With expertise in geographic and spatial analysis a key priority for VCS has been the reporting of screening data, in particular participation rates, by small geographical area. We leveraged our expertise and skills in this area to lead a project with the Victorian Department of Health and other screening program stakeholders to map breast, cervical and bowel screening participation by small geographic area in Victoria.
The challenges of participation and barriers to screening are faced by all screening programs and obtaining cross program data to better understand these issues can be difficult. Access to data from the three screening programs was required. To facilitate access to de-identified bowel screening data, ethics clearance was obtained and approval sought from the Department of Human Services for access to Medicare data.
The project has provided invaluable data to DHHS and enabled customisation of screening initiatives to drive improved participation. A key finding from the spatial mapping of bowel screening rates was the observation of an increasing trend of screening with age, with older age groups reporting a greater tendency to complete and return the FOBT kit. A gradient was also observed when examining participation by socioeconomic status, suggesting an association between socioeconomically disadvantaged areas of Victoria and lower participation. The proportion of participants in the bowel screening program who were of Aboriginal and Torres Strait Islander descent was 0.12%, much lower than the 0.36% of the population who identified as Aboriginal and Torres Strait Islander at the 2006 Census, suggesting a degree of under-participation among this group. Likewise, the proportion of the participants who spoke a language other than English at home in the bowel screening program was lower than expected compared to the same proportion in the general community using ABS population figures, at 6.7% compared to 20.6%. A major output of our geographical report of breast, cervical and bowel screening rates was the examination of areas of both high and low participation across screening programs.