Trend data for the colonoscopy follow-up rate within 360 days are available for the years 2014 to 2017. Over this period the rate decreased from 73.1% to 66.1%. Similar trends were observed for both sexes, and in each group in the target age range.1
Changes in the reporting process for follow-up colonoscopies, as well as changes in diagnostic assessment pathway practices between years, may be factors contributing to this observed decrease.1 It should also be noted that this indicator relies on information being reported to the Program Register; however, this is not mandatory, leading to incomplete data.
Aboriginal and Torres Strait Islander peoples
From 2014 to 2017, the colonoscopy follow-up rate within 360 days decreased among Indigenous Australians from 58.5% to 51.0%. A similar decrease was observed for non-Indigenous Australians, for whom the rate decreased from 73.7% to 66.5%.1, 4-6
Remoteness and socioeconomic status (SES)
From 2014 to 2017, the colonoscopy follow-up rate within 360 days decreased across all socioeconomic status areas.1, 4-6 The largest decreases in colonoscopy follow-up rates were in SES 1 and 2.
From 2015 to 2017, the colonoscopy follow-up rate decreased across all remoteness areas, although slight improvements were observed in Remote and Very Remote areas compared to 2016.1, 6
Colorectal cancer control in Australia
Since the initial trial of national colorectal cancer screening through the pilot program and, subsequent implementation of the NBCSP, improvements have been observed in mortality and survival rates. The age-standardised colorectal cancer mortality rate has decreased from 24.7 deaths per 100,000 in 2002 to 18.7 per 100,000 in 2016 and the 5-year survival rate has increased from 62.9% in 2001–2005 to 69.9% in 2011–2015.1, 7 The AIHW has analysed outcomes for persons who, in the period 2006−2010, were: aged 50-74 years; and diagnosed with colorectal cancer. During this time, in Phases 1 and 2 of the NBSCP, invitations to screen were sent to persons turning 50, 55 or 65 years old. For persons who did not receive an invitation to screen, the risk of colorectal cancer death was 13% higher than for those that did receive an invitation to screen.8
The NCCI measures Capture of stage data and Distribution of cancer stage present national data for Registry-Derived stage (RD-Stage) at diagnosis for the top 5 cancers by incidence in 2011. These data show that people aged 50 years and over had a higher proportion of early stage colorectal cancers at diagnosis (stage 1 and stage 2) than those aged less than 50 years. RD-stage data collection in subsequent years will provide us with more detailed evidence regarding the impact of the NBSCP on early detection of colorectal cancer in the target age range.