Equity in the NBCSP - Low socioeconomic areas
The NBCSP is monitored in relation to equity of access to relevant services for different population groups, including by geographical location, socioeconomic area, Indigenous status, preferred language spoken at home, and disability status. Routine monitoring of rates by various stratifications may reveal emerging trends for further investigation.
This chapter provides a summary of performance indicators for 5 population subgroups. Note that there is large overlap of the Indigenous population with 2 of the other population subgroups presented here, due to higher proportions of Indigenous Australian participants living in the lowest socioeconomic areas and in Very remote areas.
Low socioeconomic areas
This section compares performance indicator results between the highest and lowest socioeconomic areas only. However, as noted in ‘Performance of the screening program’, across all performance indicators, there is a general gradient of increasingly poorer outcomes across the five socioeconomic groupings as socioeconomic disadvantage increases.
Australians living in the lowest socioeconomic areas had a lower participation rate than those living in the highest socioeconomic areas. Further, those that screened in the lowest socioeconomic areas experienced a higher screening positivity rate than those living in the highest socioeconomic areas, yet had a lower follow‑up diagnostic assessment rate and a longer median time between a positive screen and an assessment.
Australians living in the lowest socioeconomic areas had higher age-standardised bowel cancer incidence and mortality rates than those living in the highest socioeconomic areas (Table 4.1).
Indicator | Summary of performance indicators for the lowest socioeconomic areas compared with the highest | Lowest socioeconomic | Highest socioeconomic |
|---|---|---|---|
PI 1 - Participation rate | Lower participation rate | 36.2% | 46.4% |
PI 2 - Screening positivity rate | Higher screening positivity rate | 7% | 5% |
PI 3 - Diagnostic assessment rate | Lower diagnostic assessment follow-up rate | 82% | 89% |
PI 4 - Time between positive screen and diagnostic assessment | Longer median time | 73 days | 51 days |
PI 9 - Adverse events –hospital admission | Comparison not published | n.p. | n.p. |
PI 10 - Incidence of bowel cancer | Higher age-standardised incidence rate | 126 per 100,000 | 96 per 100,000 |
PI 11 - Mortality from bowel cancer | Higher age-standardised mortality rate | 32 per 100,000 | 20 per 100,000 |
- The participation indicator PI 1 is reported against the period 2022–2023 with follow-up to June 2024. The screening indicator PI 2 is reported against the period 2023. The assessment indicators PIs 3 and 4 are reported against the period 2023 with follow-up to 31 December 2024. Incidence (PI 10) is reported for 2016–2020. Mortality (PI 11) is reported for 2018–2022.
- Indicators PI 3–9 rely on information being reported back to the NCSR (ACSQHC 2020). As this NBCSP form return is not mandated by the NBCSP, there may be incomplete form return and incomplete data. However, Participant follow-up function (PFUF) data are now used to supplement missing colonoscopy form data and MBS claims.
- PI 5a (adenoma detection rate), PI 5b (PPV of diagnostic assessment for detecting adenoma), PI 6a (bowel cancer detection rate), PI 6b (PPV of diagnostic assessment for detecting bowel cancer), PI 7 (interval cancer rate), and PI 8 (cancer clinico-pathological stage distribution) are not reported due to data incompleteness or unavailability.
Sources: AIHW ACD 2020; AIHW NMD; AIHW analysis of NCSR as at 31 December 2024 (NCSR RDE 13/01/2025).
References
ACSQHC (Australian Commission on Safety and Quality in Health Care) (2020) Colonoscopy Clinical Care Standard, Australian Commission on Safety and Quality in Health Care, Sydney, accessed 14 May 2025.