Screening

PI 2 – Screening positivity rate

PI2 Definition

The percentage of people who returned a valid NBCSP screening test and received a positive screening result (warranting further assessment) between 1 January 2024 and 31 December 2024.

Rationale: The positive screening test rate determines the diagnostic assessment workload and lesion detection rate. It is important that the accepted positivity range is reviewed and revised (to improve lesion detection rates while limiting ‘false’ positive results) if necessary. Monitoring this is important for program planning and quality assurance. Further, monitoring the positivity rate by various stratifications may reveal emerging positive or negative trends that need to be investigated, and rectified.

Data quality: All valid iFOBT results are recorded in the NCSR.

Guide to interpretation: This indicator counts all tests analysed in the defined period, not tests analysed from those invited in the defined period; therefore, the cohort monitored is different from the cohort monitored in the participation indicator.

Those aged 45–49 can now request a screening kit; however, this age group is not reported in this performance indicator.

National screening positivity rate, 2024: 5.8%.

The following apply to the 1,274,203 invitees who had a screening test analysed in 2024:

Australia-wide: A total of 73,745 people received a positive screening test result, giving an overall Australia-wide screening positivity rate of 5.8% (Table A3.6).

Sex: Male participants had a higher screening positivity rate than females (7% compared with 5%, respectively), across all age groups (Figure 3.6).

Age: The screening positivity rate increased with each age group, from 5% for people aged 50–64 to 7% for those aged 70–74 (Figure 3.6).

Screening round: The screening positivity rate was highest for people during their first round of screening (7% compared with 6% for those whose subsequent screen was more than 2 years after their first screen) (Figure 3.7). Those who screened at their next biennial invitation had the lowest screening positivity (5%).

Figure 3.6: Screening positivity rate of people aged 50-74, by sex and age, Australia, 2024

This figure comprises a vertical bar chart showing the screening positivity rate for males and females by age group. The chart shows that the screening positivity rate was higher for males than females and increased with each age group. The lowest positivity was for females aged 55–59 (4.4%) and the highest for males aged 70–74 (8.5%).

Source: Table A3.6.

Figure 3.7: Screening positivity rate of people aged 50-74, by screening round, Australia, 2024

This figure comprises a vertical bar chart showing the screening positivity rate by screening round. The chart shows that the screening positivity rate was highest for people receiving their first round of screening (7%, compared with 6.2% for those completing a subsequent screening round after more than 2 years, and 4.9% for those completing their next biennial screen).

Source: Table A3.7.

State or territory: The screening positivity rate was 6% in all jurisdictions except the Australian Capital Territory (5%) and the Northern Territory (7%) (Figure 3.8).

Figure 3.8: Screening positivity rate of people aged 50-74, by state or territory, Australia, 2024

This vertical bar chart depicts the screening positivity rate by state or territory. It shows that the screening positivity rate was highest for people living in the Northern Territory (6.7%) and lowest for people living in the Australian Capital Territory (4.9%).

Source: Table A3.8.

Remoteness area: The screening positivity rate was highest for people living in Very remote areas (8%) and lowest for those living in Major cities (6%) (Figure 3.9a).

Socioeconomic area: The screening positivity rate was highest for people living in the lowest socioeconomic areas (7%) and lowest for those living in the highest socioeconomic areas (5%) (Figure 3.9b).

Figure 3.9a: Screening positivity rate of people aged 50-74, by remoteness area, Australia, 2024

The figure shows that the screening positivity rate was highest for people living in Very remote areas (8.2%) and lowest for people living in Major cities (5.6%).

Source: Table A3.8.

Figure 3.9b: Screening positivity rate of people aged 50-74, by socioeconomic area, Australia, 2024

The figure shows that the screening positivity rate was highest for people living in the lowest socioeconomic areas (6.9%) and the lowest positivity rate for people living in the highest socioeconomic areas (4.7%).

Source: Table A3.8.

Indigenous status: Indigenous Australians had a higher screening positivity rate than non-Indigenous Australians (8% compared with 6%, respectively) (Table A3.9).

Preferred language spoken at home: Those who preferred to speak a language other than English at home had the same screening positivity rate as those who spoke English at home (6% for both) (Table A3.9).

Disability status: Those reporting severe or profound activity limitation had a higher screening positivity rate than those not reporting such limitation (11% compared with 6%, respectively) (Table A3.9). Reasons for this difference are not well understood but may include a lower level of physical activity (Wolin et al. 2011) or comorbidities and medications that increase the likelihood of a positive iFOBT screening result in people with severe or profound activity limitation. Note that from 2025 the simplified participant details form mailed with the bowel screening kit no longer asks for self-reported disability status. This disaggregation will be phased out in future reports in favour of future data linkage projects collecting disability status.


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