standardised to 2000 USA population
  7. ^^ Age standardized mortality rate from 2002-2006 Queensland, Western Australia, South Australia and Northern Territory combined
  8. ** Age standardized incidence rate 2000-2004. Data for NSW, Vic., Qld, WA, SA and NT combined
  9. * 1996-2001 Standardised to Maori population
  10. a Rate adjusted to the 2000 USA standard population
  11. b Age standardized to the 1991 Canadian Population. Mortality rates are from 2000 for First Nations and 2001 for Canada. First Nation rates are for on reserve but include the off reserve population for British Columbia and Alberta
  12. cAge standardized to the 1991 Canadian population. Rates are from 1997-2001
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BMC Public Health

ISSN: 1471-2458

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