Nursing Public Health: Bowel Cancer in Australia

Running head: NURSING PUBLIC HEALTH
Nursing public health
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1NURSING PUBLIC HEALTH
Describe the health issue
Bowel cancer or colorectal cancer has become one major public health issue in Australia
due to the high prevalence of incidence in Australia. Bowel cancer was the third most diagnosed
type of cancer in Australia in 2013 and it is estimated to become the second most commonly
diagnosed cancer in Australia. The rate at which incidence of bowel cancer is increasing is
understood from the fact that 6, 986 cases were reported in 1982 compared to 14, 962 cases in
2013 (Australian Institute Health and Welfare (AIHW) 2017). It is estimated that around 17, 000
new cases of colorectal cancer will be diagnosed in Australia in 2018. In 2014, bowel cancer was
the second leading cause of death contributing to about 4, 071 deaths in Australia. The age
standardized mortality rate in 2014 was 15 deaths per 100, 000 person and it is estimated that
deaths from colorectal cancer is expected to increase to 4, 129 cases by 2018 (Australian
Government| Cancer Australia 2018)).
Another issue for Australia is inequalities in bowel cancer incidence and mortality rate.
For all types of cancer, the age standardized incidence rate and mortality rate for all cancer is
higher for indigenous Australians compared to non-indigenous Australian (Young et al. 2015).
For indigenous Australians, the highest five year prevalence rate was found for colorectal cancer
in 2013. 612 new cases for colorectal cancer was diagnosed in indigenous Australian in 2009-
2013. The disparities in colorectal cancer incidence is also understood from the fact that
indigenous Australians diagnosed with colorectal cancer has 58% chances of survival compared
to 67% survival chance for non-indigenous Australians (AIHW 2018).
Influencing factors for a marginalized group

2NURSING PUBLIC HEALTH
There is different modifiable and inherited risk factor for the development of colorectal
cancer. Firstly, the risk increases with age and people above 50 years are more likely to be
suffering from bowel cancer. Secondly, smoking, alcohol consumption, obesity and physical
activity are some modifiable risk factor for developing bowel cancer. Increased prevalence of
smoking and alcohol consumption are the contributing factor for increases in new cases of bowel
cancer in indigenous Australians. Cigarette smoking is one of the common risk factor for
colorectal cancer and direct association between cigarette smoking and risk of bowel cancer has
been established in research (Wei, Lin and Chang 2011). Tobacco use is widespread among the
Aboriginal and Torres Strait Islander people. About 39% of indigenous people above 15 years
were daily smokers in 2015 and people living in remote areas were more likely to smoke
compared to those in non-remote areas (Greenhalgh, Bayly and Winstanley 2017). Hence, for
this reason, smoking is one of the influencing factors for increases risk of bowel cancer in
indigenous population.
Chronic alcohol use is also an important factor contributing to disparities. According to
2012-2013 Health Survey, indigenous Australians rate for single occasion risk guidelines was 1.1
times higher than non-indigenous groups (pmc.gov.au 2017). Ahmed, Shahid and Episkenew
(2015) gave evidence regarding increased risk of several cancers as well as colorectal cancer due
to chronic alcohol consumption. Poor socioeconomic condition of aboriginal people can also be
linked greater rate of alcohol consumption and risk of cancers. Experience of poverty,
discrimination and physical violence increases risk of alcohol use in the target population group
(Beckmann et al. 2015). Another reason for poor survival chances of indigenous Australians for
bowel cancer is the disparities observed in participation for bowel screening. Unequal
participation in bowel screening affects the rate of cancer incidence and mortality in indigenous

3NURSING PUBLIC HEALTH
Australians. Poor attendance in bowel screening reduces the likelihood of receiving treatment
and delayed diagnosis too. The cumulative effect of this entire factor is high likelihood of bowel
cancer diagnoses with poor survival rate. Due to presence of such risk factors, disparities have
been observed in incidence rate of colorectal cancer.
Health promotion campaign to address the health issue
The National Bowel Cancer Screening program is one health promotion campaign in
Australia that is working to reduce the prevalence of bowel cancer cases in Australia. It is a
population based screening program and the main aim and objective of the program is to
promote early detection of bowel cancer and reduce the rate of mortality due to bowel cancer in
Australia. The main features of the program is providing screening to people without any
obvious symptoms and detect cancer at an early stage so that it is easy to treat. The
immunochemical Faecal Occult Blood Test (FOBT) is the main test that is used in the program.
The test detects blood in faeces after taking a sample of faeces. The FOBT kit is sent to eligible
people by mail and the response is sent back to laboratory for analysis. Patients with positive test
need to visit clinician and follow-up services for discussion on treatment. A National Program
Register has been created that that collects data related to diagnosis and survival rate. It supports
at risk individual to get free screening every two years and increase their chances of survival
(cancerscreening.gov.au 2018).
Discuss how the program response to the special needs of marginalized group
The National Bowel Cancer Screening Program has been launched for reducing bowel
cancer incidence for Australian population. The program is expanding and targeting to cover all
Australians between 50 and 74 years of age by 2020. The program began in 2006 and till 2014,