Bowel Cancer Screening Participation in Rural Tasmania: A Comparative Case Study of Four Local Government Areas

Background: Bowel cancer is a preventable condition, yet it is the second most common cancer after prostate cancer, with one in 12 Australians developing the disease by age 85. If detected early, the chances of survival are very high. One way to detect bowel cancer before it becomes a problem is through the use of a screening kit. The Australian government has distributed free kits to specific age groups since 2006, through their National Bowel Cancer Screening Program (NBCSP). Participation in the NBCSP is currently quite low (39% Australia-wide). In Tasmania, participation rates among local government areas (LGAs) range from 28% to 47%. These differences in participation are especially apparent in rural and remote areas and form the focus of this research. Aim: Our research aims to determine why there are marked differences in National Bowel Cancer Screening Program participation rates between rural LGAs in Tasmania. Secondary aims include developing future strategies for increased screening uptake in rural Tasmania. Method: A total of four LGAs, identified as having either high (n=2) or low (n=2) NBCSP participation rates, were included in the study. Face to face interviews with community members and stakeholders across the four LGAs were recorded and transcribed to obtain qualitative data. A total of 50 male and female community members aged 50-75 were recruited and interviewed regardless of whether they had used the NBCSP kit. A total of 28 health professionals including doctors, pharmacists, nurses and health promotion officers, working in each of the four LGAs were also interviewed. All interviews were recorded and transcribed. Thematic analysis was conducted to elucidate common barriers and enablers for screening, as well as suggestions for increasing NBCSP participation rates in Tasmania. Demographic data including age, gender, and educational attainment were collected from community members to further identify potential associations with screening participation. Results: All interviews have been successfully completed and transcribed, and thematic analysis has begun. Themes emerging from the data to date include the importance of community connectedness; the role of women in encouraging men to screen; health literacy; new/transient versus established/stable communities; and access to follow-up colonoscopies. Final results will be available shortly and presented in full. Conclusion: The findings from this study will highlight differences and reasons for screening participation in four rural Tasmanian LGAs. The results will have implications for the NBCSP in terms of recommendations for increasing participation in the program.