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Colorectal cancer screening and subsequent incidence of colorectal cancer: results from the 45 and Up Study

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With a mean of 43.8 new cases diagnosed per 100 000 individuals in 2008, Australia has one of the highest age-standardised colorectal cancer (CRC) incidence rates worldwide, accounting for 12.7% of total cancers and 10% of all cancer deaths nationally.1

Survival from CRC highly depends on stage at diagnosis, and clinical trials have demonstrated that screening using faecal occult blood testing (FOBT) increases the detection rate of early-stage disease and reduces CRC mortality.2 Further, the efficacy of endoscopic polypectomy in preventing adenomas from progressing to CRC has led to a decrease in the incidence of CRC in screening trials.3 As a result, population-based screening programs to reduce mortality from CRC have been implemented in many nations in recent years.46

In Australia, national guidelines for CRC screening were introduced in 1999, recommending asymptomatic persons aged 50 years and over be screened using FOBT at least every 2 years.7 However, CRC screening tests were not freely available until the National Bowel Cancer Screening Program (NBCSP) was launched in 2006 with a one-off faecal occult blood test mailed to all people turning 55 and 65, and, from 2008, additionally to people turning…