Please use this identifier to cite or link to this item:
https://hdl.handle.net/2440/137877
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Type: | Journal article |
Title: | The ‘hot zone policy’ for colorectal cancer screening presents unique risks and opportunities for rural Australia |
Author: | Worthington, J. Lew, J.B. He, E. Broun, K. D'Onise, K. Grogan, P. Canfell, K. Feletto, E. |
Citation: | Australian Journal of Rural Health, 2023; 31(3):580-586 |
Publisher: | Wiley |
Issue Date: | 2023 |
ISSN: | 1038-5282 1440-1584 |
Statement of Responsibility: | Joachim Worthington, Jie-Bin Lew, Emily He, Kate Broun, Katina D'Onise, Paul Grogan, Karen Canfell, Eleonora Feletto |
Abstract: | Objective: Colorectal cancer has geographic inequities in Australia, with higher mortality rates and lower participation in the National Bowel Cancer Screening Program (NBCSP) in remote and rural areas. The at-home kit is temperaturesensitive, necessitating a ‘hot zone policy’ (HZP); kits are not sent when an area's average monthly temperature is above 30°C. Australians in HZP areas are susceptible to potential screening disruptions but may benefit from well-timed interventions to improve participation. This study describes the demographics of HZP areas and estimates the impacts of potential screening changes. Methods: The number of individuals in HZP areas was estimated, as well as correlations with remoteness, socio-economic and Indigenous status. The potential impacts of screening changes were estimated. Results: Over a million eligible Australians live in HZP areas, which are more likely to be remote/rural, have lower socio-economic status and higher Indigenous populations. Predictive modelling estimates that any 3-month screening disruption would increase CRC mortality rates up to 4.1 times more in HZP areas vs unaffected areas, while targeted intervention could decrease mortality rates 3.4 times more in HZP areas. Conclusion: People living in affected areas would be negatively impacted by any NBCSP disruption, compounding existing inequities. However, well-timed health promotion could have a stronger impact. |
Keywords: | models of rural service delivery oncology policy public health remote health delivery |
Rights: | © 2023 The Authors. Australian Journal of Rural Health published by John Wiley & Sons Australia, Ltd on behalf of National Rural Health Alliance Ltd. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. |
DOI: | 10.1111/ajr.12977 |
Grant ID: | http://purl.org/au-research/grants/nhmrc/1194784 http://purl.org/au-research/grants/nhmrc/2014964 http://purl.org/au-research/grants/nhmrc/1194679 http://purl.org/au-research/grants/nhmrc/1135172 |
Published version: | http://dx.doi.org/10.1111/ajr.12977 |
Appears in Collections: | Public Health publications |
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hdl_137877.pdf | Published version | 535.51 kB | Adobe PDF | View/Open |
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