Research partnership addressing bowel cancer screening and diagnosis inequalities
A research project underway at Surgical, Treatment and Rehabilitation Service (STARS) is identifying barriers and challenges associated for Aboriginal and/or Torres Strait Islander patients participating in bowel cancer screening and diagnosis.
A research partnership is hoping to address inequities in bowel cancer screening and diagnosis for Aboriginal and/or Torres Strait Islander people.
A research project underway at Surgical, Treatment and Rehabilitation Service (STARS) is identifying barriers and challenges associated for Aboriginal and/or Torres Strait Islander patients participating in bowel cancer screening and diagnosis.
Aboriginal and/or Torres Strait Islander people are less likely to participate in the colorectal cancer screening program and more likely to be diagnosed at later stages, leading to poorer outcomes and survival rates.
For lead researcher Dr Mark Appleyard, the focus of the research project was to better understand the inequities in bowel cancer screening and colonoscopy participation through a combination of data analysis and yarn-style interviews.
“We investigated the participation rates, experiences and challenges associated with the National Bowel Cancer Screen Program (NBSCP) and diagnostic colonoscopy among Indigenous clients within the IUIH network clinics and Metro North, including semi-structured interviews with eight Indigenous clients and 13 healthcare team members,” Dr Appleyard said.
Quantitative findings revealed a concerningly low uptake of the NBCSP, with only 16.3 per cent of eligible Indigenous clients participating over the past two years, behind the national average of 31 per cent for Indigenous and 41 per cent of non-Indigenous individuals.
Both patients and healthcare team members identified several barriers and challenges associated with participation in bowel cancer screening including:
- clinical nature of the procedure
- fear/anxiety about test results
- transportation/travel issues
- gender-specific concerns like men and women’s business
- perception that the screening was non-essential
- inadequate education
- challenges relating to life circumstances (homelessness/housing instability, limited phone access)
- feelings of embarrassment or shame
- lack of adequate information about Indigenous culture (healthcare team)
- previous experience of poor or discriminatory treatment by hospital staff.
Enablers to participation included the importance of education, encouragement, the presence of more Indigenous staff in hospitals, culturally appropriate information brochures and having a family history of bowel cancer.
“Findings highlight the complexity of factors contributing to the hesitancy or reluctance of NBSCP and diagnostic colonoscopy participation and the importance of culturally sensitive intervention, community engagement and logistical support in improving bowel cancer screening among Indigenous clients,” Dr Appleyard said.
“The study contributes valuable insights that can inform policy decisions and healthcare practices aimed at reducing health disparities in bowel screening among Indigenous communities.”
Results from the study informed the development of a culturally sensitive endoscopy pathway at the Surgical, Treatment and Rehabilitation Service (STARS), including dedicated pre-assessment clinics and men’s and women’s business endoscopy procedure lists.
The study was a partnership between Metro North, the University of Queensland, and the Institute of Urban Indigenous Health (IUIH) and received part funding from a Research Alliance for Urban Goori Health (RAUGH) Collaborative Seed Grant in 2022.