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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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