The latest AIHW National Bowel Cancer Screening Program (NBCSP) Report (2019-2020) reveals participation rates continue to remain static at 43.8% (2018-19: 43.5%) and colonoscopy wait times for those who receive a positive screen continue to exceed the recommended 30 days.

According to the report, 5.76 million people aged 50-74 were invited to participate in the NBCSP in 2019-20 and 2.52 million tests were returned.
Of those who participated, 85,693 received a positive test result. 
A positive result means that blood was detected in the sample and requires further investigation via colonoscopy within 30 days.
But only 12,963 (15.1%) participants were recorded as receiving a follow-up colonoscopy within the recommended time frame.
Of those participants who received the procedure following a positive screen, the wait varied between 113 days (WA) and 190 days (Tas), depending on where they live.
Medical guidelines acknowledge that wait times exceeding 120 days between first healthcare presentation and diagnostic colonoscopy are associated with poorer clinical outcomes.
Today’s report reveals that despite some improvements, colonoscopy wait-times continue to exceed medical guidelines.
“Studies have found delays in colonoscopy completion longer than nine months following a positive test result are associated with a greater risk of bowel cancer and more advanced disease at the time of colonoscopy,” said Bowel Cancer Australia Medical Director, A/Prof Graham Newstead AM.
“Recently published research found the risk of dying from bowel cancer among people not completing a colonoscopy after a positive test result doubles compared to those who did,” he added.
The NBCSP Report follows a large US study of colonoscopy data among average-risk people under age 50 published in Gastroenterology.
The study found 5% of average-risk people aged 45-49 years (6.2%: 50-54 years) had bowel cancer and 28% (33%: 50-54 years) had precancerous polyps.
“These findings support starting bowel cancer screening at age 45 years,” A/Prof Newstead said.
“Lowering the screening start age can provide this younger age group with a level of protection not currently offered by the national screening program as they have a clinically comparable prevalence of polyps at higher risk of becoming bowel cancer to those aged 50-54 years,’ he added.
“Those diagnosed aged 50-54 could have had their bowel cancers detected earlier had the screening age been lowered to 45, as it typically takes 5 to 10 years for a polyp to become a cancer,” he said.
While all major US guidelines endorse average-risk bowel cancer screening from age 45, Australian guidelines continue to lag.
A 12-month review of screening ages in Australia has just commenced, despite being proven as cost-effective during the previous 2017 review.