Review of the National Bowel Cancer Screening Program and development of a new National Bowel Cancer Screening Program Policy Framework

The aim of this project is to review the national bowel cancer screening program (NBCSP) for the purpose of informing a new policy framework and identifying potential program modifications or improvements. This project will review Phase Four of the NBCSP and provide a policy framework for the future of the program.

Project Background

The BEST Centre joined with Deloitte Access Economics to assist in a review of the National Bowel Cancer Screening Program (NBCSP). Bowel cancer is one of the leading causes of cancer death in Australia, yet if detected in its early stages has a 90% cure rate (Australian Institute of Health and Welfare, 2019). The NBCSP is an Australian Government initiative to address the incidence and mortality of bowel cancer in Australian through the implementation of a population-based cancer screening program.

The NBCSP invites eligible Australian men and women aged between 50 and 74 to screen for bowel cancer every two years using a free test at home. Yet, current overall participation rates in the program are around 44%: women’s participation is higher than men’s (46% compared to 42% in 2018-2019 period) (Australian Institute of Health Welfare, 2020).

The NBCSP was implemented in Australia in a phased approach in 2006, undergoing several evolutions. The current phase of the program, Phase Four, included full expansion of the program to biennial screening by 2020 and piloting an alternative pathway for Aboriginal and Torres Strait Islander participants. The review of Phase Four contributes to the development of policy framework that will guide delivery of the program going forward, seeking to optimise program outcomes.

Why is this important?

A robust review of Phase Four of the NBCSP is important as the program has undergone several changes since the previous Phase Two review. The Phase Four review will inform the future Policy Framework to improve outcomes for eligible Australians including those at risk of bowel cancer and maximise participation. It is important to conduct periodic robust evidence-based evaluations of the NBCSP to identify emerging motivators and barriers to uptake along with program efficiencies and inefficiencies. Review findings will guide development of future program policy which can further increase program uptake and thus reduce deaths by bowel cancer in Australians.

What are we doing?

QUT’s BEST team’s role in the project was to incorporate behavioural economics and social marketing frameworks into research methods to better understand key drivers for participation and non-participation. This was achieved through designing a survey questionnaire to elicit attitudes, beliefs and service delivery preferences from participants and non-participants of the NBCSP. The consumer questionnaire was an important complement to a range of other primary and secondary data collection activities undertaken by Deloitte Access Economics as part of the review.

As part of the survey design process, the BEST team first conducted a literature review of existing academic and grey literature on bowel cancer screening to identify psychological, cultural, and contextual influences to screening behaviours. Appropriate theoretical frameworks from behavioural economics and services marketing were then selected and implemented within the design of a survey questionnaire. The survey design aimed to understand NBCSP participant and non-participant motivations, barriers, attitudes and behaviours.

The BEST team provided advice to Deloitte on approaches for analysis and interpretation of survey data including the development of bowel cancer screening consumer personas. Insights elicited from analysis will inform a new policy framework to maximise participation in future program delivery.

What have we found out?

The research findings were released in May 2022. Please view the final report HERE. In 2022, the Commonwealth government invited comments on the report from participants and stakeholders, as well as interested members of the public to inform the program’s future direction. The invitation to comment can be viewed HERE.

For more information about this project, please email: rebekah.bennett@qut.edu.au