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] |