Population characteristics related to colorectal cancer testing in New South Wales, Australia: Results from the 45 and Up Study cohort

Objective: To compare the characteristics of people who utilize colorectal cancer screening tests with those who do not. Setting: Self-reported questionnaire data from 15,900 women and 14,953 men aged 50 or over who had never had colorectal cancer were taken from the 45 and Up Study cohort in Australia in 2006. Methods: A cross-sectional analysis of colorectal cancer test behaviour within the last five years by faecal occult blood test (FOBT), or by any test (FOBT, sigmoidoscopy or colonoscopy) was performed. Results: A total of 36.2% of participants reported colorectal cancer testing and 17.9% reported having a FOBT. Both FOBT and any testing were reduced significantly in groups with the following attributes compared with the remaining population; ages 50-59 and 80+; female; no family history of colorectal cancer; lower education; lower income; not speaking English at home; lack of private health insurance; not being retired; not living with a partner and not having other screening tests. Compared with other participants, test uptake was particularly low among current smokers (relative risk 0.76, 95% CI 0.71-0.80), sedentary participants (0.71, 95% CI 0.66-0.77), those without fruit (0.77, 95% CI 0.71-0.84) or vegetables (0.79, 95% CI 0.69-0.90) in their daily diet and those with a disability (0.91, 95% CI 0.85-0.97). Compared with participants from major cities, outer regional area participants were significantly more likely to report a FOBT (1.31, 95% CI 1.23-1.39) however participants in remote areas were significantly less likely to have had any colorectal cancer test (0.75, 95% CI 0.67-0.85). Conclusion: Subgroups of the Australian population may require targeted intervention to ensure equity in colorectal cancer screening.