The Bowel Cancer Screening Alliance is undertaking research on the barriers and facilitators to NBCSP participation amongst Culturally and Linguistically Diverse (CALD) Australian populations. 

The Australian Institute for Health and Welfare (AIHW) has estimated the participation rate of people who speak Language Other Than English (LOTE) at home, using census data and comparing these with Participant Detail Forms, reporting a lower participation rate (25.1–32.1%) for LOTE compared with English speakers (42.8–45.6%) . These statistics suggest that a substantial proportion of eligible people are likely missing-out on bowel cancer screening through the free Australian program, and this may be due to various and intersecting barriers.

In 2021, 6,649,200 people resided in Victoria and 41% of Victorian residents had both parents born overseas and 35% were, themselves, born overseas.

A large body of research has confirmed the critical importance of the GP (or Primary Care Practitioner) in the successful roll-out of the bowel cancer screening program, regardless of culture and language status. As part of the NBCSP’s Alternative Access Model, GPs can now bulk order kits to issue to eligible patients during an appointment.

A greater use of GPs at the time of first screening offer (i.e. age 50 years) is likely to increase participation rate for the CALD community. But more research is needed to understand how to implement this strategy.

Research projects

Chinese AAM project

This research project aims to determine the acceptability and feasibility of the NBCSP’s Alternative Access Model (AAM) among the Mandarin-speaking Chinese community and primary healthcare providers who provide health services to Mandarin-speaking Chinese people.

Through co-design with both groups, we aim to understand barriers to, and facilitators of, the use of the AAM with the ultimate goal of identifying appropriate strategies for implementation of the model that will optimize participation and sustainability. By gaining a deeper understanding of the challenges and perspectives unique to the Mandarin-speaking Chinese community in Australia, this research will provide guidance for the use of the AAM that should lead to increased participation in the NBCSP.

Offspring project

The decision-making process surrounding participation in bowel cancer screening is a critical aspect of public health, with early detection being paramount for successful treatment outcomes. This project focuses on examining the influence of adult children on their parents’ decisions regarding bowel cancer screening participation across various cultural groups. Understanding the role of filial values, familial dynamics, and cultural norms in shaping these decisions is essential for developing targeted interventions to increase screening uptake among diverse populations. By exploring the interplay between familial relationships, communication patterns, and socio-cultural beliefs, this study aims to provide valuable insights into enhancing participation rates in bowel cancer screening programs.

BCSA is also supporting foundational research, in particular University of Melbourne PhD student Bing Yi Han’s research on Understanding Health Decision-making in Collectivistic Families, supervised by Professor Shanton Chang. This research will assist in identifying potential interventions for trials. 

Investigators and researchers

Prof Carlene Wilson3, Dr Joyce Jiang3, Dr Lanxi Huang3, Prof Jenny McIntosh123, Prof Shanton Chang3, Dana McKay4, Jennifer Huang3

Affiliated organisations

  1. Centre for Cancer Research, University of Melbourne, Australia
  2. Department of General Practice and Primary Care, University of Melbourne, Australia
  3. Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Australia.
  4. Royal Melbourne Institute of Technology, Australia
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