Aboriginal and/or Torres Strait Islander people
Indigenous Australians had a lower estimated participation rate than non-Indigenous Australians. They also experienced a higher screening positivity rate but have a lower follow-up diagnostic assessment rate and a longer median time between a positive screen and an assessment. Indigenous Australians had higher age-standardised bowel cancer incidence rates and higher mortality rates compared with non-Indigenous Australians (Table 4.3).
Reasons for differences in screening outcomes between Indigenous and non-Indigenous Australians are not known; however, the fact that higher proportions of Indigenous Australians live in Remote and Very remote locations and in lower socioeconomic areas, where access to relevant services can be an issue, may be contributing factors.
Indicator | Summary of performance indicators for Indigenous Australians compared with non-Indigenous Australians | Indigenous | Non-Indigenous |
|---|---|---|---|
PI 1 - Participation rate(a) | Lower participation rate | 37.7% | 41.9% |
PI 2 - Screening positivity rate | Higher screening positivity rate | 8% | 6% |
PI 3 - Diagnostic assessment rate | Lower diagnostic assessment follow-up rate | 78% | 86% |
PI 4 - Time between positive screen and diagnostic assessment | Longer median time | 78 days | 62 days |
PI 9 - Adverse events –hospital admission | Comparison not published | n.p. | n.p. |
PI 10 - Incidence of bowel cancer(b)(c) | Higher age-standardised incidence rate | 122 per 100,000 | 110 per 100,000 |
PI 11 - Mortality from bowel cancer(c)(d) | Higher age-standardised mortality rate | 39 per 100,000 | 27 per 100,000 |
(a) Participation rates by Indigenous status were estimated using 2021 Census proportions (see Appendix C for more information).
(b) Includes only New South Wales, Victoria, Queensland, Western Australia, the Australian Capital Territory, and the Northern Territory.
(c) These rates were calculated using Indigenous populations based on the 2016 Census and should not be compared with rates calculated using populations based on previous Censuses. See Box 3.1 for more information.
(d) Includes only New South Wales, Queensland, Western Australia, South Australia and the Northern Territory.
Notes:
- 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 is reported for 2016–2020. Mortality 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.
- The incidence counts and rates for Indigenous and non-Indigenous Australians presented are underestimates due to the relatively large proportion of people whose Indigenous status is not stated. Also, it is likely that some Indigenous Australians are misclassified as non‑Indigenous Australians. Therefore, the estimates presented should be interpreted with caution.
- Bowel cancer incidence and mortality rates for Indigenous and non-Indigenous Australians are compared using age-standardised rates to account for the different age structures of these populations.
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.