Fewer than half of eligible Australians are screening for bowel cancer and those who receive a positive result are waiting months for diagnosis.
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Just 40.9 per cent of people who were sent the at-home test returned it for analysis in 2020 and 2021, according to the latest National Bowel Cancer Screening Program report.
Participation dropped to levels last seen in 2015-16 despite a federal government push since 2019 to raise awareness.
"From all our research over the years people still cite 'messy and embarrassing' as one of the main reasons why they are reluctant to do the test," Bowel Cancer Australia CEO Julien Wiggins said.
"There's also an age demographic of maybe people in their early 50s ... who don't necessarily see the test kit as being as of much benefit as some of the older population."
However, one in 10 new cases of bowel cancer now occur in people aged below 50 who aren't eligible for the national screening program, according to Bowel Cancer Australia.
The participation figures don't take into account those who do a colonoscopy each year with some people preferring an alternative to the screening program.
But for those currently doing neither, Mr Wiggins said screening "does have the potential to save your life".
Long wait times risks psychological harm
In 2021, six per cent of tests returned a positive result but wait times for a follow-up colonoscopy blew out in every state and territory.
COVID-19 exacerbated already lengthy wait times and strategies in place to clear the backlog are "taking time" to work.
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In Tasmania, some people were left waiting more than seven months to find out if their positive screening result was in fact bowel cancer.
Only 15.6 per cent of participants nationwide were as receiving a colonoscopy within the recommended 30-day timeframe.
Mr Wiggins said the opportunity for early detection was lost by delays in following up a positive screening result.
"Delayed treatment leads to poor outcomes and unnecessary deaths," he said.
"Long colonoscopy wait times directly impact on patients and can contribute to unnecessary stress, anxiety, not knowing if cancer is present."
Government urges Aussies to 'Get2It'
The federal government has announced a $10.8 million campaign in partnership with Cancer Council Australia to encourage eligible Aussies to "Get2It" and complete the test.
Bowel cancer is the second biggest cancer killer in Australia and increasing the screening rate to 60 per cent could save 84,000 lives by 2040.
Early data from Cancer Council Victoria has found major natural disasters affected participation rates including the 2019-20 Black Summer bushfires.
"We know cancer screening saves lives - and not screening costs us lives," Health Minister Mark Butler said.
"Please put the test somewhere like the bathroom as a reminder. Doing the test as soon as you get it could save your life."
The bowel cancer screening test is sent in the mail to Australians every two years from the age of 50 to 74.
The test looks for small amounts of blood in faeces that's invisible to the naked eye and may be caused by early stage bowel cancer.
Early detection can lead to successful treatment of bowel cancer in 90 per cent of cases.
For information visit bowelcanceraustralia.org/screening