Information for Health Workers – Bowel screening and Aboriginal and Torres Strait Islander People

An information sheet for Aboriginal and Torres Strait Islander Health Workers and nurses to assist with encouraging Aboriginal and Torres Strait Islander people to screen through the National Bowel Cancer Screening Program

Page last updated: 23 September 2017 (this page is generated automatically and reflects updates to other content within the website)

PDF version: Information for Health Workers– Bowel screening and Aboriginal and Torres Strait Islander People (PDF 426 KB)

Why is bowel screening important?

Bowel cancer is common among Aboriginal and Torres Strait Islander people. If found early, up to 90% of cases can be treated successfully.

Often bowel cancer has no obvious symptoms. Bowel screening can detect changes to the bowel long before a patient notices any problems.

Aboriginal and Torres Strait Islander people have low participation rates in bowel screening and are more likely to have late stage cancer by the time they are diagnosed – when the cancer is much more difficult to treat successfully.

The National Bowel Cancer Screening Program (NBCSP)

The National Bowel Cancer Screening Program (NBCSP) provides a free bowel screening test for eligible people aged between 50 and 74.

Clinical guidelines recommend faecal occult blood testing (FOBT) every two years for most people over 50.1

The NBCSP mails free immunochemical FOBT kits to eligible people to complete in their own home.

A 2014 study found that NBCSP invitees for 2006 - 2008 had 15% less risk of dying from bowel cancer than non-invitees, and cancer stage at diagnosis was on average less advanced.2

This test can save lives, so spread the word

Patients are more likely to complete a bowel screening test if it is recommended by a trusted health professional.

Menzies School of Health Research carried out extensive consultations about bowel screening with Aboriginal and Torres Strait Islander people, and found many would like their GP or health worker to raise the issue with them.3

What you can do

  • Alert patients that they will receive a bowel screening kit in the mail when they turn 50.
  • For patients aged 50 to 74 years:
    • Ask them if they have received a kit before, if not call the Program Info Line to check their details are correct on the Program Register.
    • Check when they are due to receive a kit at cancerscreening.gov.au/eligibility.
    • Encourage them to do the test when they get it in the mail – explain why it’s important and what they need to do. Provide a copy of the ‘How to do the bowel screening test’ instructions.
    • Encourage them to call the Program Info Line to check their eligibility for a free kit, if they are eligible a kit will sent to their home.
    • Order some demonstration kits for your clinic by emailing NBCSP@health.gov.au.
    • Display posters and brochures to encourage people to screen. See what’s available at indigenousbowelscreening.com.au.

Cultural concerns

Some patients may be embarrassed talking about taking a faecal sample. Some may prefer to talk about bowel screening with a non-Indigenous doctor or nurse, because of the sensitivity of the subject. Others may want to talk with an Aboriginal or Torres Strait Islander health professional. As with other sensitive matters, men may wish to talk to a male health professional and women may prefer to talk to a female health professional.

Talk with your co-workers and health centre management about the best way to organise and talk about bowel screening with your Aboriginal and Torres Strait Islander patients.

Finding the right words

Some messages that have tested well for talking about bowel screening with Aboriginal and Torres Strait Islander patients include;
  • Are you ok talking to me about bowel screening? Would you prefer to talk to a GP/nurse/male or female health professional?
  • Bowel cancer can develop without any symptoms. But if found early, it can usually be treated successfully.
  • There is a simple test to help find bowel changes early. The test can find tiny amounts of blood in your poo, long before you would notice any changes.
  • If blood is found, it doesn’t necessarily mean you have cancer. There can be other reasons why you might have blood in your poo and we would need to find out why.
  • Some people think doing a bowel screening test is shameful or embarrassing. The real shame is if you don’t do the test and then later, you’re not around for your family.
  • I’ve done the test myself.
  • Don’t delay, do a bowel test today.
  • It’s not shame, it’s a part of life.

More Information

For information about the NBCSP go to: www.cancerscreening.gov.au/bowel
Resources for encouraging bowel screening for Aboriginal and Torres Strait Islander patients can be found at: www.indigenousbowelscreen.com.au
For information on the Program call the Program Info Line: 1800 118 868
Free call (calls from mobiles may be charged)

Original artwork by Jordan Lovegrove.

References

  1. Guidelines for the Prevention, Early Detection and Management of Colorectal Cancer. Cancer Council Australia and Cancer Network, Sydney 2005.
  2. Australian Institute of Health and Welfare 2014. Analysis of bowel cancer outcomes for the NBCSP. Cat.no. CAN 87. Canberra: AIHW.
  3. Menzies School of Health Research, 2016. Report to the Australian Government Department of Health, unpublished.

Like to know more?

Visit the online learning module at: Indigenousbowelscreening.com.au